RESUMEN
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario. AIM: The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children. METHODOLOGY: The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done. RESULTS: The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children. CONCLUSION: Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.
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Trastorno por Déficit de Atención con Hiperactividad , Madres , Humanos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estudios Transversales , Femenino , Niño , India/epidemiología , Madres/psicología , Prevalencia , Adulto , Masculino , Preescolar , Salud Bucal , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricosRESUMEN
BACKGROUND: Recent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD. METHODS: The study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups. DISCUSSION: This study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release. TRIAL REGISTRATION: ClinicalTrials.gov NCT06080373. Registered on October 12, 2023.
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Trastorno por Déficit de Atención con Hiperactividad , Terapia Cognitivo-Conductual , Estudios Multicéntricos como Asunto , Prisioneros , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Terapia Cognitivo-Conductual/métodos , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/psicología , Prisioneros/psicología , Adulto , Resultado del Tratamiento , Reincidencia , Listas de Espera , Factores de Tiempo , Masculino , Calidad de VidaRESUMEN
OBJECTIVE: ADHD is subject to stigma from the general population. Exposure to stigma poses the risk of developing self-stigma of youth and parents, but few studies have focused on self-stigma of ADHD. Furthermore, parental factors have been implicated in self-stigma of youth, but no previous research has assessed the association between self-stigma of parents and youth. Therefore, the objective of this study was to better understand the experience of self-stigma of youth and their parents in the context of ADHD. METHOD: Fifty-five youth with ADHD (aged 8-17) and one parent reporter per youth completed surveys to report their experiences. RESULTS: The results of this study found that both youth and parents reported significantly lower self-stigma scores compared to most previously published research. Parents of boys reported higher self-stigma scores compared to parents of girls. Youth who reported higher self-stigma also reported lower self-esteem. Self-stigma scores in youth were predicted by inattentive symptoms but not hyperactive/impulsive symptoms or parental self-stigma. CONCLUSION: Results emphasize the importance of understanding self-stigma of ADHD, symptom severity, and the need for interventions for families with ADHD.
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Trastorno por Déficit de Atención con Hiperactividad , Padres , Autoimagen , Estigma Social , Humanos , Trastorno por Déficit de Atención con Hiperactividad/psicología , Masculino , Femenino , Adolescente , Padres/psicología , Niño , Canadá , Encuestas y CuestionariosRESUMEN
BACKGROUND: Opioid use disorder (OUD) poses a global health challenge, and despite medications for opioid use disorder (MOUD) and psychosocial interventions, relapse remains a significant concern. Comorbid psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), are one of the major factors associated with poor OUD treatment outcome. We aimed to estimate the frequency of probable ADHD (in childhood and in adulthood) in patients with OUD; to assess the factors associated with this comorbidity; and to explore the factors that mediate the relationship between ADHD and OUD treatment outcome. METHODS: We conducted an observational study using a sample of 229 patients aged 18 years and older who were diagnosed with OUD and had received MOUD for at least six months. Participants were assessed through a structured interview and self-report questionnaires. Multivariate logistic regressions and a mediation analysis were performed. RESULTS: Almost half of the participants reported probable ADHD in childhood, and ADHD persisted into adulthood among two-thirds of the patients. The factors associated with poor OUD treatment outcome included earlier onset of OUD, lower education, and greater impulsivity. There was no direct effect of probable ADHD in childhood on OUD treatment outcome, but there was an indirect effect through negative urgency, the tendency to respond impulsively to negatively connoted emotional experiences. CONCLUSIONS: The findings suggest that ADHD symptoms, particularly impulsivity, may contribute to vulnerability in opioid use and play a crucial role in treatment outcomes for this population. TRIAL REGISTRATION: ClinicalTrials identifier NCT01847729.
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Trastorno por Déficit de Atención con Hiperactividad , Conducta Impulsiva , Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides , Humanos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Masculino , Femenino , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/tratamiento farmacológico , Trastornos Relacionados con Opioides/psicología , Adulto , Francia/epidemiología , Resultado del Tratamiento , Prevalencia , Persona de Mediana Edad , Adulto Joven , Comorbilidad , Adolescente , Analgésicos Opioides/uso terapéuticoRESUMEN
BACKGROUND: Mental health settings are increasingly using co-facilitation of educational group interventions in collaboration with patient partners and service users. However, despite promising results, limited information is available regarding the feasibility and satisfaction levels of these programmes among adults newly diagnosed with attention-deficit hyperactivity/impulsivity disorder (ADHD). Hence, this study aimed to determine the feasibility, acceptability, and preliminary effects of a user co-facilitated psychoeducational group programme for adults diagnosed with ADHD. METHODS: This feasibility proof-of-concept randomised controlled trial recruited outpatients from a Norwegian community mental health centre. Outpatients randomised to the intervention group (IG) received a psychoeducational programme supplementing Treatment As Usual (TAU), while the control group received TAU. Feasibility was determined by the acceptance rate, adherence rate, and dropout rate. Acceptability was measured with the Client Satisfaction Questionnaire and a 3-item scale measuring satisfaction with the received information. To test the preliminary effects, self-efficacy, symptom severity, and quality of life were measured at baseline and pre- and post-intervention. RESULTS: Feasibility was demonstrated; most of the patients were willing to enrol, participants attended 82% of the psychoeducational programme, and only 13% dropped out of the study. The between-group analyses revealed that the IG reported significantly greater mean satisfaction than the CG. Moreover, the intervention group was more satisfied with the information they received during the psychoeducational programme. Concerning the preliminary effects, the linear mixed model showed improvement in quality of life (the subscale relationship); however, other patient-reported outcomes did not show improvements. CONCLUSIONS: This proof-of-concept randomised controlled trial supports the feasibility and acceptability of the user co-facilitated psychoeducational programme for patients newly diagnosed with ADHD in an outpatient setting. While preliminary findings indicate promise in enhancing patient-reported outcomes, a larger study is warranted to assess the intervention's effectiveness rigorously. TRIAL REGISTRATION: NCT03425, 09/11/2017.
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Trastorno por Déficit de Atención con Hiperactividad , Estudios de Factibilidad , Satisfacción del Paciente , Prueba de Estudio Conceptual , Humanos , Femenino , Masculino , Adulto , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/psicología , Educación del Paciente como Asunto/métodos , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Calidad de Vida/psicología , Autoeficacia , Noruega , Psicoterapia de Grupo/métodosRESUMEN
BACKGROUND: Sex differences in the symptomatology of adults with attention-deficit/hyperactivity disorder (ADHD) have often been overlooked when studying behavioral abnormalities. However, it is known that women exhibit considerably more stronger symptoms related to emotional competence than men. Since affective functions significantly influence the processing of risky decision-making and risk-engagement, we assume that risky behavior in ADHD is affected by sex differences. Therefore, we specifically investigated sex-specific effects on the interaction between emotionally induced changes in physiology and behavioral performance on a decision-making task. METHODS: Skin conductance responses of twenty-nine adults with ADHD (n = 16 male; n = 13 female) and thirty-three adults in the control group (n = 14 male; n = 19 female) were recorded during the performance in a modified version of the Balloon Analogue Risk Task (BART). Additional questionnaires were used to reveal insights in the self-assessment of emotional competence, risk perception, and feedback sensitivity. Emotional arousal and decision-making behavior were analyzed using linear mixed-effects models. RESULTS: Results showed different effects of sex on risk behaviors in controls and ADHD. In contrast to healthy controls, female adults with ADHD showed a significantly greater risk engagement in the BART compared to males with ADHD. This contrary sex relation was not observed in skin conductance responses and revealed a significantly different sex-dependent correlation of body response and behavioral task performance in ADHD. Comparisons with results from self-assessments furthermore indicate a reduced behavioral self-perception in women with ADHD, but not in men. CONCLUSION: In summary, we found an altered interaction between physiological activity and risky behavior in women with ADHD. Thus, the present study indicates a reduced sensitivity towards the own bodily responses in women with ADHD, which could consequently cause increased risky DM behavior in daily life. The current results suggest that more consideration needs to be given to sex-specific effects on physiological processes and behavior in adults with ADHD.
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Trastorno por Déficit de Atención con Hiperactividad , Toma de Decisiones , Respuesta Galvánica de la Piel , Asunción de Riesgos , Humanos , Femenino , Masculino , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Adulto , Toma de Decisiones/fisiología , Respuesta Galvánica de la Piel/fisiología , Factores Sexuales , Emociones/fisiología , Adulto Joven , Caracteres SexualesRESUMEN
OBJECTIVE: Working memory training for Attention-Deficit/Hyperactivity Disorder (ADHD) has focused on increasing working memory capacity, with inconclusive evidence for its effectiveness. Alternative training targets are executive working memory (EWM) processes that promote flexibility or bolster stability of working memory contents to guide behavior via selective attention. This randomized, placebo-controlled study was designed to assess feasibility, tolerability, and behavioral target engagement of a novel EWM training for ADHD. METHOD: 62 ADHD-diagnosed adolescents (12-18 years) were randomized to EWM training or placebo arms for 20 remotely coached sessions conducted over 4-5 weeks. Primary outcome measures were behavioral changes on EWM tasks. Secondary outcomes were intervention tolerability, trial retention, and responsiveness to adaptive training difficulty manipulations. RESULTS: Linear regression analyses found intervention participants showed medium effect size improvements, many of which were statistically significant, on Shifting and Filtering EWM task accuracy and Shifting and Updating reaction time measures. Intervention participants maintained strong self-rated motivation, mood, and engagement and progressed through the adaptive difficulty measures, which was further reflected in high trial retention. CONCLUSIONS: The results suggest that these EWM processes show promise as training targets for ADHD. The subsequent NIMH R33-funded extension clinical trial will seek to replicate and extend these findings.
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Trastorno por Déficit de Atención con Hiperactividad , Función Ejecutiva , Estudios de Factibilidad , Memoria a Corto Plazo , Humanos , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/psicología , Adolescente , Masculino , Femenino , Función Ejecutiva/fisiología , Niño , Resultado del Tratamiento , Terapia Cognitivo-Conductual/métodos , Entrenamiento CognitivoRESUMEN
Comorbidity between attention-deficit/hyperactivity disorder (ADHD) and gaming disorder (GD) is widely recognized in the literature. Previous research has indicated gender-dependent underlying mechanisms in the development and maintenance of problematic gaming. Motivational research presents an opportunity to provide further insight regarding the nature of this association. Self-report data were collected from videogame players (N = 14,740) using an online survey in collaboration with a popular gaming magazine. The survey included items concerning symptoms of ADHD and GD, motives for gaming, and time spent playing videogames. Structural equation modeling was used to create two parallel mediation models (one for males, one for females), including motives to play games as mediators. This was done to potentially explain psychological drivers of the association between ADHD and GD. Results demonstrated a common pathway from inattention to GD symptom severity through the immersion/escapism motivation for both males (ß = 0.068; p < 0.001) and females (ß = 0.081; p < 0.05), while the paths from inattention to GD symptom severity through the habit/boredom motive (ß = 0.094; p < 0.001) and competition motive (ß = 0.021; p < 0.001) were only significant for males. Gamers experiencing symptoms of ADHD, especially inattentive symptoms, are at risk of the occurrence of GD symptoms through videogames becoming a source of maladaptive coping with daily psychological disturbances. Males experiencing inattentive symptoms tend to additionally develop problematic patterns of use through videogame playing, becoming a subjectively meaningless and boredom-reduction-oriented habitual activity or a platform of virtual competition. Unique differences suggest the necessity of different treatment approaches for males and females.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno de Adicción a Internet , Motivación , Juegos de Video , Humanos , Masculino , Trastorno por Déficit de Atención con Hiperactividad/psicología , Femenino , Juegos de Video/psicología , Trastorno de Adicción a Internet/psicología , Trastorno de Adicción a Internet/epidemiología , Factores Sexuales , Adulto , Adulto Joven , Adolescente , Tedio , Encuestas y Cuestionarios , ComorbilidadRESUMEN
BACKGROUND: Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems. METHODS: This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle. RESULTS: Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: ß = 2.01, P < 0.001; high-deprivation: ß = 1.03, P < 0.001; high-unpredictability: ß = 0.83, P = 0.001; high-overall adversity: ß = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys. LIMITATIONS: The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data. CONCLUSIONS: This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.
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Experiencias Adversas de la Infancia , Estilo de Vida , Humanos , Masculino , Femenino , Estudios Longitudinales , Experiencias Adversas de la Infancia/estadística & datos numéricos , Estilo de Vida Saludable , Adolescente , Niño , Depresión/epidemiología , Depresión/psicología , Salud Mental , Ejercicio Físico/psicología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Adulto , Factores de RiesgoRESUMEN
Children with attention-deficit hyperactivity disorder (ADHD) have difficulties in social interactions. Studying brain activity during social interactions is difficult with conventional artificial stimuli. This pioneering study examined the neural correlates of social perception in children with ADHD and matched controls using naturalistic stimuli. We presented 20 children with ADHD and 20 age-and-sex-matched controls with tailored movies featuring high- or low-level social interactions while recording electroencephalographic signals. Both groups exhibited synchronized gamma-band oscillations, but controls demonstrated greater inter-subject correlations. Additionally, the difference in inter-subject correlations between high- and low-interaction movies was significantly larger in controls compared to ADHD patients. Between 55 and 75 Hz comparing viewing high interaction movies with low interaction moves, controls had a significantly larger weighting in the right parietal lobe, while ADHD patients had a significantly smaller weighting in the left occipital lobe. These findings reveal distinct spatiotemporal neural signatures in social interaction processing among children with ADHD and controls using naturalistic stimuli. These neural markers offer potential for group differentiation and assessing intervention efficacy, advancing our understanding ADHD-related social interaction mechanisms.
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Trastorno por Déficit de Atención con Hiperactividad , Electroencefalografía , Interacción Social , Humanos , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Masculino , Niño , Femenino , Biomarcadores , Ritmo Gamma/fisiología , Estudios de Casos y Controles , Encéfalo/fisiopatología , AdolescenteRESUMEN
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies. METHODS: A total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M). RESULTS: 64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI "positive attitude" subscale (B = -0.438, p = 0.024) (R = 0.496, R2 = 0.246, F(2,66) = 10.747, p < 0.001). LIMITATION: While considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed. CONCLUSION: Affective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.
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Adaptación Psicológica , Trastorno por Déficit de Atención con Hiperactividad , Comorbilidad , Trastorno Ciclotímico , Depresión , Temperamento , Humanos , Masculino , Femenino , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Adulto , Trastorno Ciclotímico/psicología , Trastorno Ciclotímico/epidemiología , Depresión/epidemiología , Depresión/psicología , Estudios Retrospectivos , Escalas de Valoración Psiquiátrica , Persona de Mediana Edad , Adulto Joven , Habilidades de AfrontamientoRESUMEN
Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.
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Ácido Glutámico , Conducta Impulsiva , Humanos , Conducta Impulsiva/fisiología , Animales , Ácido Glutámico/metabolismo , Encéfalo/metabolismo , Trastorno por Déficit de Atención con Hiperactividad/metabolismo , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicologíaRESUMEN
BACKGROUND: Exposure to fathers' positive parenting has been associated reducing mental disorder symptoms during adolescence, evidence on the mechanisms underlying this association is lacking. One potential mechanism linking fathers' positive parenting and mental disorders is environmental sensitivity (ES). Here we studied whether the increased positive behaviors of both parents (1) separately, (2) relatively, (3) and jointly predict reduced depression, attention deficit hyperactivity disorder (ADHD) symptoms, suicidal ideation (SI), and increased well-being in Chinese adolescents. Additionally we investigated (4) whether ES moderates these relationships. METHODS: This study involving 7010 Chinese adolescents (55.6 % girls) aged 15 to 18 from six junior high schools in Shaanxi, China was conducted at four timepoints. ES was assessed using the Highly Sensitive Child (HSC) scale at ages 15 and 16, parental positive behaviors using the Parental Bonding Instrument (PBI) at ages 16 and 17, and psychopathology symptoms using the 9-item Patient Health Questionnaire (PHQ-9), Strengths and Difficulties Questionnaire (SDQ), and Positive and Negative Suicide Ideation (PANSI) Inventory at ages 17 and 18. RESULTS: (1) Multilevel analyses revealed that increased positive parenting predicted reduced psychiatric disorder symptoms and improved well-being; (2) trend interaction indicated that the compensatory effect of fathers' positive parenting was stronger in alleviating mental problems in adolescents than that of mothers'; (3) Simple slope analyses suggested that both high levels of fathers' and mothers' positive parenting predicted fewer subsequent psychiatric disorder symptoms, particularly for sensitive adolescents. LIMITATIONS: This study was limited to its generalizability to the Western Chinese adolescents. CONCLUSIONS: Substantial differences in the effects of positive paternal and maternal parenting highlight the important role of fathers' positive parenting in mental development, especially for highly sensitive adolescents.
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Relaciones Padre-Hijo , Padre , Responsabilidad Parental , Ideación Suicida , Humanos , Masculino , Responsabilidad Parental/psicología , Adolescente , Femenino , China , Padre/psicología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estudios Longitudinales , Depresión/psicología , Trastornos Mentales/psicología , Pueblos del Este de AsiaRESUMEN
OBJECTIVE: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD: This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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Trastorno por Déficit de Atención con Hiperactividad , Déficit de la Atención y Trastornos de Conducta Disruptiva , Función Ejecutiva , Humanos , Niño , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Masculino , Femenino , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/psicología , Comorbilidad , Trastorno de Oposición DesafianteRESUMEN
OBJECTIVES: This study aimed to explore the perspectives of people with attention deficit hyperactivity disorder (ADHD), their supporters and primary care professionals (PCPs), on the wider physical and mental health needs of people with ADHD and the support currently available. DESIGN: Qualitative semi-structured interviews, analysed using reflexive thematic analysis. SETTING: Five general practice surgeries across England. PARTICIPANTS: Participants with lived experience (people with ADHD and their supporters (n=11)) and PCPs (n=9) (eg, general practitioners and practice managers), recruited via clinical academic networks and previous work packages of this study. RESULTS: We generated three major themes in relation to ADHD, using reflexive thematic analysis: understanding health, barriers to health and addressing health. Within these, participants reflected on mental and physical health challenges, as well as wider social difficulties and variability in support offered/accessed. CONCLUSIONS: This study highlights that health problems in ADHD are complex and rooted both in individual factors (eg, mental health) and social factors (eg, support). This study also highlights the differences in expectations and fulfilment of healthcare.
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Trastorno por Déficit de Atención con Hiperactividad , Investigación Cualitativa , Humanos , Trastorno por Déficit de Atención con Hiperactividad/psicología , Femenino , Masculino , Inglaterra , Adulto , Atención Primaria de Salud , Persona de Mediana Edad , Entrevistas como Asunto , Necesidades y Demandas de Servicios de Salud , Salud Mental , Adulto Joven , Accesibilidad a los Servicios de Salud , Adolescente , Medicina General , Actitud del Personal de SaludRESUMEN
PURPOSE: Patient-reported experiences are a key source of information on quality in mental health care. Most patient experience surveys are limited to assessments from adults, including those conducted by parents or proxies on behalf of others. The aim of this study was to produce findings to inform development of modules on patient and parent experiences with medication in outpatient CAMHS in Norway, for use in previously validated instruments applied in national surveys. PATIENTS AND METHODS: We developed survey questions based on a systematic literature review, expert-group consultations, interviews with adolescents and parents, and pretesting of the modules in a pilot study. This study included adolescents aged 12-17 years and parents with experiences from outpatient CAMHS and we present findings from semi-structured interviews. RESULTS: Adolescents with ADHD emphasized the following aspects as important concerning medication use in CAMHS: positive effects of medication like better function and concentration in school and change of behaviour. They also stressed the importance of side effects such as eating problems, nausea, loss of appetite, insomnia, and changes in thoughts and feelings. In addition, adolescents highlighted the significance of aspects as support in daily routines for taking medications, while parents highlighted needs for a professional follow-up care. Parents emphasized aspects regarding their children's medication included both positive effects and change in behaviour, as well as their identification of negative side effects. CONCLUSION: Our findings from semi-structured interviews identified important aspects reported by both patients and parents on functions, side effects and follow-up care related to medication. The results indicated that both groups emphasized corresponding aspects of what was important regarding medication. However, when it came to follow-up care, the two groups highlighted distinct aspects, indicating differing priorities or concerns in this area.
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Servicios de Salud Mental , Padres , Investigación Cualitativa , Humanos , Adolescente , Masculino , Niño , Femenino , Padres/psicología , Noruega , Servicios de Salud del Adolescente , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Servicios de Salud del Niño , Proyectos Piloto , AdultoRESUMEN
BACKGROUND: Adolescents with attention-deficit / hyperactivity disorder (ADHD) have an increased risk of self-harm. The risk of self-harm among adolescents who display an elevated level of ADHD symptoms, but without a formal diagnosis, is not well-studied and understood. OBJECTIVE: To investigate the relationship between self-reported symptoms of ADHD and self-harm in a population-based sample of adolescents. METHODS: Adolescents in the population-based youth@hordaland study were invited to complete the Adult ADHD Self-Report Scale (ASRS) and the Short Mood and Feelings Questionnaire (SMFQ). They were asked whether they ever deliberately have taken an overdose or tried to harm themselves on purpose, once or multiple times, defined according to the code used in the Child and Adolescent Self-harm in Europe (CASE) Study. Adolescents reporting severe problems on ≥ four of six selected items on the ASRS-v 1.1 screener were defined as ADHD-screen positive (ADHD-SC+), and the remaining sample as ADHD-screen negative (ADHD-SC-). SMFQ score ≥ 12 was used to define a high level of depressive symptoms. RESULTS: A total of 9692 adolescents (mean age 17.4 years, 53.1% females) participated in the study, of which 2390 (24.7%) screened positive on the ASRS. ADHD-SC+ adolescents engaged in self-harm more often than the ADHD-SC- group (14.6% vs. 5.4%, OR = 3.02, 95%CI [2.57-3.24]). This remained significant after adjustment for demographic variables, SMFQ score ≥ 12, symptoms of conduct disorder and familial history of self-harm and suicide attempts (OR = 1.58, 95%CI [1.31-1.89]). They were also more likely to report an overdose as their method of self-harm (OR = 1.52, 95%CI [1.05-2.23]). Within the ADHD-SC+ group female sex, high levels of inattention and hyperactivity/impulsivity symptoms, SMFQ score ≥ 12, symptoms indicating conduct disorder and familial history of self-harm and suicide attempts increased the likelihood of engaging in deliberate self-harm. CONCLUSION: Adolescents who screened positive for ADHD had increased risk of engaging in self-harm. Clinicians should consider the increased risk of such engagement in adolescents who present with high level of ADHD symptoms, even in the absence of a clinical ADHD diagnosis.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Conducta Autodestructiva , Humanos , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Adolescente , Femenino , Conducta Autodestructiva/psicología , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/diagnóstico , Masculino , Encuestas y Cuestionarios , Autoinforme , Escalas de Valoración PsiquiátricaRESUMEN
BACKGROUND: Young people and adults with ADHD are at risk of a range of physical health problems. There is limited guidance on how to approach health problems in ADHD, and especially around 16-25 year olds who will be transitioning from paediatric to adult care. The aim of this scoping review was to identify psychosocial interventions that target physical health in young people and adults with ADHD. METHODS: We constructed searches in MEDLINE, PsycInfo, EMBASE of adolescents, young people and adults. Inclusion criteria were; studies of psychosocial interventions examining a component of physical health, applicable to people aged 16-25, with clinical or research diagnoses of ADHD. Data were extracted using a data extraction tool and tabulated, including study intervention framing/aims, population, intervention, and relevant outcomes (including specific statistics where relevant). RESULTS: Our search identified 22 unique papers covering, psychosocial interventions targeting at least one of sleep (n=7), smoking (n=3), substance/alcohol use (n=4), physical health/exercise (n=6) and general health (n=3). Studies examined psychotherapy/behaviour interventions (n=12), psychoeducation (n=4), digital (n=2) and social interventions (n=4). There was significant heterogeneity in intervention framing, outcome measures and population. CONCLUSION: Further work on the impact of targeted physical health interventions, with explicit reference to a conceptual framework of poor health in ADHD is required. Furthermore, future work standardising reporting of physical health outcomes in ADHD is crucial for the development of an evidence base in this field.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Intervención Psicosocial , Humanos , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/psicología , Adolescente , Adulto , Intervención Psicosocial/métodos , Adulto Joven , Estado de SaludRESUMEN
BACKGROUND: The current study examined whether coping strategies and symptoms of Adjustment Disorder in adults with ADHD differed from what was observed in the general adult population during the Covid-19 pandemic, and compared the extent to which coping strategies and symptom levels of Adjustment Disorder were related to ADHD. METHOD: This cross-sectional study was based on survey data collected during the spring of 2021 from 231 adult ADHD patients in specialist care and 1148 volunteers without ADHD in Sweden. The survey included questions about sociodemographic and clinical characteristics, along with the Brief-COPE and Adjustment Disorder-New Module 8 questionnaires. Regression models adjusting for sociodemographic and clinical characteristics were used for between-group comparisons of coping strategies and symptoms of Adjustment Disorder. RESULTS: There were some notable differences in the use of coping strategies between persons with and without ADHD; however, many of these differences were not observed in the adjusted models. The use of behavioral disengagement was more frequently observed among individuals with ADHD, whereas planning was more common among individuals without ADHD. Individuals with ADHD appeared to show higher symptom levels of Adjustment Disorder during the pandemic. Passive coping strategies, such as denial, self-blame, and behavioral disengagement, were associated with higher symptom levels of adjustment disorder in both individuals with and without ADHD. CONCLUSION: In conclusion, the results highlight that persons with ADHD may need more support to adjust to large societal changes than the general public. Potential targets for intervention towards members of this group include reducing resignation and maladaptive coping strategies.
Asunto(s)
Trastornos de Adaptación , Trastorno por Déficit de Atención con Hiperactividad , COVID-19 , Habilidades de Afrontamiento , Adulto , Humanos , Trastornos de Adaptación/psicología , Trastornos de Adaptación/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , COVID-19/psicología , COVID-19/epidemiología , Estudios Transversales , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios , Suecia/epidemiologíaRESUMEN
Hyperfocus (HF), or intense, deep concentration on a task, has gained significant research attention in recent years, particularly in regard to clinical populations such as Attention-Deficit/Hyperactivity Disorder (ADHD). The present work aims to provide validation of the 12-item dispositional adult hyperfocus questionnaire (AHQ-D) as a quantitative metric of HF in adults. We preregistered the study design and hypotheses. We administered the AHQ-D and several additional questionnaires to 347 adults (mean ± SD age: 33 ± 11 years; 47% female). Exploratory factor analysis revealed high factor loadings (0.57-0.81) on a single HF factor; item response theory analysis suggested that the questionnaire items had high discrimination and covered a wide range of responses; and we report strong internal consistency metrics (Cronbach's alpha 0.93, mean split-half reliability 0.93). Replicating our previous work, HF was positively correlated with Conners' Adult ADHD Rating Scale (CAARS) scores (r(345) = 0.53), suggesting that HF may be related to ADHD traits (though in this sample we did not specifically recruit individuals with ADHD). The AHQ-D demonstrated the hypothesized convergent validity; HF on the AHQ-D was positively correlated with HF measured using a different HF scale (r(344) = 0.69), as well as flow (r(345) = 0.12) and mind wandering (r(345) = 0.39) scores. AHQ-D HF scores showed a weak negative correlation with grit (r(345) = - 0.29). Though there was a weak negative correlation between HF and social desirability response tendency (r(345) = - 0.24), suggesting that those who care more about what others think may report less HF, there was no relationship between HF and extrasensory perception beliefs (r(345) = 0.01), suggesting that participants were not simply biased in their response tendencies. Taken together, we demonstrate strong scale metrics for the AHQ-D, the expected convergent validity, and a general lack of response bias, in addition to replicating our previous association of HF with ADHD traits. We suggest that the AHQ-D can be confidently used in future work as a valid way to measure HF in adults.