RESUMEN
Background: Previous studies have reported a high prevalence of attention deficit hyperactivity disorder (ADHD) among people living in detention (PLD) corresponding to a five- to ten-fold increase compared to the general population. Our main study objective was to provide an updated ADHD prevalence rate for PLD, including PLD in psychiatric units. Sub-objectives included (i) comparing different ways of assessing ADHD, including DSM-5 criteria and (ii) identifying which types of PLD are more likely to have ADHD. Methods: We conducted a systematic review and meta-analysis following the PRISMA guidelines and the MOOSE checklist. PubMed/Medline, PsycINFO, and Web of Sciences were searched combining "ADHD" and "prison" keywords and synonyms for articles published between January 1, 1966 and January 2, 2018. Potential sources of variation to the meta-analytic ADHD prevalence rate were investigated using meta-regressions and subgroups analyses. Results: The meta-analysis pooled 102 original studies including 69,997 participants. The adult ADHD prevalence rate was 26.2% (95% confidence interval: 22.7-29.6). Retrospective assessments of ADHD in childhood were associated with an increased prevalence estimate (41.1, 95% confidence interval: 34.9-47.2, p < 0.001). There was no significant difference in the prevalence estimate between screenings and clinical interviews in adulthood. Only three studies used the DSM-5 definition of ADHD and results were non-significantly different with other DSM versions. We found no difference according to participants' characteristics. Conclusion: Our results confirmed the high prevalence rate of ADHD among PLD, corresponding to a five-fold increase compared to the general population. In light of such high ADHD prevalence, our results reinforce the importance of addressing this critical public health issue by (i) systematically offering ADHD screening and diagnosis to all individuals entering detention, and (ii) delivering treatment, monitoring, and care for ADHD during and after detention. These strategies may help reduce recidivism and reincarceration, as well as violence in detention settings, in addition to improving the health and wellbeing of people living in detention. Additionally, our study suggests that using screening scales may be a reliable way of assessing ADHD, although caution is needed because a complete evaluation by an experienced clinician is required to provide a formal diagnosis.
RESUMEN
BACKGROUND: Metacognitions about the positive and negative effects of alcohol use have been associated with various patterns of drinking. The aim of the present study was to validate French versions of the Positive Alcohol Metacognitions Scale (PAMS) and the Negative Alcohol Metacognitions Scale (NAMS) developed by Spada and Wells (2008, Addict. Behav. 33, 515) and to investigate the relationship between metacognitions and patterns of alcohol use among university students. METHODS: Responses of 1600 university students who participated in an internet survey-based study on alcohol use were submitted to confirmatory (N=800, mean age 20.40 years, 45.50% male) and exploratory (N=800, mean age 20.34 years, 45.38% male) factor analyses in two separate samples. Alcohol use, binge drinking and mood were also assessed. RESULTS: In line with the original versions of the scales, results provided support for a two-factor structure of the French PAMS and NAMS. Both scales revealed adequate internal reliability. Good temporal stability was found for the two factors of the NAMS, whereas one factor of the PAMS showed weakness across time. Predictive validity revealed that negative alcohol metacognitions about the uncontrollability of alcohol use were found to be consistently associated with alcohol use and binge drinking, whereas positive metacognitions about alcohol use were found to be differentially associated with alcohol use and binge drinking. CONCLUSIONS: The French versions of the PAMS and NAMS exhibited suitable psychometric properties. This study also emphasized the role of metacognitions about alcohol use in drinking behaviour among university students.