Time Simulator in Virtual Reality for Children with Attention Deficit Hyperactivity Disorder

Objective Attention deficit hyperactivity disorder (ADHD) is linked to time perception deficits, with theories such as Scalar Expectancy Theory (SET) and Dynamic Attending Theory (DAT) offering different explanations. SET suggests time perception relies on a pacemaker-counter system influenced by working memory, whereas DAT highlights the role of attention in modulating time perception. This study examines the impact of attention, working memory, and motor response on time perception in children with ADHD. Method This study included 94 children (47 with ADHD, 47 typically developing), aged 7–12, matched by age and gender. Participants completed computerized tasks assessing time perception (Time Wall), sustained attention (CPT), selective attention and reaction time (Go/No-Go), and working memory (Corsi Block). ADHD diagnoses followed Diagnostic and Statistical Manual of Mental Disorders-V-Text Revision (DSM-5-TR) criteria. Data were analyzed using independent t-tests and linear regression models. Results Children with ADHD demonstrated significantly greater time perception inaccuracy than controls. Regression analyses revealed that in the ADHD group, selective attention, and reaction times in sustained and selective attention significantly predicted time perception deficits. In contrast, only age predicted inaccuracy in the control group. These findings underscore the unique cognitive mechanisms contributing to time perception deficits in ADHD. Conclusion Time perception deficits in children with ADHD appear to be primarily influenced by selective attention and motor response speed, rather than sustained attention or working memory. These findings support DAT, highlighting the importance of attention and reaction time in ADHD-related time perception deficits. Interventions targeting these factors may be essential for improving timing accuracy in ADHD children.

Attention deficit hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder that can affect many areas of the daily life of individuals and is associated with poor health outcomes and with debilitating deficits in executive function. Recently, increasing numbers of research studies have begun to investigate the associations between neural and behavioral manifestations of ADHD. This review summarizes recent research on the perception of time in ADHD and proposes that this symptom is a possible diagnostic characteristic. Controlled studies on time perception have compared individuals with ADHD with typically developing controls (TDCs) and have used methods that include the Zimbardo Time Perspective Inventory (ZTPI). Practical approaches to time perception and its evaluation have shown that individuals with ADHD have difficulties in time estimation and discrimination activities as well as having the feeling that time is passing by without them being able to complete tasks accurately and well. Although ADHD has been associated with neurologic abnormalities in the mesolimbic and dopaminergic systems, recent studies have found that when individuals with ADHD are treated medically, their perception of time tends to normalize. The relationship between ADHD and the perception of time requires greater attention. Further studies on time perception in ADHD with other abnormalities, including executive function, might be approaches that refine the classification and diagnosis of ADHD and should include studies on its varied presentation in different age groups.

Children with attention deficit hyperactivity disorder (ADHD) are often reported to have deficits of time perception. However, there is a strong relation between performance on tasks of working memory and time perception. Thus, it is possible that the poor performance of children with ADHD on time perception results from their deficit of working memory. In this study, the working memory of participants was separately assessed; therefore, we could explore the relationship between working memory and time perception of children with ADHD. Fifty-six children with ADHD and those of healthy controls completed tasks measuring working memory and time perception. The results showed that the time discrimination ability of children with ADHD was poorer than that of controls. However, there was a strong association between time perception and working memory. After controlling working memory and intelligence, the time discrimination ability of children with ADHD was not significantly poorer than that of controls. We suggest that there is an interdependent relationship between time perception and working memory for children with ADHD.

From Behavior to Cognition to the Brain and Back: What Have We Learned From Functional Imaging Studies of Attention Deficit Hyperactivity Disorder?

To examine time perception in children with attention deficit hyperactivity disorder (ADHD) and evaluate the effectiveness of Pantogam in relation to the main symptoms of the disease and the disorder of time perception. 86 children with ADHD aged 10-13 years were observed. The study group included 56 children with a combined type of ADHD (ADHD-C) and 30 children with a predominance of inattention without hyperactivity (ADD). The control group consisted of 30 children aged 10 to 13 years without psychoneurological disorders. The following research methods were used in the work: the SNAP-IY questionnaire for a quantitative assessment of ADHD manifestations, the «Working Memory» method for assessing working memory, tasks for assessing and measuring time intervals, and a study using the «subjective minute» method to assess time perception disorders. Pantogam was used in a dose of 750 mg per day for 8 weeks to treat children with ADHD. According to the SNAP-IY scale, the level of inattention in the study groups was significantly higher than the level of inattention in the control group, and the level of hyperactivity and impulsivity was significantly higher in children with ADHD-C compared to the ADHD group and the control group. When assessing working memory, a reliable decrease in the level of this indicator was found in children with both types of ADHD compared to the control group. Difficulties with time management, as assessed by parents, were noted in 88.4% of children in the study group and 36.7% of children in the control group. These disorders were especially pronounced in tasks requiring sustained attention (96.4% of children with ADHD-C and 73.3% of children with ADD). According to the results of tests for time perception, disturbances in time perception were revealed in both groups of children with ADHD. In ADHD-C, tachychrony was more pronounced, and for patients with ADD, it was typical to overestimate the elapsed time. When re-evaluating the condition of 56 children with ADHD-C after the end of the course of treatment with Pantogam, an improvement in the form of a reliable decrease in inattention and impulsivity, an improvement in working memory was recorded in 55.4% of cases. During a repeated study after the course of treatment, an improvement in time perception was also recorded. Children with ADHD, in addition to the main symptoms (inattention, hyperactivity, impulsivity), significantly more often have pronounced problems with time management, and the normalizing effect of drugs for the treatment of ADHD is manifested not only in relation to the main symptoms of the disease, but also in relation to the normalization of time perception.

Time perception differences in children with and without ADHD

Time perception differences in children with and without ADHD*1

Previous studies have found heterogeneous association between DAT1-3'-UTR-VNTR and attention deficit hyperactivity disorder (ADHD). Various proportions of conduct disorder (CD) comorbidity in their ADHD samples may partially explain the observational discrepancies. Evidence for this comes from family and twin studies which found ADHD probands with CD (ADHD + CD) are genetically different from those without CD (ADHD - CD). Genotypes of 20 DAT1 markers were analyzed in 576 trios, consisting of 141 ADHD + CD and 435 ADHD - CD. In addition to the classical TDT test, a specific genetic heterogeneity test was performed to identify variants that have different transmission patterns in the two phenotypic subgroups. After multiple-test correction, rs40184 and rs2652511 were significant in TDT tests. Further heterogeneity test found the two SNPs had a significant transmission pattern difference between ADHD + CD and ADHD - CD children, indicating that DAT1 has a significantly greater genetic influence on ADHD without CD. Although the result needs further replications, it does highlight the importance of selecting genetically homogeneous samples for molecular genetic analyses of ADHD.

Children evaluated for attention deficit hyperactivity disorder (ADHD) may have other disorders resembling ADHD leading to inappropriate stimulant medication use. This study was completed to identify relationships between referral complaints of ADHD, behavior problems or learning problems and age, gender, final diagnosis, and medication use. One hundred eighty-nine children ages 2 to 15 years referred for evaluation of ADHD, behavior or learning problems were evaluated by an interdisciplinary team. Diagnoses of ADHD, specific learning disability (SLD), mental retardation (MR), developmental language disorders (LANG), and other behavior disorders (DIS) were established. Medication use pre- and post-evaluation was reviewed. Forty-three percent of all subjects had a final diagnosis of ADHD. Forty percent referred specifically for presumed ADHD did not have it. More children older than 5 years were diagnosed as having ADHD than those 5 years old or younger (p < 0.0001). More subjects 5 years old or younger were diagnosed as having LANG than those older than 5 years (p < 0.0001). Fewer subjects with a chief complaint of ADHD were diagnosed with MR than those with behavior or learning problems (p = 0.001). In subjects 5 years old or younger, 35% were diagnosed with MR and 49% with other DIS. In children older than 5 years, 41% were diagnosed with SLD. Ten percent of subjects without ADHD were using stimulants. Only 48% of subjects with confirmed ADHD took stimulants. Children presenting with behavior problems or those 5 years old or younger are at higher risk for MR, LANG, and DIS and less likely to have ADHD. Children presenting with learning problems or those older than 5 years are more likely to have SLD or ADHD. Multiple diagnoses were common for all ages and presentations. Ten percent of children without confirmed ADHD used stimulants before evaluation.

Transcranial random noise stimulation shifts time reproduction in opposite directions for ADHD and TD individuals.

This cross-sectional study sought to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder among adults admitted to 2 chemical dependency treatment centers. It was hypothesized that ADHD alone or in combination with conduct disorder would be overrepresented in a population of patients with psychoactive substance use disorders. Two hundred one participants were selected randomly from 2 chemical dependency treatment centers. Standardized clinical interviews were conducted using the Structured Clinical Interview for DSM-IV, the Addiction Severity Index, and DSM-IV criteria for ADHD. Reliabilities for the diagnostic categories were established using the Cohen kappa, and the subgroups of individuals with and without ADHD and conduct disorder were compared. Forty-eight (24%) of the participants were found to meet DSM-IV criteria for ADHD. The prevalence of ADHD was 28% in men (30/106) and 19% in women (18/95; NS). Seventy-nine participants (39%) met criteria for conduct disorder, and 34 of these individuals also had ADHD. Overall, individuals with ADHD (compared with those without ADHD) were more likely to have had more motor vehicle accidents. Women with ADHD (in comparison with women without ADHD) had a higher number of treatments for alcohol abuse. Individuals with conduct disorder (in comparison with those without conduct disorder) were younger, had a greater number of jobs as adults, and were more likely to repeat a grade in school, have a learning disability, be suspended or expelled from school, have an earlier age at onset of alcohol dependence, and have had a greater number of treatments for drug abuse. They were more likely to have a lifetime history of abuse of and/or dependence on cocaine, stimulants, hallucinogens, and/or cannabis. A significant overrepresentation of ADHD exists among inpatients with psychoactive substance use disorders. Over two thirds of those with ADHD in this sample also met criteria for conduct disorder. Our sample had a very large overlap between ADHD and conduct disorder, and the major comorbidities identified here were attributable largely to the presence of conduct disorder. Individuals who manifest conduct disorder and/or ADHD represent a significant proportion of those seeking treatment for psychoactive substance use disorders. They appear to have greater comorbidity and may benefit from a treatment approach that addresses these comorbidities specifically through medical and behavioral therapies.

Virtual Reality Is No Game in Psychiatric Treatment

Digital health interventions (DHI) using virtual reality (VR) technologies have been developed to treat attention deficit hyperactivity disorder (ADHD). While previous studies have mainly evaluated the feasibility of VR as an ADHD intervention, there is a dearth of research examining the decision-making psychology and influencing factors among parents of ADHD patients regarding the adoption of such emerging VR intervention techniques, which carry inherent risks. Building on the principles of Prospect Theory, this study highlights preference structures, belief characteristics, and community participation. The study selected 23 explanatory variables, including parents’ comprehension of VR treatment, level of trust, information sources, time and financial costs. A self-designed questionnaire was used to collect data on the willingness of parents of ADHD children to opt for VR treatment. By constructing a binary logistic regression model, we examine the preference structure, belief characteristics and decision readiness of parents of children with ADHD when choosing a virtual reality intervention policy. Parents’ choices of VR interventions for their children are complex. While parents consider the therapeutic benefits of VR, the time investment required for children’s treatment, and knowledge on VR interventions from online communities, their decisions are not always made objectively like an agent would. Instead, they frequently make choices based on a willingness to take risks, placing greater emphasis on relative rather than absolute values. Their decision-making is often swayed by online community information, resulting in choices that may not optimize benefits and sometimes disregarding financial and time costs related to their children’s health. Overall, parents of children with ADHD have demonstrated acceptance of the innovative VR intervention technique. Through examining the factors that impact preference selection, the implementation and promotion of VR intervention in ADHD treatments can be facilitated, thereby advancing the development of Digital Health Interventions (DHI). This can provide valuable insights for developing effective ADHD intervention strategies.

Children's Beliefs About Causes of Childhood Depression and ADHD: A Study of Stigmatization

Studies of attention deficit hyperactivity disorder (ADHD) have reliably found reduced amplitude event-related potentials (ERPs) measuring attention-related brain function, indicating impairment in the brain's ability to automatically orient attention to odd or novel environmental stimuli and to represent that information in working memory. However, the relationship between abnormal neurocognition and dysfunction in specific brain regions in ADHD remains unclear. The authors used functional magnetic resonance imaging (fMRI) to identify brain regions with abnormal hemodynamic activity during processing of target and novelty oddball stimuli that engage attention. Forty-six boys 11-18 years of age participated in the study, including 23 diagnosed as having ADHD with hyperactivity and impulsivity (combined type) and 23 demographically matched control subjects. Event-related fMRI data were collected while participants performed a three-stimulus auditory oddball task. Hemodynamic activity was compared between ADHD participants and control subjects in brain regions previously linked to P3 ERPs. Participants with ADHD showed deficits in brain activity elicited by infrequent attentionally engaging stimuli in regions associated with attentional orienting and working-memory cognitive processes. These deficits co-occurred with highly variable and slow task performance. This study links ADHD attentional orienting and working-memory deficits to dysfunction in specific cortical brain regions. The results indicate that ADHD pathophysiology impairs brain systems that are important for allocating attention and using cognitive representations to guide cognition and behavior. Attention-related neural dysfunction is thus an important factor to consider in neurobiological theories of ADHD.