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Stein C, O'Keeffe F, McManus C, Tubridy N, Gaughan M, McGuigan C, Bramham J. Premorbid cognitive functioning influences differences between self-reported cognitive difficulties and cognitive assessment in multiple sclerosis. J Neuropsychol 2024; 18:47-65. [PMID: 37212461 DOI: 10.1111/jnp.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
Cognitive difficulties are reported in up to 60% of people with MS (pwMS). There is often a discrepancy between self-reported cognitive difficulties and performance on cognitive assessments. Some of this discrepancy can be explained by depression and fatigue. Pre-MS cognitive abilities may be another important variable in explaining differences between self-reported and assessed cognitive abilities. PwMS with high estimated premorbid cognitive functioning (ePCF) may notice cognitive difficulties in daily life whilst performing within the average range on cognitive assessments. We hypothesised that, taking into account depression and fatigue, ePCF would predict (1) differences between self-reported and assessed cognitive abilities and (2) performance on cognitive assessments. We explored whether ePCF predicted (3) self-reported cognitive difficulties. Eighty-seven pwMS completed the Test of Premorbid Functioning (TOPF), the Brief International Cognitive Assessment for MS (BICAMS), self-report measures of cognitive difficulty (MS Neuropsychological Questionnaire; MSNQ), fatigue (MS Fatigue Impact Scale; MFIS) and depression (Hospital Anxiety and Depression Scale; HADS). Results revealed that, taking into account covariates, ePCF predicted (1) differences between self-reported and assessed cognitive abilities, p < .001 (model explained 29.35% of variance), and (2) performance on cognitive assessments, p < .001 (model explained 46.00% of variance), but not (3) self-reported cognitive difficulties, p = .545 (model explained 35.10% of variance). These results provide new and unique insights into predictors of the frequently observed discrepancy between self-reported and assessed cognitive abilities for pwMS. These findings have important implications for clinical practice, including the importance of exploring premorbid factors in self-reported experience of cognitive difficulties.
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Affiliation(s)
| | - Fiadhnait O'Keeffe
- University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital, Dublin, Ireland
| | - Caoimhe McManus
- University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital, Dublin, Ireland
| | - Niall Tubridy
- University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital, Dublin, Ireland
| | | | - Christopher McGuigan
- University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital, Dublin, Ireland
| | - Jessica Bramham
- University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital, Dublin, Ireland
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Keenan L, Bramham J, Dinca M, Coogan AN, Downes M. Sleep and daytime functioning in children with tourette syndrome: A two-week case-control study with actigraphy and cognitive assessments. Sleep Med 2024; 113:313-327. [PMID: 38101103 DOI: 10.1016/j.sleep.2023.11.1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
There is increasing recognition of the high prevalence of sleep issues in children with Tourette syndrome (TS), a condition characterised by motor and vocal tics. Overnight polysomnography (PSG) has been the primary mode of sleep assessment in the TS literature, despite the extensive use of actigraphy in other neurodevelopmental populations. As a result, there are existing research gaps surrounding day-to-day variability of sleep in TS and links to daytime functioning. This study adopts a naturalistic, intensive longitudinal design to examine sleep in children with TS while considering potential links to tic severity and daytime functioning. Participants were 34 children aged between 8 and 12 years (12 with TS, 22 neurotypical controls). Wrist actigraphs tracked sleep-wake cycles across two weeks and a battery of scales and cognitive assessments measured sleep disturbances and daytime functioning. Mixed models using N = 476 nights of actigraphy data found that relative to controls, children with TS had significantly increased time in bed, increased sleep onset latency, reduced sleep efficiency, lower subjective sleep quality, but comparable actual sleep time. Higher self-report tic severity at bedtime did not predict increased sleep onset latency. In the sleep disturbance scale, 83.33 % of children with TS met the clinical cut-off for a sleep disorder. Parent-report emotional, behavioural, and executive difficulties were greater in the TS group relative to controls, but performance on cognitive tasks was comparable between groups. Together, findings highlight sleep disturbances as an important clinical factor to consider in the management of TS, though further research is required to substantiate findings in larger-scale studies. This study demonstrates the feasibility of assessing sleep via actigraphy in children with TS, supporting more widespread use in the future.
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Affiliation(s)
- Lisa Keenan
- School of Psychology, University College Dublin, Ireland
| | | | - Maria Dinca
- School of Psychology, University College Dublin, Ireland
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3
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Keenan L, Bramham J, Downes M. Parent-Report Sleep Disturbances and Everyday Executive Functioning Difficulties in Children with Tourette Syndrome. Dev Neuropsychol 2024; 49:39-60. [PMID: 38224316 DOI: 10.1080/87565641.2023.2300428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
There is an increasing need to identify and treat sleep disturbances in Tourette syndrome (TS), a neurodevelopmental condition characterized by tics. This study explored sleep, tics, and executive functioning in children with TS (n=136) and neurotypical controls (n=101) through parent-report scales and open-ended questions. 85% of children with TS scored in the clinical range for a sleep disorder. Higher tic severity predicted increased sleep disturbances and executive difficulties. Qualitative insights indicated a bidirectional link between sleep and tics, which warrants consideration in clinical settings. Further research is needed to explore causal links.
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Affiliation(s)
- Lisa Keenan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Michelle Downes
- School of Psychology, University College Dublin, Dublin, Ireland
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Stein C, O'Keeffe F, Strahan O, McGuigan C, Bramham J. Systematic review of cognitive reserve in multiple sclerosis: Accounting for physical disability, fatigue, depression, and anxiety. Mult Scler Relat Disord 2023; 79:105017. [PMID: 37806233 DOI: 10.1016/j.msard.2023.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/03/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Cognitive reserve (CR) describes an individual's ability to adapt cognitive processes in response to brain atrophy, and has been reported to explain some of the discrepancy between brain atrophy and cognitive functioning outcomes in multiple sclerosis (MS). CR in MS is typically investigated by assessing an individual's pre- and/or post-diagnosis enrichment, which includes premorbid intellectual abilities, educational level, occupational attainment, and engagement in cognitively enriching leisure activities. Common MS symptoms (e.g., physical disability, fatigue, depression, anxiety) may impact an individual's ability to engage in various CR-enhancing activities post-diagnosis. It is unknown to what extent these MS symptoms have been taken into account in MS research on CR. As such, we identified whether studies assessed CR using measures of premorbid or continuous (including post-diagnosis) enrichment. For studies investigating continuous enrichment, we identified whether studies accounted for MS-impact, which MS symptoms were accounted for, and how, and whether studies acknowledged MS symptoms as potential CR-confounds. METHODS Three electronic databases (PsycINFO, PubMed, Scopus) were searched. Eligible studies investigated CR proxies (e.g., estimated premorbid intellectual abilities, vocabulary knowledge, educational level, occupational attainment, cognitively enriching leisure activities, or a combination thereof) in relation to cognitive, brain atrophy or connectivity, or daily functioning outcomes in adult participants with MS. We extracted data on methods and measures used, including any MS symptoms taken into account. Objectives were addressed using frequency analyses and narrative synthesis. RESULTS 115 studies were included in this review. 47.8% of all studies investigated continuous enrichment. Approximately half of the studies investigating continuous enrichment accounted for potential MS-impact in their analyses, with only 31.0% clearly identifying that they treated MS symptoms as potential confounds for CR-enhancement. A narrative synthesis of studies which investigated CR with and without controlling statistically for MS-impact indicated that accounting for MS symptoms may impact findings concerning the protective nature of CR. CONCLUSION Fewer than half of the studies investigating CR proxies in MS involved continuous enrichment. Just over half of these studies accounted for potential MS-impact in their analyses. To achieve a more complete and accurate understanding of CR in MS, future research should investigate both pre-MS and continuous enrichment. In doing so, MS symptoms and their potential impact should be considered. Establishing greater consistency and rigour across CR research in MS will be crucial to produce an evidence base for the development of interventions aimed at improving quality of care and life for pwMS.
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Affiliation(s)
- Clara Stein
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Fiadhnait O'Keeffe
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Orla Strahan
- University College Dublin, Belfield, Dublin 4, Ireland
| | - Christopher McGuigan
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Jessica Bramham
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Cogley C, Bramham J, Bramham K, Smith A, Holian J, O'Riordan A, Teh JW, Conlon P, Mac Hale S, D'Alton P. High rates of psychological distress, mental health diagnoses and suicide attempts in people with chronic kidney disease in Ireland. Nephrol Dial Transplant 2023; 38:2152-2159. [PMID: 36702532 PMCID: PMC10539206 DOI: 10.1093/ndt/gfad021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND People with chronic kidney disease (CKD) experience high levels of psychological distress, which is associated with higher mortality and adverse health outcomes. Little is known about the rates of a range of mental health difficulties or rates of suicide attempts in people with CKD. METHODS Individuals with CKD (n = 268; age range 18-94 years, mean = 49.96 years) on haemodialysis (n = 79), peritoneal dialysis (n = 46), transplant recipients (n = 84) and who were not on renal replacement therapy (RRT; n = 59) were recruited through the Irish Kidney Association social media pages and three Irish hospitals. Participants completed surveys to gather demographics and mental health histories, the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short Form Health Survey (SF-12) to measure health-related quality of life (HRQoL). RESULTS A total of 23.5% of participants self-reported they had received a mental health diagnosis, with depression (14.5%) and anxiety (14.2%) being the most common, while 26.4% of participants had experienced suicidal ideation and 9.3% had attempted suicide. Using a clinical cut-off ≥8 on the HADS subscales, current levels of clinically significant anxiety and depression were 50.7% and 35.4%, respectively. Depression levels were slightly higher for those on haemodialysis compared with those with a transplant and those not on RRT. Depression, anxiety and having a mental health diagnosis were all associated with lower HRQoL. CONCLUSIONS People with CKD in Ireland experience high levels of psychological distress, mental health difficulties, suicidal ideation and suicide attempts. The identification of and intervention for mental health difficulties in CKD should be prioritised in clinical care.
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Affiliation(s)
- Clodagh Cogley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | | | - John Holian
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Aisling O'Riordan
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Jia Wei Teh
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Peter Conlon
- Nephrology Department, Beaumont Hospital, Dublin, Ireland
| | | | - Paul D'Alton
- School of Psychology, University College Dublin, Dublin, Ireland
- King's College Hospital NHS Trust, London, UK
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Cogley C, Carswell C, Bramham J, Bramham K, Smith A, Holian J, Conlon P, D’Alton P. Improving kidney care for people with severe mental health difficulties: a thematic analysis of twenty-two healthcare providers' perspectives. Front Public Health 2023; 11:1225102. [PMID: 37448661 PMCID: PMC10338099 DOI: 10.3389/fpubh.2023.1225102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction People with severe mental health difficulties (SMHDs) and concurrent kidney disease have less access to quality kidney care and worse clinical outcomes. Our research investigates the barriers and facilitators to effective kidney care for people with SMHDs, and how care might be improved for this underserved population. Methods We conducted semi-structured interviews with twenty-two physical (n = 14) and mental (n = 8) healthcare professionals with experience working with people with SMHDs and concurrent kidney disease. Interview data were analysed and interpreted using reflexive thematic analysis. Results Four themes were generated from the data: 1. "It's about understanding their limitations and challenges, without limiting their rights" describes how some people with SMHDs need additional support when accessing kidney care due to challenges with their mental state, motivation, cognitive difficulties, or mistrust of the healthcare system. 2. "There are people falling through the cracks" describes how the separation of physical and mental healthcare, combined with under-resourcing and understaffing, results in poorer outcomes for people with SMHDs. 3. "Psychiatry is a black spot in our continuing medical education" describes how many renal healthcare providers have limited confidence in their understanding of mental health and their ability to provide care for people with SMHDs. 4. "When they present to a busy emergency department with a problem, the staff tend to go '…psych patient"" describes how stigma towards people with SMHDs can negatively impact quality of care. Conclusion Healthcare professionals accounts' describe how people with SMHDs and kidney disease can have favourable outcomes if they have appropriate hospital, community and social supports. Findings indicate that effective management of kidney disease for people with SMHDs requires integrated physical and mental health care, which takes an individualised "whole person" approach to addressing the interaction between kidney disease and mental health.
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Affiliation(s)
- Clodagh Cogley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Claire Carswell
- Department of Health Sciences, University of York, York, United Kingdom
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | | | - John Holian
- St Vincent’s University Hospital, Dublin, Ireland
| | | | - Paul D’Alton
- School of Psychology, University College Dublin, Dublin, Ireland
- St Vincent’s University Hospital, Dublin, Ireland
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Gallagher R, Kessler K, Bramham J, Dechant M, Friehs MA. A proof-of-concept study exploring the effects of impulsivity on a gamified version of the stop-signal task in children. Front Psychol 2023; 14:1068229. [PMID: 36844283 PMCID: PMC9946965 DOI: 10.3389/fpsyg.2023.1068229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
This proof-of-concept study provides an appraisal of a remotely administered gamified Stop-Signal Task (gSST) for future use in studies using child sample. Performance on the standard Stop-Signal (SST) task has been shown previously to differentiate attention-deficit-hyperactivity-disorder groups from controls. As is the case with the SST, it was envisaged that those with greater impulsivity would perform worse than those with lower levels of impulsivity in the gSST. The potential advantage of the gSST is that it could be perceived as less monotonous than the original SST and has the potential to provide higher data quality in child samples, however future research will need to be conducted to determine this. The gSST was administered remotely via video chat to 30 child participants within a community sample aged 8-12 to investigate the effect of ADHD symptoms and intrinsic motivation on gSST performance. Qualitative data was collected based on feedback from participants to gain insight into how the gSST was received by participants. A positive correlation was observed between impulsive/hyperactivity and gSST performance, however there was insufficient evidence to suggest that impulsivity predicted performance. With regards to accuracy, results suggested that impulsivity level significantly predicted the rate of go-omission errors. No relationships were observed between intrinsic motivation inventory (IMI) subscales and performance or IMI and impulsivity. Nevertheless, mean IMI scores were overarchingly high for each of the IMI subscales, suggesting that regardless of performance and/or level of impulsive behaviour, the child sample obtained in this study demonstrated high levels of intrinsic motivation, which was supported by the predominantly positive subjective feedback provided by the child participants. The present study provides some evidence based on quantitative and qualitative results for the efficacy of gSST for use with children. Future research with a larger sample of children is warranted to examine how performance on the SST and gSST compare/differ.
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Affiliation(s)
- Ruth Gallagher
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Klaus Kessler
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Martin Dechant
- ZEISS Vision Science Lab, Institute for Ophthalmic Research, Tübingen University, Tübingen, Germany,UCLIC, University College London, London, United Kingdom
| | - Maximilian A. Friehs
- School of Psychology, University College Dublin, Dublin, Ireland,Lise-Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Department of Psychology of Conflict, Risk and Safety, University of Twente, Enschede, Netherlands,*Correspondence: Maximilian A. Friehs,
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Keating J, Hasshim N, Bramham J, McNicholas F, Carr A, Downes M. An exploration of early sleep development in preschool children with and without a familial history of ADHD. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Bellew D, Davenport L, Monaghan R, Cogley C, Gaughan M, Yap SM, Tubridy N, Bramham J, McGuigan C, O'Keeffe F. Interpreting the clinical importance of the relationship between subjective fatigue and cognitive impairment in multiple sclerosis (MS): How BICAMS performance is affected by MS-related fatigue. Mult Scler Relat Disord 2022; 67:104161. [PMID: 36126538 DOI: 10.1016/j.msard.2022.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/18/2021] [Revised: 07/31/2022] [Accepted: 09/04/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND There is evidence that subjective fatigue can influence cognitive functioning in multiple sclerosis (MS). DeLuca et al.'s (2004) Relative Consequence Model proposes that impairments to other high-level cognitive functions, such as memory, result from the disease's effect on information processing speed. OBJECTIVE The primary aims of the study were to investigate both 1) the relationship between subjective fatigue and cognitive functioning, as measured by the widely used Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in MS; and 2) the consequential effect of fatigue on information processing speed as predicted by the Relative Consequence Model. METHODS 192 participants with MS attending tertiary referral MS centre completed the Modified Fatigue Impact Scale and BICAMS. RESULTS Multiple correlation analyses determined that there were statistically significant relationships between all domains assessed by the BICAMS and levels of fatigue, such that higher levels of self-reported fatigue were associated with lower performance on information-processing, and visual and verbal learning. After controlling for information processing speed, the strength of correlation between fatigue and learning performance weakened. Linear regression analysis showed that fatigue predicted the most variance in verbal learning and 11.7% of the overall variance in BICAMS performance. CONCLUSION Subjective fatigue and objective cognitive performance in MS are related. Caution is advised in the interpretation of BICAMS scores in cases where high levels of fatigue are present, and more detailed neuropsychological assessments may be required in order to accurately identify objective cognitive impairment independent of subjective fatigue.
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Affiliation(s)
- David Bellew
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Laura Davenport
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ruth Monaghan
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Clodagh Cogley
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Maria Gaughan
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Siew Mei Yap
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Niall Tubridy
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Christopher McGuigan
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Fiadhnait O'Keeffe
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
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10
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Seery C, Wrigley M, O'Riordan F, Kilbride K, Bramham J. What adults with ADHD want to know: A Delphi consensus study on the psychoeducational needs of experts by experience. Health Expect 2022; 25:2593-2602. [PMID: 35999687 PMCID: PMC9615057 DOI: 10.1111/hex.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction A lack of knowledge about attention‐deficit/hyperactivity disorder (ADHD) can contribute to feelings of distress and difficulty in seeking and accepting an ADHD diagnosis. The present study uses a Delphi consensus design to investigate the psychoeducational needs of adults with ADHD and the information about ADHD they would like included in digital health interventions for adults with ADHD. Inclusion of perspectives of service users in developing such interventions ensures that they are evidence based and addresses the risks of engagement barriers. Methods The expert panel consisted of 43 adults with ADHD (age range: 23–67 years). Panel members were asked to rate the importance of the proposed topics and provide additional suggestions. Suggested topics and topics that did not achieve consensus were included for ranking in the second round. Results Interquartile ratings were used to determine consensus. A high consensus was achieved in both rounds, with an agreement on 94% of topics in the first round and 98% in the second round. Most topics were rated as important or essential. Conclusions The findings highlighted that adults with ADHD want to learn about many different aspects of ADHD and the importance of considering their perspectives when developing psychosocial interventions. Findings can be applied when creating psychoeducational content for adult ADHD. Patient or Public Contribution Adults with ADHD were recruited to the Delphi panel to use an experts‐by‐experience approach. In doing so, we are engaging service users in the development of a psychoeducational smartphone app. The evaluation of the app will involve interviews with app users. Additionally, the present study was developed and conducted with ADHD Ireland, a charity based in Ireland that advocates for people with ADHD.
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Affiliation(s)
- Christina Seery
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Margo Wrigley
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | - Fiona O'Riordan
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | | | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
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11
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Davenport L, Cogley C, Monaghan R, Gaughan M, Yap M, Bramham J, Tubridy N, McGuigan C, O'Keeffe F. Investigating the association of mood and fatigue with objective and subjective cognitive impairment in multiple sclerosis. J Neuropsychol 2022; 16:537-554. [PMID: 35765743 DOI: 10.1111/jnp.12283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/27/2021] [Accepted: 06/01/2022] [Indexed: 12/01/2022]
Abstract
Discrepancies between subjective cognitive difficulties and objective measures of cognitive function in people with MS have been identified and may be related to mood and fatigue. The aim of the present study was to examine associations of depression and fatigue with discrepancies between subjective and objective cognitive functioning in pwMS. 177 participants with MS attending a University Hospital Department of Neurology MS Outpatient clinic completed the Brief International Cognitive Assessment for MS (BICAMS), MS Neuropsychological Questionnaire (MSNQ), Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS). To quantify the discrepancy between objective (BICAMS) and subjective (MSNQ) cognitive functioning, discrepancy scores were calculated by subtracting MSNQ z-score from composite BICAMS z-score. Based on their discrepancy score, participants were grouped as 'Underestimated', 'Overestimated' and 'Non-discrepant'. 39% of the total sample demonstrated poorer subjective cognitive functioning than their objective cognitive performance suggested ('Underestimated'). 23% of the total sample indicated lower objective scores than their subjective report suggests ('Overestimated'). 38% participants indicated relatively no discrepancy between objective and subjective cognitive measures ('Non-discrepant'). Significant differences were observed between the discrepancy groups in terms of depression and fatigue, with the 'Underestimated' group demonstrating greater levels of depression and fatigue (ps < .01). Regression analysis indicated that cognitive fatigue and depression significantly contributed to variance in subjective cognitive functioning. Our findings suggest that subjective reports of cognitive function may be influenced by depression and fatigue, emphasising the importance of cognitive, mood and fatigue screening as part of routine clinical care.
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Affiliation(s)
- Laura Davenport
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | - Clodagh Cogley
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | | | | | - Mei Yap
- St. Vincent's University Hospital, Dublin, Ireland
| | - Jessica Bramham
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | | | | | - Fiadhnait O'Keeffe
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
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12
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Twomey DM, Allen N, Agan MLF, Hayes AM, Higgins A, Carton S, Roche R, Hevey D, Bramham J, Brady N, O'Keeffe F. Self-reported outcomes and patterns of service engagement after an acquired brain injury: a long-term follow-up study. Brain Inj 2021; 35:1649-1657. [PMID: 34898342 DOI: 10.1080/02699052.2021.2004617] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE To describe the clinical characteristics, self-reported outcomes in domains relating to activities of daily living and patterns of service engagement in the survivors of a moderate-to-severe acquired brain injury over seven years. RESEARCH DESIGN A longitudinal research design was used. METHODS AND PROCEDURES Thirty-two individuals who sustained a moderate-to-severe acquired brain injury completed a Sociodemographic and Support Questionnaire at one (t1) and seven years (t2) after completing a publicly funded inpatient neurorehabilitation program. MAIN OUTCOMES AND RESULTS There were minimal changes in independent living, mobility, ability to maintain key relationships and in return to work in the interval between t1 and t2. Sixty-nine percent of participants engaged with two or more allied health professional services and 75% engaged with support services in the community over the seven years. CONCLUSIONS There were minimal additional gains in outcomes relating to activities of daily-living and there was a high level of service need in the first decade postinjury. Young and middle-aged individuals who sustain an ABI may continue to live in the community for decades with some level of disability and may require ongoing access to services.
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Affiliation(s)
- Deirdre M Twomey
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Niamh Allen
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | | | - Aoife M Hayes
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Andrea Higgins
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Simone Carton
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Richard Roche
- Department of Psychology, Maynooth University, Ireland
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland.,Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Nuala Brady
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Psychology, Trinity College Dublin, Dublin, Ireland.,Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland.,Psychology Department St. Vincent's University Hospital, Dublin, Ireland
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13
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Abstract
Objective: The aim of the current study was to examine relations between sleep problems and family factors and early markers of ADHD in young children with and without a familial risk for ADHD.Methods: Differences in sleep behavior and family functioning in children under 6 years with (n = 72) and without (n = 139) a familial risk for ADHD were investigated. The influence of family and sleep factors on the development of early temperament markers of ADHD (effortful control and negative affect) was explored. Parents/caregivers completed questionnaires on family functioning, child sleep behavior, and general regulatory behaviors.Results: A significant difference was observed between high-risk and low-risk groups for family functioning in the infant/toddler (<3 years) and preschool (>3 years) cohorts. Parents of infants/toddlers in the high-risk group reported poorer infant sleep. However, there were no sleep differences reported for the preschool cohort. Family functioning was found to predict effortful control, while sleep quality predicted negative affect.Conclusion: The results of this study highlight potential family and sleep issues for young children with a familial history of ADHD and the potential influence of these factors on early temperament markers of ADHD. Future research should explore these relations further in order to better establish whether early sleep and family interventions could mitigate later ADHD symptomatology.
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Affiliation(s)
- J Keating
- School of Psychology, University College Dublin, Dublin, Ireland
| | - J Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - F McNicholas
- School of Psychiatry, University College Dublin, Dublin, Ireland
| | - A Carr
- School of Psychology, University College Dublin, Dublin, Ireland
| | - N Hasshim
- School of Psychology, University College Dublin, Dublin, Ireland.,Divison of Psychology, De Montfort University, Leicester, UK
| | - M Downes
- School of Psychology, University College Dublin, Dublin, Ireland
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14
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Seery C, Bramham J, O’Connor C. Effects of a psychiatric diagnosis vs a clinical formulation on lay attitudes to people with psychosis. Psychosis 2021. [DOI: 10.1080/17522439.2021.1901302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Christina Seery
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
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15
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Cogley C, O'Reilly H, Bramham J, Downes M. A Systematic Review of the Risk Factors for Autism Spectrum Disorder in Children Born Preterm. Child Psychiatry Hum Dev 2021; 52:841-855. [PMID: 32980936 DOI: 10.1007/s10578-020-01071-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
Preterm birth is associated with an increased risk for autism spectrum disorder, with various factors proposed to underlie this relationship. The aim of this systematic review was to provide a narrative synthesis of the literature regarding the prenatal, perinatal and postnatal factors associated with autism spectrum disorder in children born preterm. Medline, Embase and PsycINFO databases were searched via Ovid to identify studies published from January 1990 to December 2019. Original studies in which a standardized diagnostic tool and/or clinical assessment was used to diagnose autism, along with a risk factor analysis to identify associated predictors, were included. A total of 11 eligible studies were identified. Male sex, being born small for gestational age and general cognitive impairment were the most robust findings, with each reported as a significant factor in at least two studies. Comparisons across studies were limited by variation in risk factor measurement and gestational age ranges investigated.
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Affiliation(s)
- Clodagh Cogley
- School of Psychology, University College Dublin, Newman Building, Belfield, Dublin 4, Ireland.
| | - Helen O'Reilly
- School of Psychology, University College Dublin, Newman Building, Belfield, Dublin 4, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Newman Building, Belfield, Dublin 4, Ireland
| | - Michelle Downes
- School of Psychology, University College Dublin, Newman Building, Belfield, Dublin 4, Ireland
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16
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Grogan K, O'Daly H, Bramham J, Scriven M, Maher C, Fitzgerald A. A qualitative study on the multi-level process of resilience development for adults recovering from eating disorders. J Eat Disord 2021; 9:66. [PMID: 34108053 PMCID: PMC8191215 DOI: 10.1186/s40337-021-00422-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/24/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery. METHOD Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis. RESULTS The overarching theme which described the process of developing resilience was 'Bouncing back to being me', which involved three stages: 'Who am I without my ED?', 'My eating disorder does not define me', and 'I no longer need my eating disorder'. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement. CONCLUSION This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes.
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Affiliation(s)
- Katie Grogan
- School of Psychology, University College Dublin, Dublin, Ireland.
| | - Hannah O'Daly
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Mary Scriven
- Elm Mount Unit, St. Vincent's University Hospital, Dublin, Ireland
| | - Caroline Maher
- Elm Mount Unit, St. Vincent's University Hospital, Dublin, Ireland
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17
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Keating J, Bramham J, Downes M. Sensory modulation and negative affect in children at familial risk of ADHD. Res Dev Disabil 2021; 112:103904. [PMID: 33639605 DOI: 10.1016/j.ridd.2021.103904] [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] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/05/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/AIMS Sensory modulation difficulties are commonly reported in patients with ADHD, however there has been little focus on the development of these difficulties in young children at a higher risk of later ADHD diagnosis. This study investigated whether children with a familial history of ADHD show greater sensory modulation difficulties. We also explored whether sensory modulation was linked to negative affectivity, which has been highlighted as a potential early marker of ADHD. METHODS Parents of children under 6 years with a family history of ADHD (n = 65) and no family history (n = 122) completed questionnaires on sensory modulation and temperament. RESULTS Children from families with ADHD were reported to display extreme patterns of hyperresponsiveness and hyporesponsiveness, relative to controls. No differences emerged for the sensory seeking domain. Some children within the high-risk group reported high scores across all three sensory modulation patterns. Regression analysis revealed that hyperresponsiveness predicted higher levels of negative affect. CONCLUSIONS/IMPLICATIONS This study is the first to report greater sensory modulation difficulties in children at familial risk of ADHD. Future research should establish whether children with sensory modulation and temperament difficulties in early childhood are more vulnerable to developing ADHD.
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Affiliation(s)
- J Keating
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.
| | - J Bramham
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - M Downes
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
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18
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Keating J, Gaffney R, Bramham J, Downes M. Sensory modulation difficulties and assessment in children with attention deficit hyperactivity disorder: A systematic review. European Journal of Developmental Psychology 2021. [DOI: 10.1080/17405629.2021.1889502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jennifer Keating
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Rebecca Gaffney
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Michelle Downes
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
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19
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Corboy H, Blanco-Campal A, Bates R, Bramham J, Libon DJ, Greene C. The development, validation and normative data study of the English in Ireland adaption of the Philadelphia repeatable Verbal Learning Test (EirPrVLT-12) for use in an older adult population. Clin Neuropsychol 2020; 34:83-109. [PMID: 32924790 DOI: 10.1080/13854046.2020.1815854] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Cultural adaptations of verbal serial list-learning tests such as the California Verbal Learning Test (CVLT) and the Philadelphia (repeatable) Verbal Learning Test (P(r)VLT) have been shown to be clinically necessary. This paper aimed to culturally adapt, validate and provide normative data for an English in Ireland adaptation of the P(r)VLT, i.e. the EirPrVLT-12, in order to improve episodic memory assessments for Irish adults. Method: EirPrVLT-12 word lists were constructed using a word frequency study of Irish adults (n = 58). Two twelve-word, four-trial forms were constructed (standard and alternate form). A normative study included 145 participants who met strict inclusion criteria. Results: EirPrVLT-12 performance varied depending on age, gender, education, estimated IQ and socioeconomic status. Construct validity was established by correlations with other cognitive tests. Principal component analysis yielded a three-factor solution relating to general verbal learning, intrusions and interference. Normed EirPrVLT-12 scaled scores and percentiles stratified by age are available on the Open Science Framework at https://osf.io/vjzsp/, as are regression equations to predict individual scores based on age, gender and education. Conclusions: The data obtained underscores the clinical ultility of the EirPrVLT-12 to assess episodic memory in Irish older adults. Future research was recommended to validate the EirPrVLT-12 in a clinical population, extend normative data to younger populations and develop norms for the alternate form.
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Affiliation(s)
- Holly Corboy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Alberto Blanco-Campal
- Department of Psychiatry for the Older Person, Memory Clinic Services, Health Service Executive, Louth, Ireland
| | - Rachel Bates
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - David J Libon
- Department of Geriatric and Gerontology, and the Department of Psychology, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Ciara Greene
- School of Psychology, University College Dublin, Dublin, Ireland
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20
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Salomone S, Fleming GR, Bramham J, O'Connell RG, Robertson IH. Neuropsychological Deficits in Adult ADHD: Evidence for Differential Attentional Impairments, Deficient Executive Functions, and High Self-Reported Functional Impairments. J Atten Disord 2020; 24:1413-1424. [PMID: 26769747 DOI: 10.1177/1087054715623045] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This study is aimed to investigate neuropsychological deficits in adult ADHD. Method: Neuropsychological deficits in terms of executive functions, divided, selective, and sustained attention, were investigated in a group of adults with ADHD using a series of neuropsychological tests as well as electroencephalography (EEG). Subjective ratings of everyday life attention and memory problems were also collected. Results: Adults with ADHD showed impairments in executive functions, divided attention and sustained attention, compared with adult controls. Performance on selective attention tasks in adults with ADHD was instead no different from control participants' performance. EEG results confirmed neuropsychological findings by showing a selective impairment on P3 event-related potential (ERP) amplitude indicative of sustained attention deficits. Higher subjective ratings of everyday attentional and memory problems were also found in the ADHD group compared with the control group. Conclusion: This pattern of results suggests differential impairments of attentional skills. Impaired executive functions and higher subjective functional impairments were also found.
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Affiliation(s)
| | | | - Jessica Bramham
- St. Patrick's University Hospital, Dublin, Ireland.,University College Dublin (UCD), Dublin, Ireland
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21
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Kiiski H, Bennett M, Rueda-Delgado LM, Farina FR, Knight R, Boyle R, Roddy D, Grogan K, Bramham J, Kelly C, Whelan R. EEG spectral power, but not theta/beta ratio, is a neuromarker for adult ADHD. Eur J Neurosci 2020; 51:2095-2109. [PMID: 31834950 DOI: 10.1111/ejn.14645] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/14/2022]
Abstract
Adults with attention-deficit/hyperactivity disorder (ADHD) have been described as having altered resting-state electroencephalographic (EEG) spectral power and theta/beta ratio (TBR). However, a recent review (Pulini et al. 2018) identified methodological errors in neuroimaging, including EEG, ADHD classification studies. Therefore, the specific EEG neuromarkers of adult ADHD remain to be identified, as do the EEG characteristics that mediate between genes and behaviour (mediational endophenotypes). Resting-state eyes-open and eyes-closed EEG was measured from 38 adults with ADHD, 45 first-degree relatives of people with ADHD and 51 unrelated controls. A machine learning classification analysis using penalized logistic regression (Elastic Net) examined if EEG spectral power (1-45 Hz) and TBR could classify participants into ADHD, first-degree relatives and/or control groups. Random-label permutation was used to quantify any bias in the analysis. Eyes-open absolute and relative EEG power distinguished ADHD from control participants (area under receiver operating characteristic = 0.71-0.77). The best predictors of ADHD status were increased power in delta, theta and low-alpha over centro-parietal regions, and in frontal low-beta and parietal mid-beta. TBR did not successfully classify ADHD status. Elevated eyes-open power in delta, theta, low-alpha and low-beta distinguished first-degree relatives from controls (area under receiver operating characteristic = 0.68-0.72), suggesting that these features may be a mediational endophenotype for adult ADHD. Resting-state EEG spectral power may be a neuromarker and mediational endophenotype of adult ADHD. These results did not support TBR as a diagnostic neuromarker for ADHD. It is possible that TBR is a characteristic of childhood ADHD.
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Affiliation(s)
- Hanni Kiiski
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Marc Bennett
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Medical Research Council- Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Francesca R Farina
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rachel Knight
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rory Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Darren Roddy
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Department of Physiology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Katie Grogan
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Clare Kelly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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22
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Moran C, Scotto di Palumbo A, Bramham J, Moran A, Rooney B, De Vito G, Egan B. Effects of a Six-Month Multi-Ingredient Nutrition Supplement Intervention of Omega-3 Polyunsaturated Fatty Acids, vitamin D, Resveratrol, and Whey Protein on Cognitive Function in Older Adults: A Randomised, Double-Blind, Controlled Trial. J Prev Alzheimers Dis 2019; 5:175-183. [PMID: 29972210 DOI: 10.14283/jpad.2018.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To investigate the impact of a six-month multi-ingredient nutrition supplement intervention (Smartfish®), containing omega-3 polyunsaturated fatty acids (PUFAs), vitamin D, resveratrol, and whey protein, on cognitive function in Irish older adults. DESIGN Double-blind, randomised controlled trial (ClinicalTrials.gov: NCT02001831). A quantitative, mixed-model design was employed in which the dependent variable (cognitive function) was analysed with a between-subjects factor of group (placebo, intervention) and within-subjects factor of testing occasion (baseline, three-months, six-months). SETTING Community-based intervention including assessments conducted at University College Dublin, Ireland. PARTICIPANTS Thirty-seven community-dwelling older adults (68-83 years; mean (x̄)= 75.14 years; standard deviation (SD)= 3.64; 18 males) with normal cognitive function (>24 on the Mini Mental State Examination) were assigned to the placebo (n= 17) or intervention (n= 20) via a block randomisation procedure. INTERVENTION Daily consumption for six-months of a 200mL liquid juice intervention comprising 3000mg omega-3 PUFAs [1500mg docosahexaenoic acid (DHA) and 1500mg eicosapentaenoic acid (EPA)], 10μg vitamin D3, 150mg resveratrol and 8g whey protein isolate. The placebo contained 200mL juice only. MEASUREMENTS A standardised cognitive assessment battery was conducted at baseline and follow-ups. Individual test scores were z-transformed to generate composite scores grouped into cognitive domains: executive function, memory, attention and sensorimotor speed. Motor imagery accuracy and subjective awareness of cognitive failures variables were computed from raw scores. RESULTS A hierarchical statistical approach was used to analyse the data; first, by examining overall cognitive function, then by domain, and then by individual test scores. Using mixed between-within subjects, analyses of variance (ANOVAs), no significant differences in overall cognitive function or composite cognitive domains were observed between groups over time. The only significant interaction was for Stroop Color-Word Time (p< 0.05). The intervention group demonstrated reduced task completion time at three- and six-month follow-ups, indicating enhanced performance. CONCLUSION The present nutrition intervention encompassed a multi-ingredient approach targeted towards improving cognitive function, but overall had only a limited beneficial impact in the older adult sample investigated. Future investigations should seek to establish any potential clinical applications of such targeted interventions with longer durations of supplementation, or in populations with defined cognitive deficits.
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Affiliation(s)
- C Moran
- Catherine Moran, School of Psychology, Trinity College Institute for Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland, E-mail:
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23
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Lonergan A, Doyle C, Cassidy C, MacSweeney Mahon S, Roche RA, Boran L, Bramham J. A meta-analysis of executive functioning in dyslexia with consideration of the impact of comorbid ADHD. Journal of Cognitive Psychology 2019. [DOI: 10.1080/20445911.2019.1669609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Aoife Lonergan
- Department of Psychology, University College Dublin, Dublin, Ireland
| | - Caoilainn Doyle
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Clare Cassidy
- Department of Psychology, National University of Ireland, Galway, Ireland
| | | | | | - Lorraine Boran
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Jessica Bramham
- Department of Psychology, University College Dublin, Dublin, Ireland
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24
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Whitwell S, Bramham J, Moriarty J. Simple schizophrenia or disorganisation syndrome? A case report and review of the literature. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.11.6.398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Simple schizophrenia is a sometimes controversial diagnosis. Here we review the concept with particular reference to its history in diagnostic systems. Using an illustrative real case of a 25-year-old man, we show that there is a need to retain this diagnostic category, which may fit better within proposed dimensional (psychomotor poverty, disorganisation and reality distortion) rather than categorical classifications of schizophrenia. Symptoms of the disorder may be better revealed by functional assessment than by relying on descriptive psychopathology.
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25
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Grogan K, Gormley CI, Rooney B, Whelan R, Kiiski H, Naughton M, Bramham J. Differential diagnosis and comorbidity of ADHD and anxiety in adults. Br J Clin Psychol 2017; 57:99-115. [DOI: 10.1111/bjc.12156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/08/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Katie Grogan
- School of Psychology; University College Dublin; Ireland
- Adult ADHD Assessment Clinic; St. Patrick's University Hospital; Dublin Ireland
| | | | - Brendan Rooney
- School of Psychology; University College Dublin; Ireland
| | - Robert Whelan
- Whelan Lab-Translational Cognitive Neuroscience; Trinity College Dublin; Ireland
| | - Hanni Kiiski
- Whelan Lab-Translational Cognitive Neuroscience; Trinity College Dublin; Ireland
| | - Marie Naughton
- Adult ADHD Assessment Clinic; St. Patrick's University Hospital; Dublin Ireland
| | - Jessica Bramham
- School of Psychology; University College Dublin; Ireland
- Adult ADHD Assessment Clinic; St. Patrick's University Hospital; Dublin Ireland
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26
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Kerley CP, Hutchinson K, Bramham J, McGowan A, Faul J, Cormican L. Vitamin D Improves Selected Metabolic Parameters but Not Neuropsychological or Quality of Life Indices in OSA: A Pilot Study. J Clin Sleep Med 2017; 13:19-26. [PMID: 27707440 DOI: 10.5664/jcsm.6378] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 05/26/2016] [Accepted: 09/02/2016] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVES Our group and others have reported a high rate of vitamin D deficiency in obstructive sleep apnea (OSA), where vitamin D levels (25(OH) D) correlate negatively with OSA severity and some of its associated metabolic alterations. Data regarding vitamin D supplementation in OSA are lacking. We wanted to evaluate the effect of vitamin D3 supplementation on OSA symptoms and metabolic parameters. METHODS We conducted a pilot, double-blind, randomized, placebo-controlled trial of daily supplementation with 4,000 IU vitamin D3 (D3) or placebo (PL). We studied 19 Caucasian adults (14 male, mean age 55 y, mean body mass index [BMI] 30.4 kg/m2) with OSA. Fifteen patients were stable on continuous positive airways pressure (CPAP) therapy, whereas four were CPAP naïve. Assessments were completed at baseline and after 15 weeks of supplementation. Outcomes included sleepiness (Epworth Sleepiness Scale), quality of life (Sleep Apnea Quality of Life Inventory), fatigue (fatigue severity scale) and neuropsychological function (trail making test and Connor's Continuous Performance Test II). In addition, we assessed biochemical indices of vitamin D status (25(OH)D, calcium), inflammation (high sensitivity C-reactive protein, and lipoprotein-associated phospholipase A2), lipids (total cholesterol [low-density and high-density lipoprotein]) and glycemic indices (fasting glucose, oral glucose tolerance test). RESULTS There was no change in BMI, medication, or CPAP usage. Although there was no change in neuropsychological or quality of life indices, we observed a significant increase in 25(OH)D (p = 0.00001) and significant decreases in both low-density lipoprotein (p = 0.04) and lipoprotein-associated phospholipase A2 (p = 0.037) as well as trends toward decreased fasting glucose (p = 0.09) and increased high-density lipoprotein (p = 0.07) in the D3 group compared to PL. CONCLUSIONS Vitamin D3 supplementation increased vitamin D levels and decreased metabolic markers compared to placebo. Larger trials are required.
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Affiliation(s)
- Conor P Kerley
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland
| | - Katrina Hutchinson
- Biomnis Ireland, Sandyford Business Estate, Dublin, Ireland.,NCBES, NUI Galway, Ireland
| | - Jessica Bramham
- School of Psychology, University College, Dublin, Belfield, Dublin, Ireland
| | - Aisling McGowan
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - John Faul
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Liam Cormican
- Respiratory and Sleep Diagnostics Department, Connolly Hospital, Blanchardstown, Dublin, Ireland
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27
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Abstract
OBJECTIVE Given that the diagnosis of adulthood ADHD depends on the retrospective self-report of childhood ADHD symptoms, this study aimed to establish whether current mood affects the accuracy of retrospective self-ratings of childhood ADHD. METHOD Barkley's Adult ADHD Rating Scale (BAARS) was used to assess the retrospective self- and parent-reports of childhood ADHD symptoms of 160 adults with ADHD and 92 adults without ADHD. Self-rated current mood was also measured using the Hospital Anxiety and Depression Scale (HADS). RESULTS Higher BAARS self-ratings correlated with higher HADS self-ratings. Strongest correlations were evident between hyperactive/impulsive symptoms and anxiety symptoms. There was no relationship between current mood and accuracy of self-report. CONCLUSION Current mood does not affect the accuracy of retrospective self-ratings of ADHD. Future research should aim to provide new measures of anxiety in ADHD to avoid the double counting of hyperactive/impulsive and anxiety symptoms.
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Dawson F, Shanahan S, Fitzsimons E, O'Malley G, Mac Giollabhui N, Bramham J. The impact of caring for an adult with intellectual disability and psychiatric comorbidity on carer stress and psychological distress. J Intellect Disabil Res 2016; 60:553-563. [PMID: 27028105 DOI: 10.1111/jir.12269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/22/2016] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Given that carers of individuals with intellectual disability (ID) and carers of individuals with psychiatric disorders experience elevated levels of stress and psychological distress, carers of individuals with both ID and a comorbid psychiatric disorder are potentially at even greater risk for psychological difficulties. The aim of the present study was to investigate the psychological well-being of carers of adults with a dual diagnosis compared with carers of adults with intellectual disability alone. METHOD Four-hundred and forty-two questionnaires were sent to four community services and seventy-five family carers of adults with intellectual disability responded. Psychological well-being of carers was assessed using the Questionnaire on Resources and Stress - Friedrich edition (QRS-F) and the General Health Questionnaire (GHQ). Comorbid psychopathology for their family member with ID was assessed using the Reiss Screen for Maladaptive Behaviour (RSMB). RESULTS Twenty-four percent of the individuals with ID were reported to have comorbid psychopathology. Between-group analyses compared carers of people with ID and comorbid psychopathology to carers of people with ID alone. Regression analyses examined the relationship between psychopathology and other care-related variables to carer stress and psychological distress. Carers of people with ID and comorbid psychopathology were found to have significantly higher levels of stress and psychological distress than carers of people with ID alone. Autism was found to be the only significant predictor of both stress and psychological distress among measures of psychopathology. CONCLUSIONS Additional comorbid psychopathology in individuals with intellectual disability has a significant impact on their carers' psychological well-being.
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Affiliation(s)
- F Dawson
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - S Shanahan
- St John of God Kildare Services, Celbridge, Ireland
| | - E Fitzsimons
- St John of God Carmona Services, Dun Laoghaire, Ireland
| | - G O'Malley
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - N Mac Giollabhui
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - J Bramham
- UCD School of Psychology, University College Dublin, Belfield, Ireland
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Tropeano M, Howley D, Gazzellone MJ, Wilson CE, Ahn JW, Stavropoulos DJ, Murphy CM, Eis PS, Hatchwell E, Dobson RJB, Robertson D, Holder M, Irving M, Josifova D, Nehammer A, Ryten M, Spain D, Pitts M, Bramham J, Asherson P, Curran S, Vassos E, Breen G, Flinter F, Ogilvie CM, Collier DA, Scherer SW, McAlonan GM, Murphy DG. Microduplications at the pseudoautosomal SHOX locus in autism spectrum disorders and related neurodevelopmental conditions. J Med Genet 2016; 53:536-47. [PMID: 27073233 DOI: 10.1136/jmedgenet-2015-103621] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 11/04/2015] [Accepted: 03/10/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND The pseudoautosomal short stature homeobox-containing (SHOX) gene encodes a homeodomain transcription factor involved in cell-cycle and growth regulation. SHOX/SHOX enhancers deletions cause short stature and skeletal abnormalities in a female-dominant fashion; duplications appear to be rare. Neurodevelopmental disorders (NDDs), such as autism spectrum disorders (ASDs), are complex disorders with high heritability and skewed sex ratio; several rare (<1% frequency) CNVs have been implicated in risk. METHODS We analysed data from a discovery series of 90 adult ASD cases, who underwent clinical genetic testing by array-comparative genomic hybridisation (CGH). Twenty-seven individuals harboured CNV abnormalities, including two unrelated females with microduplications affecting SHOX. To determine the prevalence of SHOX duplications and delineate their associated phenotypic spectrum, we subsequently examined array-CGH data from a follow-up sample of 26 574 patients, including 18 857 with NDD (3541 with ASD). RESULTS We found a significant enrichment of SHOX microduplications in the NDD cases (p=0.00036; OR 2.21) and, particularly, in those with ASD (p=9.18×10(-7); OR 3.63) compared with 12 594 population-based controls. SHOX duplications affecting the upstream or downstream enhancers were enriched only in females with NDD (p=0.0043; OR 2.69/p=0.00020; OR 7.20), but not in males (p=0.404; OR 1.38/p=0.096; OR 2.21). CONCLUSIONS Microduplications at the SHOX locus are a low penetrance risk factor for ASD/NDD, with increased risk in both sexes. However, a concomitant duplication of SHOX enhancers may be required to trigger a NDD in females. Since specific SHOX isoforms are exclusively expressed in the developing foetal brain, this may reflect the pathogenic effect of altered SHOX protein dosage on neurodevelopment.
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Affiliation(s)
- Maria Tropeano
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Arcavacata di Rende, CS, Italy
| | - Deirdre Howley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew J Gazzellone
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - C Ellie Wilson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK Individual Differences, Language and Cognition Lab, Department of Developmental and Educational Psychology, University of Seville, Seville, Spain
| | - Joo Wook Ahn
- Department of Cytogenetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Dimitri J Stavropoulos
- Genome Diagnostics, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Clodagh M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK
| | - Peggy S Eis
- Population Diagnostics, Inc., Melville, New York, USA
| | - Eli Hatchwell
- Population Diagnostics, Inc., Melville, New York, USA
| | - Richard J B Dobson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dene Robertson
- Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK
| | - Muriel Holder
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Melita Irving
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Dragana Josifova
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Annelise Nehammer
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mina Ryten
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Debbie Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark Pitts
- Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK
| | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Philip Asherson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah Curran
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Evangelos Vassos
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gerome Breen
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Frances Flinter
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - David A Collier
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Discovery Neuroscience Research, Eli Lilly and Company Ltd, Erl Wood Manor, Windlesham, Surrey, UK
| | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Molecular Genetics, McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada
| | - Grainne M McAlonan
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Adult Autism Spectrum and ADHD Services, Behavioural and Developmental Psychiatry, Clinical Academic Group, King's Health Partners, London, UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Kiiski HSM, Ní Riada S, Lalor EC, Gonçalves NR, Nolan H, Whelan R, Lonergan R, Kelly S, O'Brien MC, Kinsella K, Bramham J, Burke T, Ó Donnchadha S, Hutchinson M, Tubridy N, Reilly RB. Delayed P100-Like Latencies in Multiple Sclerosis: A Preliminary Investigation Using Visual Evoked Spread Spectrum Analysis. PLoS One 2016; 11:e0146084. [PMID: 26726800 PMCID: PMC4699709 DOI: 10.1371/journal.pone.0146084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 12/11/2015] [Indexed: 01/21/2023] Open
Abstract
Conduction along the optic nerve is often slowed in multiple sclerosis (MS). This is typically assessed by measuring the latency of the P100 component of the Visual Evoked Potential (VEP) using electroencephalography. The Visual Evoked Spread Spectrum Analysis (VESPA) method, which involves modulating the contrast of a continuous visual stimulus over time, can produce a visually evoked response analogous to the P100 but with a higher signal-to-noise ratio and potentially higher sensitivity to individual differences in comparison to the VEP. The main objective of the study was to conduct a preliminary investigation into the utility of the VESPA method for probing and monitoring visual dysfunction in multiple sclerosis. The latencies and amplitudes of the P100-like VESPA component were compared between healthy controls and multiple sclerosis patients, and multiple sclerosis subgroups. The P100-like VESPA component activations were examined at baseline and over a 3-year period. The study included 43 multiple sclerosis patients (23 relapsing-remitting MS, 20 secondary-progressive MS) and 42 healthy controls who completed the VESPA at baseline. The follow-up sessions were conducted 12 months after baseline with 24 MS patients (15 relapsing-remitting MS, 9 secondary-progressive MS) and 23 controls, and again at 24 months post-baseline with 19 MS patients (13 relapsing-remitting MS, 6 secondary-progressive MS) and 14 controls. The results showed P100-like VESPA latencies to be delayed in multiple sclerosis compared to healthy controls over the 24-month period. Secondary-progressive MS patients had most pronounced delay in P100-like VESPA latency relative to relapsing-remitting MS and controls. There were no longitudinal P100-like VESPA response differences. These findings suggest that the VESPA method is a reproducible electrophysiological method that may have potential utility in the assessment of visual dysfunction in multiple sclerosis.
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Affiliation(s)
- Hanni S. M. Kiiski
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
- * E-mail:
| | - Sinéad Ní Riada
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Edmund C. Lalor
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Nuno R. Gonçalves
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Hugh Nolan
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, UCD College of Human Sciences, University College Dublin, Dublin, Ireland
| | - Róisín Lonergan
- Department of Neurology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Siobhán Kelly
- Department of Neurology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Marie Claire O'Brien
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, UCD College of Human Sciences, University College Dublin, Dublin, Ireland
| | - Katie Kinsella
- Department of Neurology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Jessica Bramham
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, UCD College of Human Sciences, University College Dublin, Dublin, Ireland
| | - Teresa Burke
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, UCD College of Human Sciences, University College Dublin, Dublin, Ireland
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Seán Ó Donnchadha
- Cognitive and Behavioural Neuroscience Research Group, School of Psychology, UCD College of Human Sciences, University College Dublin, Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Niall Tubridy
- Department of Neurology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Richard B. Reilly
- Neural Engineering Group, Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
- School of Engineering, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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31
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Coyle C, Bramham J, Dundon N, Moynihan M, Carr A. Exploring the Positive Impact of Peers on Adolescent Substance Misuse. Journal of Child & Adolescent Substance Abuse 2015. [DOI: 10.1080/1067828x.2014.896761] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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O'Malley GK, McHugh L, Mac Giollabhui N, Bramham J. Characterizing adult attention-deficit/hyperactivity-disorder and comorbid borderline personality disorder: ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors. Eur Psychiatry 2015; 31:29-36. [PMID: 26657598 DOI: 10.1016/j.eurpsy.2015.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/22/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To characterize adults with comorbid attention-deficit/hyperactivity-disorder (ADHD) and borderline personality disorder (BPD) with regard to ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors. METHOD A between-group design compared a group of individuals diagnosed with ADHD (n=40) with a group diagnosed with BPD and who also met the criteria for ADHD (ADHD+BPD) (n=20). RESULTS Significant differences were observed for both childhood and current impulsivity symptoms, whereby ADHD+BPD exhibited increased impulsivity; no differences on self-report and cognitive measures of impulsivity were reported. The ADHD+BPD group scored significantly higher on measures of depression, anxiety and numerous other axis I and II conditions. The ADHD+BPD group scored significantly lower on most measures of intellectual functioning and attention, however largely not on those relating to response inhibition. Furthermore, group differences were observed for psychosocial factors, including education, substance use and criminal record. CONCLUSION Comorbid ADHD and BPD is characterized by more symptoms of impulsivity, additional psychopathology, comparatively lower intellectual and attentional functioning and increased psychosocial difficulties.
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Affiliation(s)
- G K O'Malley
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - L McHugh
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - N Mac Giollabhui
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - J Bramham
- School of Psychology, University College Dublin (UCD), Dublin, Ireland.
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Grogan K, Bramham J. Demographic, developmental and psychosocial predictors of the development of anxiety in adults with ADHD. ACTA ACUST UNITED AC 2015; 8:35-44. [PMID: 26487156 DOI: 10.1007/s12402-015-0183-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 03/02/2015] [Accepted: 09/10/2015] [Indexed: 10/22/2022]
Abstract
The purpose of this research was to investigate potential demographic, developmental and psychosocial predictors of anxiety in the context of ADHD. Participants included 267 adults with a diagnosis of ADHD (168 males:99 females) and an age range of 18-70 years (M = 31 years; SD = 10.03 years). A background interview, parent questionnaire and rating scales were used to gather participant information. Correlations, independent t tests and one-way analysis of variances were used to identify variables associated with anxiety, and a stepwise multiple regression was used to identify potential predictors of anxiety. Variables associated with anxiety included childhood aggression, employment status, difficulties making friends, number of children and caffeine intake. Childhood aggression and caffeine intake were the potential predictors. Clinicians should be aware of these potential predictors of anxiety in the context of ADHD in order to minimise the likelihood of the development or maintenance of comorbid anxiety. Future research is needed in order to draw any conclusions on cause and effect.
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Affiliation(s)
- Katie Grogan
- UCD School of Psychology, Newman Building, University College Dublin, Dublin 4, Ireland.
| | - Jessica Bramham
- UCD School of Psychology, Newman Building, University College Dublin, Dublin 4, Ireland
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Belfort T, Bramham J, Simões Neto JP, Sousa MFBD, Santos RLD, Nogueira MML, Torres B, Rosa RDLD, Dourado MCN. Cross-cultural adaptation of the Social and Emotional Questionnaire on Dementia for the Brazilian population. SAO PAULO MED J 2015; 133:358-66. [PMID: 26517147 PMCID: PMC10876360 DOI: 10.1590/1516-3180.2014.00180501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 10/29/2014] [Accepted: 01/05/2015] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Impairments in social and emotional functioning may affect the communication skills and interpersonal relationships of people with dementia and their caregivers. This study had the aim of presenting the steps involved in the cross-cultural adaptation of the Social and Emotional Questionnaire (SEQ) for the Brazilian population. DESIGN AND SETTING Cross-cultural adaptation study, conducted at the Center for Alzheimer's Disease and Related Disorders in a public university. METHODS The process adopted in this study required six consecutive steps: initial translation, translation synthesis, back translation, committee of judges, pretesting of final version and submission to the original author. RESULTS In general, the items had semantic, idiomatic, conceptual and experiential equivalence. During the first pretest, people with dementia and their caregivers had difficulties in understanding some items relating to social skills, which were interpreted ambiguously. New changes were made to allow better adjustment to the target population and, following this, a new pretest was performed. This pre-test showed that the changes were relevant and gave rise to the final version of the instrument. There was no correlation between education level and performance in the questionnaire, among people with dementia (P = 0.951). CONCLUSION The Brazilian Portuguese version of the Social and Emotional Questionnaire was well understood and, despite the cultural and linguistic differences, the constructs of the original version were maintained.
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Affiliation(s)
- Tatiana Belfort
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jessica Bramham
- Clinical Neuropsychology, School of Psychology, University College Dublin, Dublin, Ireland
| | - José Pedro Simões Neto
- Department of Sociology and Political Science, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Maria Fernanda Barroso de Sousa
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel Luiza dos Santos
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcela Moreira Lima Nogueira
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Torres
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rachel Dias Lopes da Rosa
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Cristina Nascimento Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Moran A, Bramham J, Collet C, Guillot A, MacIntyre TE. Motor imagery in clinical disorders: importance and implications. Front Psychiatry 2015; 6:23. [PMID: 25762942 PMCID: PMC4332162 DOI: 10.3389/fpsyt.2015.00023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 02/04/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- Aidan Moran
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Christian Collet
- Centre de Recherche et d’Innovation sur le Sport, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Aymeric Guillot
- Centre de Recherche et d’Innovation sur le Sport, Université Claude Bernard Lyon 1, Villeurbanne, France
- Institut Universitaire de France, Paris, France
| | - Tadhg Eoghan MacIntyre
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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Salomone S, Fleming GR, Shanahan JM, Castorina M, Bramham J, O'Connell RG, Robertson IH. The effects of a Self-Alert Training (SAT) program in adults with ADHD. Front Hum Neurosci 2015; 9:45. [PMID: 25713523 PMCID: PMC4322720 DOI: 10.3389/fnhum.2015.00045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/17/2015] [Indexed: 11/13/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD), a neuropsychiatric condition characterized by attention and impulsivity problems, is one of the most common behavioral disorders. The first line of treatment for ADHD is psychostimulant medication, but this has limited effectiveness, particularly in adults, and is often associated with adverse side-effects. Thus, it is imperative that new non-pharmaceutical approaches to treatment are developed. This study aims to evaluate the impact of a non-pharmacological Self-Alert Training (SAT) intervention on ADHD symptom prevalence, psychological and cognitive functioning, and on everyday functional impairment in adults with ADHD. Fifty-one adult participants with a current diagnosis of ADHD were randomized to either SAT or a Control Training (CT) program. They were assessed at baseline, immediately following the 5-week training period, and after 3-months using ADHD symptoms scales, as well as a series of neuropsychological tests and psychological questionnaires. Subjective ratings of everyday life attention and memory problems were also collected. The SAT group showed significant improvements in ADHD inattentive and impulsive symptoms, depressive symptoms and in self-efficacy ratings compared to the CT group at both post-training and at the 3-month assessment. Pre-post improvements in SAT participants on untrained cognitive tasks measuring selective attention and executive functions were also observed. Finally, the SAT group reported improved subjective ratings of everyday life attention at both assessment points. This pattern of results suggests that SAT may be beneficial in treating ADHD symptoms as well as psychological and cognitive impairments in adult ADHD. A large-scale randomized controlled trial (RCT) is needed.
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Affiliation(s)
- Simona Salomone
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland
| | - Grainne R Fleming
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland
| | - Jacqueline M Shanahan
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland
| | - Marco Castorina
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland
| | - Jessica Bramham
- St. Patrick's University Hospital Dublin, Ireland ; School of Psychology, University College Dublin Dublin, Ireland
| | - Redmond G O'Connell
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland ; School of Psychology, Trinity College Dublin Dublin, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin Dublin, Ireland ; School of Psychology, Trinity College Dublin Dublin, Ireland
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Ortiz N, Parsons A, Whelan R, Brennan K, Agan MLF, O'Connell R, Bramham J, Garavan H. Decreased frontal, striatal and cerebellar activation in adults with ADHD during an adaptive delay discounting task. Acta Neurobiol Exp (Wars) 2015; 75:326-38. [PMID: 26581388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An important characteristic of childhood attention-deficit/hyperactivity disorder (ADHD) is a bias towards small immediate versus larger delayed rewards, but it is not known if this symptom is also a feature of adult ADHD. A delay-discounting task was administered to participants with adult ADHD and a comparison group in conjunction with functional magnetic resonance imaging. Participants responded to a series of questions that required judgments between small sums of money available immediately and larger sums obtained after a temporal delay. Question parameters were adjusted by an adaptive algorithm designed to converge on each participant's discounting indifference point, an individual set point at which there is equal valuation of both choices. In all participants, robust task activation was observed in regions previously identified in functional imaging studies of delay discounting. However, adults with ADHD showed less task activation in a number of regions including the dorsolateral prefrontal cortex, superior frontal gyrus, anterior cingulate, caudate nucleus and declive of the cerebellum. Additionally, the degree to which a participant discounted delayed rewards was inversely related to task activation in the cerebellum. The results suggest that the bias towards immediate rewards in childhood ADHD may not persist behaviorally, but instead present in adulthood as alterations in frontostriatal and frontocerebellar networks.
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Affiliation(s)
- Nick Ortiz
- University of Vermont, Department of Psychiatry, Burlington, USA,
| | - Aisling Parsons
- University College Dublin School of Psychology, Dublin, Ireland
| | - Robert Whelan
- University College Dublin School of Psychology, Dublin, Ireland
| | - Katie Brennan
- University of Vermont, Department of Psychiatry, Burlington, USA
| | - Maria L F Agan
- University College Dublin School of Psychology, Dublin, Ireland
| | - Redmond O'Connell
- Trinity College Dublin, Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Jessica Bramham
- University College Dublin School of Psychology, Dublin, Ireland
| | - Hugh Garavan
- University of Vermont, Department of Psychiatry, Burlington, USA
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Abstract
INTRODUCTION People with anorexia nervosa (AN) are known to have difficulties with social and emotional functioning, as indicated by their symptom presentation and also performance on tests of emotion perception. This study explores the level of empathy in AN, in terms of resonant experience of emotion in other people using a self-report measure. METHODS Twenty-eight women with acute AN were compared to 25 women who have recovered from AN, and a further 54 healthy control (HC) participants. They were assessed using a questionnaire to measure reported levels of empathy, emotional recognition, social conformity, and antisocial behaviour. RESULTS The acute AN group reported lower levels of empathy than the recovered AN group and HC, but they also reported less antisocial behaviour. No differences were found in emotional recognition or social conformity. CONCLUSIONS These results suggest that emotional empathy is reduced during acute AN. Lower levels of antisocial behaviour may reflect a contrasting desire of people with AN to minimise presentation of antisocial behaviour in the acute state.
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Affiliation(s)
- Robin Morris
- a Department of Psychology , Institute of Psychiatry, King's College London , London , UK
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39
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Lennon A, Bramham J, Carroll À, McElligott J, Carton S, Waldron B, Fortune D, Burke T, Fitzhenry M, Benson C. A qualitative exploration of how individuals reconstruct their sense of self following acquired brain injury in comparison with spinal cord injury. Brain Inj 2013; 28:27-37. [DOI: 10.3109/02699052.2013.848378] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Johnston K, Dittner A, Bramham J, Murphy C, Knight A, Russell A. Attention deficit hyperactivity disorder symptoms in adults with autism spectrum disorders. Autism Res 2013; 6:225-36. [PMID: 23788522 DOI: 10.1002/aur.1283] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [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: 03/19/2012] [Accepted: 01/21/2013] [Indexed: 11/06/2022]
Abstract
Features of attention deficit hyperactivity disorder (ADHD) and impairments on neuropsychological, tests of attention have been documented in children with autism spectrum disorders (ASDs). To date, there has been a lack of research comparing attention in adults with ASD and adults with ADHD. In study 1, 31 adults with ASD and average intellectual function completed self-report measures of ADHD symptoms. These were compared with self-report measures of ADHD symptoms in 38 adults with ADHD and 29 general population controls. In study 2, 28 adults with a diagnosis of ASD were compared with an age- and intelligence quotient-matched sample of 28 adults with ADHD across a range of measures of attention. Study 1 showed that 36.7% of adults with ASD met Diagnostic and Statistical Manual-IV criteria for current ADHD "caseness" (Barkley Current self-report scores questionnaire). Those with a diagnosis of pervasive developmental disorder-not otherwise specified were most likely to describe ADHD symptoms. The ASD group differed significantly from both the ADHD and control groups on total and individual symptom self-report scores. On neuropsychological testing, adults with ASD and ADHD showed comparable performance on tests of selective attention. Significant group differences were seen on measures of attentional switching; adults with ADHD were significantly faster and more inaccurate, and individuals with Asperger's syndrome showed a significantly slower and more accurate response style. Self-reported rates of ADHD among adults with ASD are significantly higher than in the general adult population and may be underdiagnosed. Adults with ASD have attentional difficulties on some neuropsychological measures.
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Affiliation(s)
- Kate Johnston
- Kings College London, Institute of Psychiatry/South London and Maudsley NHS Foundation Trust, Forensic Psychology Service, National and Specialist Child and Adolescent Mental Health Service, Michael Rutter Centre, De Crespigny Park, London, UK.
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41
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Ó Donnchadha S, Burke T, Bramham J, O'Brien MC, Whelan R, Reilly R, Kiiski H, Lonergan R, Kinsella K, Kelly S, McGuigan C, Hutchinson M, Tubridy N. Symptom overlap in anxiety and multiple sclerosis. Mult Scler 2013; 19:1349-54. [PMID: 23413298 DOI: 10.1177/1352458513476742] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The validity of self-rated anxiety inventories in people with multiple sclerosis (pwMS) is unclear. However, the appropriateness of self-reported depression scales has been widely examined. Given somatic symptom overlap between depression and MS, research emphasises caution when using such scales. OBJECTIVE This study evaluates symptom overlap between anxiety and MS in a group of 33 individuals with MS, using the Beck Anxiety Inventory (BAI). METHODS Participants underwent a neurological examination and completed the BAI. RESULTS A novel procedure using hierarchical cluster analysis revealed three distinct symptom clusters. Cluster one ('wobbliness' and 'unsteady') grouped separately from all other BAI items. These symptoms are well-recognised MS-related symptoms and we question whether their endorsement in pwMS can be considered to reflect anxiety. A modified 19-item BAI (mBAI) was created which excludes cluster one items. This removal reduced the number of MS participants considered 'anxious' by 21.21% (low threshold) and altered the level of anxiety severity for a further 27.27%. CONCLUSION Based on these data, it is suggested that, as with depression measures, researchers and clinicians should exercise caution when using brief screening measures for anxiety in pwMS.
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Bramham J, Murphy DGM, Xenitidis K, Asherson P, Hopkin G, Young S. Adults with attention deficit hyperactivity disorder: an investigation of age-related differences in behavioural symptoms, neuropsychological function and co-morbidity. Psychol Med 2012; 42:2225-2234. [PMID: 22369977 DOI: 10.1017/s0033291712000219] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The outcomes of attention deficit hyperactivity disorder (ADHD) have been studied extensively in the first decades of life, but less is known about ADHD in adulthood. Hence we investigated cross-sectional age-related differences in behavioural symptoms, neuropsychological function and severity of co-morbid disorders within a clinically referred adult ADHD population. METHOD We subdivided 439 referrals of individuals with ADHD (aged 16-50 years) into four groups based on decade of life and matched for childhood ADHD severity. We compared the groups on measures of self- and informant-rated current behavioural ADHD symptoms, neuropsychological performance, and self-rated co-morbid mood and anxiety symptoms. RESULTS There was a significant age-related reduction in the severity of all ADHD symptoms based on informant-ratings. In contrast, according to self-ratings, inattentive symptoms increased with age. Neuropsychological function improved across age groups on measures of selective attention and response inhibition. There was a mild correlation between the severity of depression symptoms and increasing age. CONCLUSIONS This observational study suggests that, in adulthood, ADHD symptoms as measured using informant-ratings and neuropsychological measures continue to improve with increasing age. However the subjective experience of people with ADHD is that their symptoms worsen. This dichotomy may be partially explained by the presence of co-morbid affective symptoms. The main limitation of the study is that it is cross-sectional rather than longitudinal, and the latter design would provide more conclusive evidence regarding age-related changes in an adult ADHD population.
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Affiliation(s)
- J Bramham
- School of Psychology, University College Dublin, Dublin, Republic of Ireland.
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Kiiski H, Reilly RB, Lonergan R, Kelly S, O'Brien MC, Kinsella K, Bramham J, Burke T, Ó Donnchadha S, Nolan H, Hutchinson M, Tubridy N, Whelan R. Only low frequency event-related EEG activity is compromised in multiple sclerosis: insights from an independent component clustering analysis. PLoS One 2012; 7:e45536. [PMID: 23029079 PMCID: PMC3448656 DOI: 10.1371/journal.pone.0045536] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 08/23/2012] [Indexed: 11/24/2022] Open
Abstract
Cognitive impairment (CI), often examined with neuropsychological tests such as the Paced Auditory Serial Addition Test (PASAT), affects approximately 65% of multiple sclerosis (MS) patients. The P3b event-related potential (ERP), evoked when an infrequent target stimulus is presented, indexes cognitive function and is typically compared across subjects' scalp electroencephalography (EEG) data. However, the clustering of independent components (ICs) is superior to scalp-based EEG methods because it can accommodate the spatiotemporal overlap inherent in scalp EEG data. Event-related spectral perturbations (ERSPs; event-related mean power spectral changes) and inter-trial coherence (ITCs; event-related consistency of spectral phase) reveal a more comprehensive overview of EEG activity. Ninety-five subjects (56 MS patients, 39 controls) completed visual and auditory two-stimulus P3b event-related potential tasks and the PASAT. MS patients were also divided into CI and non-CI groups (n = 18 in each) based on PASAT scores. Data were recorded from 128-scalp EEG channels and 4 IC clusters in the visual, and 5 IC clusters in the auditory, modality were identified. In general, MS patients had significantly reduced ERSP theta power versus controls, and a similar pattern was observed for CI vs. non-CI MS patients. The ITC measures were also significantly different in the theta band for some clusters. The finding that MS patients had reduced P3b task-related theta power in both modalities is a reflection of compromised connectivity, likely due to demyelination, that may have disrupted early processes essential to P3b generation, such as orientating and signal detection. However, for posterior sources, MS patients had a greater decrease in alpha power, normally associated with enhanced cognitive function, which may reflect a compensatory mechanism in response to the compromised early cognitive processing.
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Affiliation(s)
- Hanni Kiiski
- Trinity Centre for Bioengineering, Trinity College Dublin, Ireland
| | | | - Róisín Lonergan
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Siobhán Kelly
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | | | - Katie Kinsella
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Teresa Burke
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Seán Ó Donnchadha
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Hugh Nolan
- Trinity Centre for Bioengineering, Trinity College Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Niall Tubridy
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Robert Whelan
- Trinity Centre for Bioengineering, Trinity College Dublin, Ireland
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
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Salomone S, Shanahan JM, Bramham J, O'Connell RG, Robertson IH. A biofeedback-based programme to improve attention and impulsivity in adults with ADHD. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/03033910.2012.708899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Johnston K, Madden AK, Bramham J, Russell AJ. Response inhibition in adults with autism spectrum disorder compared to attention deficit/hyperactivity disorder. J Autism Dev Disord 2011; 41:903-12. [PMID: 21116700 DOI: 10.1007/s10803-010-1113-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are hypothesised to involve core deficits in executive function. Previous studies have found evidence of a double dissociation between the disorders on specific executive functions (planning and response inhibition). To date most research has been conducted with children. No studies have directly compared the stable cognitive profile of adults. It was hypothesised that adults with ASD would show generally intact response inhibition whereas those with ADHD would show more global impairment. Participants were 24 adults aged 18-55 with high functioning ASD, 24 with ADHD, and 14 age and IQ matched controls. Participants completed three standardised measures of response inhibition. Participants with ASD had generally intact response inhibition but slow response latencies, possibly due to deficits in response initiation. Adults with ADHD did not show the more global impairments hypothesised. There were some significant differences between the clinical groups across measures of inhibition. In terms of performance style, adults with ASD were slow and accurate whilst those with ADHD showed an impulsive style.
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Affiliation(s)
- Kate Johnston
- Kings College London, Institute of Psychiatry/South London & Maudsley NHS Foundation Trust, London, UK.
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46
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Abstract
Social and emotional impairments are frequently reported following acquired brain injury, including an inability to adopt another's perspective, empathize, and display guilt, and inappropriate social conduct. Case studies suggest that these problems are particularly apparent when the injury is sustained in childhood, with deficits increasing with age and persisting throughout adulthood. In addition to these deficits, individuals may have limited insight into their cognitive or social-emotional deficits, which in turn may also affect social functioning and have implications for the success of rehabilitation. Despite the frequency of these problems, there is a dearth of suitable measures for detecting them in children or adolescents. The purpose of the current study was to develop one such measure from a measure initially intended for adults. Normative data were collected from 109 typically-developing 11- to 14-year-olds and their parent/guardian on the Social-Emotional Questionnaire for Children (SEQ-C). Factor and reliability analyses were conducted and the subscales were then explored in association with key demographic information. Social-emotional development showed a fluctuating course across early adolescence, alongside some gender differences. This measure, with its normative data, will be of value to neuropsychologists wishing to explore such functioning in their clinical practice.
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Kiiski H, Reilly R, Lonergan R, Kelly S, O'Brien M, Kinsella K, Bramham J, Burke T, O'Donnchadha S, Nolan H, Hutchinson M, Tubridy N, Whelan R. Change in PASAT performance correlates with change in P3 ERP amplitude over a 12-month period in multiple sclerosis patients. J Neurol Sci 2011; 305:45-52. [DOI: 10.1016/j.jns.2011.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/28/2011] [Accepted: 03/04/2011] [Indexed: 11/24/2022]
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Lunt L, Bramham J, Morris RG, Bullock PR, Selway RP, Xenitidis K, David AS. Prefrontal cortex dysfunction and 'Jumping to Conclusions': bias or deficit? J Neuropsychol 2011; 6:65-78. [PMID: 22257612 DOI: 10.1111/j.1748-6653.2011.02005.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The 'beads task' is used to measure the cognitive basis of delusions, namely the 'Jumping to Conclusions' (JTC) reasoning bias. However, it is not clear whether the task merely taps executive dysfunction - known to be impaired in patients with schizophrenia - such as planning and resistance to impulse. To study this, 19 individuals with neurosurgical excisions to the prefrontal cortex, 21 unmedicated adults with Attention Deficit Hyperactivity Disorder (ADHD), and 25 healthy controls completed two conditions of the beads task, in addition to tests of memory and executive function as well as control tests of probabilistic reasoning ability. The results indicated that the prefrontal lobe group (in particular, those with left-sided lesions) demonstrated a JTC bias relative to the ADHD and control groups. Further exploratory analyses indicated that JTC on the beads task was associated with poorer performance in certain executive domains. The results are discussed in terms of the executive demands of the beads task and possible implications for the model of psychotic delusions based on the JTC bias.
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Affiliation(s)
- Laura Lunt
- Department of Psychology, Institute of Psychiatry, King's College London, UK.
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Bramham J, Morris RG, Hornak J, Bullock P, Polkey CE. Social and emotional functioning following bilateral and unilateral neurosurgical prefrontal cortex lesions. J Neuropsychol 2011; 3:125-43. [DOI: 10.1348/174866408x293994] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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50
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Xenitidis K, Paliokosta E, Rose E, Maltezos S, Bramham J. ADHD symptom presentation and trajectory in adults with borderline and mild intellectual disability. J Intellect Disabil Res 2010; 54:668-677. [PMID: 20412369 DOI: 10.1111/j.1365-2788.2010.01270.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND This study examined symptoms and lifetime course of Attention Deficit Hyperactivity Disorder (ADHD) in adults with borderline and mild Intellectual Disability (ID). METHOD A total of 48 adults with ID and ADHD were compared with 221 adults with ADHD without ID using the informant Barkley scale for childhood and adulthood symptoms. RESULTS The ADHD/ID group presented with greater severity of (adult and childhood) symptoms compared with the non-ID group. For the ADHD/non-ID group, most symptoms improved significantly from childhood to adulthood, whereas only two symptoms changed significantly for the ID group. Principal component analysis revealed scattered loading of different items into five components for the ADHD/ID group that were not consistent with the classic clusters of inattentive, hyperactive and impulsive symptoms. A negative correlation was found between severity of symptoms and IQ. CONCLUSIONS ADHD in adults with ID may have a more severe presentation and an uneven and less favourable pattern of improvement across the lifespan in comparison with adults without ID.
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Affiliation(s)
- K Xenitidis
- South London and The Department of Maudsley Foundation Trust, Adult ADHD Service, London, UK
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