Screening For ADHD Research Articles

Prevalence and Epidemiological Characteristics of ADHD in Pre-School and School Age Children in the Province of Tarragona, Spain

Objective: To report the ADHD estimated prevalence in Spain, considering differences in sex, age, presentation, and severity. Method: This study has a two-phase design and forms part of the Neurodevelopmental Disorders Epidemiological Research Project (EPINED). The ADHD screening was conducted through parent (N = 3,727) and teacher (N = 6,894). To perform ADHD diagnosis (DSM-5), screen positive and a subsample of the screen negative children and their parents were assessed using neuropsychological tests and a semi-structured psychiatric interview. Results: The ADHD overall estimate prevalence was 5.5% (7.7% in school-age children; 3.0% in pre-schoolers) and 3.5% for subclinical conditions. The combined presentation and mild severity were the most common, while 18.2% were highly impaired. Previous diagnoses were found in 12% of pre-schoolers and 41% school-aged. Conclusion: The prevalence found in Spain is higher than other European reports. The low ratio of prior-diagnoses indicates a need to provide resources for assessment in school and clinical settings.

C.02.03 Managing ADHD and comorbid substance use disorders

A large and growing body of literature supports the association between cocaine addiction and impulsivity. The aim of the study was to test whether pretreatment screening for adult ADHD, and self-report and behavioral measures of impulsivity have prognostic utility in clinical practice with cocaine users. We enrolled a cohort of N = 86 treatment-seeking cocaine users, assisted by a public addiction service, in a 24 week study. At baseline, we performed screening for adult ADHD, assessed the presence of co-occurring mental disorders, and applied measures of drug use severity, trait-like impulsivity (Barratt Impulsiveness Scale; BIS-11), decision-making (Iowa Gambling Task; IGT), risk-taking (Balloon Analogue Risk Task; BART), and ability to inhibit cognitive interference (Stroop Color Word Test; SCWT). Patients positive to the screening for ADHD showed a higher level of self-reported impulsivity and a longer history of drug use, but did not differ from those without ADHD in adherence to psychosocial treatments and number of negative urines for cocaine during the 24 weeks. Among all of the self-report and behavioral measures used, only IGT BIS-11 was associated with cocaine abstention. The small effect size and the problematic direction of the associations found do not give strong support to the routine use of self-regulation measures to guide clinical decisions in public addiction treatment settings.

ADHD Screening Tool: Investigating the effectiveness of a tablet-based game with machine learning

ADHD Screening Tool: Investigating the effectiveness of a tablet-based game with machine learning

High Yield of Screening for ADHD in the Epilepsy Monitoring Unit

Objective: ADHD is common in patients with epilepsy, but adult patients with possible epilepsy are not routinely screened for ADHD. We aimed to characterize the results of two validated screening tools in the setting of an Epilepsy Monitoring Unit (EMU). Method: This study utilized the validated Adult ADHD Self-Report Scale version 1.1 (ASRS) and Conners Continuous Performance Test, third edition (CPT-III) to screen patients who were admitted to the EMU at a Level 4 epilepsy center. Patients with epileptic seizures (ES) were compared with patients with psychogenic nonepileptic seizures (PNES). Results: In all, 40.6% of patients screened positive using the ASRS. A significantly greater proportion of patients with PNES (63.6%) screened positive compared with patients with ES (27.8%, Fisher’s exact test, p = .005). Positive ASRS screens showed no significant association with positive CPT screens (chi-square test, p = .146). Conclusion: Adult patients admitted to the EMU are at a high risk of comorbid attention deficits.

Prevalence of ADHD in Accident Victims: Results of the PRADA Study.

Background: Recent research has shown an increased risk of accidents and injuries in ADHD patients, which could potentially be reduced by stimulant treatment. Therefore, the first aim of our study was to evaluate the prevalence of adult ADHD in a trauma surgery population. The second aim was to investigate accident mechanisms and circumstances which could be specific to ADHD patients, in comparison to the general population. Methods: We screened 905 accident victims for ADHD using the ASRS 18-item self-report questionnaire. The basic demographic data and circumstances of the accidents were also assessed. Results: Prevalence of adult ADHD was found to be 6.18% in our trauma surgery patient sample. ADHD accident victims reported significantly higher rates of distraction, stress and overconfidence in comparison to non-ADHD accident victims. Overconfidence and being in thoughts as causal mechanisms for the accidents remained significantly higher in ADHD patients after correction for multiple comparison. ADHD patients additionally reported a history of multiple accidents. Conclusion: The majority of ADHD patients in our sample had not previously been diagnosed and were therefore not receiving treatment. The results subsequently suggest that general ADHD screening in trauma surgery patients may be useful in preventing further accidents in ADHD patients. Furthermore, psychoeducation regarding specific causal accident mechanisms could be implemented in ADHD therapy to decrease accident incidence rate.

Construction and validation of an ADHD screening tool for preschool children: A study with Spanish population

Most cases of ADHD occur in children under five, and this situation calls for screening tools with high sensitivity and specificity for early age. This study presents the ADHD-3P, a new screening tool developed with Spanish population for preschool children. From an initial pool of 151 items, face validity analyses, followed by item analyses and analysis of the scale, were carried out. A 27-item scale (? = .95) composed of three factors: hyperactivity (? = .92), inattention (? = .92), and other symptoms (? = .81) resulted from the analyses. Discriminant power was high (89.7% for ADHD, and 88.3% for non-ADHD). Diagnostic performance was evaluated through Receiver-Operating Characteristic curves, and excellent sensitivity (92.86%) and specificity (89.86%) were obtained. In sum, the ADHD-3Pis a promising tool to be used by parents, teachers, and pediatricians.

Feasibility, Implementation and Outcomes of Tablet-Based Two-Step Screening for Adult ADHD in Primary Care Practice

Background: Primary care clinicians need to recognize and diagnose Adult ADHD (AADHD). We tested the feasibility and outcomes of a two-step screening process for AADHD in primary care. Methods: Seven practices screened patients using computerized surveys. Patients screening positive completed the AADHD Quality of Life (AAQoL). We explored the impact of screening on workflow and the acceptability to patients, and identified key barriers/opportunities to continuing screening. Results: Of the 711 participating adults, 188 (26.4%) screened positive, of which 32 (17.0%) had scores at least one standard deviation below means on two or more domains on the AAQoL (average 23.6 ± 7.3). These 32 individuals represented 4.5% of all participants. Clinicians were willing to screen, diagnose, and treat AADHD, but need additional resources. The screening process and technology was acceptable to patients and staff. Conclusions: A two-step screening method shows promise for routine screening for AADHD.

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Use of Concerta for mood symptoms of DMDD with comorbid ADHD Screening children with abdominal pain for anxiety The lack of adjustment problems for children with same-sex parents

Robot-Assisted ADHD Screening in Diagnostic Process

This paper presents a novel approach to screening children with ADHD, one of the most prevalent childhood disorders. We have designed the robot-assisted, game-like test that directly reflects children’s behavior on measuring ADHD symptoms. Using the sensors in the robot system, most of the children’s behavior is automatically measured during the entire course of the test. We collected real data by carrying out tests to 326 children from 3rd to 4th grades in the field. A unified frame that classifies multiple categories of ADHD, ADHD-at-Risk and normal has been set up to investigate a wide spectrum of classifiers and their optimal hyper-parameters. The results of the data analysis show highly confident ADHD classification, up to 97% (F1 score). It could be a practical tool for clinicians and special teachers to use in the diagnosis of childhood ADHD.

로봇을 이용한 활동과제 제시에 따른 ADHD 선별 가능성 연구

로봇을 이용한 활동과제 제시에 따른 ADHD 선별 가능성 연구

Evaluation of Psychometric Properties and Factorial Structure of ADHD Module of K-SADS-PL in Children From Rural Kenya

Objective: We determined the reliability of The Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime (K-SADS-PL) for screening and diagnosing ADHD in children. Method: K-SADS-PL was administered to 2,074 children in the community. Psychometric properties, factorial structure, and clinical validity of K-SADS-PL in screening or diagnosis of ADHD were examined. Results: Internal consistency was excellent for items in the screening interview (Macdonald’s Omega [ω] = 0.89; 95% confidence interval [CI] [0.87, 0.94]) and diagnostic supplement (ω = 0.95; 95% CI [0.92, 0.99]). The standardized coefficients for items in the screening interview were acceptable (0.59-0.85), while fit indices for single factorial structure reached acceptable levels. Screening items were associated with high sensitivity (97.8%; 95% CI [97.2, 98.5%]) and specificity (94.0%; 95% CI [93.0, 95.0%]) for diagnosis of ADHD in the supplement. The test-retest and interinformant reliability as measured by intraclass correlation coefficient was good for most of the items. Conclusion: This large study shows that K-SADS-PL can be reliably used to screen and diagnose ADHD in children in Kenya.

AACAP Integrated Care Initiative Aims to Change Culture of Care for Youth

AACAP Integrated Care Initiative Aims to Change Culture of Care for Youth

16p11: Description of the behavioral and morphological phenotype of a “mirror” syndrome

Objective: Copy number variations (CNVs) in the 16p11.2 gene region are translated into different morphological and neurobehavioral phenotypes. The main objective of our study is to describe these differences according to the type of CNV. It is proposed as a secondary objective the design of a protocol of assessment and follow-up for these patients. Methods: Retrospective descriptive study in patients with CNVs in 16p11.2 diagnosed in a Tertiary Hospital using Array-CGH. We collected anthropometric data, dysmorphic features, and performed neuropsychological assessments (ASD, ADHD, intellectual and neurodevelopment screening). Results: A total of 9 patients with 16p11 CNVs were studied. 6 cases with a deletion, being 100% of these de novo; and 3 cases with a duplication, being 67% of the cases inherited. Patients with deletions were overweight / obese and macrocephalus, while patients with duplications present a normal BMI and microcephaly. Clinical manifestations observed in the patients studied included ophthalmological disorders (22%), psychomotor retardation (67%), mild intellectual deficit (56%), autism spectrum disorder (22%) and ADHD (78%). All of the patients that exceed cut point in SNAP -IV in the sample were carriers of a deletion, predominating in them the inattentive subtype ADHD. Conclusion: CNV carriers in the 16p11.2 gene region present mirror anthropometric phenotypes and the most frequently associated conditions were psychomotor development delay, ASD, and ADHD. Inattentive type ADHD is the most commonly observed in patients with deletions, and no significant differences in neuropsychological profile were observed at other levels depending on the type of CNVs. Taking into account the above, it is proposed to carry out an assessment and follow-up protocol that includes a standardized medical history, a comprehensive physical examination including ophthalmologic examination and complementary examinations to rule out intellectual deficit, ASD and ADHD.

Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers

Objective: The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Method: Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale–deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Results: Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems (p = .009, d = 1.03) and a higher number of psychiatric comorbidities (p < .001, d = 1.62) compared with those without ADHD. Substance abuse/dependence constituted a predictor for having a history of ADHD (odds ratio [OR] = 4.07, p = .025). Conclusion: ADHD–PG comorbidity is linked to factors that worsen the prognosis. Thus, screening for ADHD and verifying persistence in adulthood should be an integral component in the interdisciplinary treatment of problem/pathological gamblers.

Reliability and validity of DS-ADHD: A decision support system on attention deficit hyperactivity disorders

Background and objectivesThe purpose of this study is to examine the reliability of the clinical use of the self-built decision support system, diagnosis-supported attention deficit hyperactivity disorder (DS-ADHD), in an effort to develop the DS-ADHD system, by probing into the development of indicating patterns of past screening support systems for ADHD. MethodsThe study collected data based on 107 subjects, who were divided into two groups, non-ADHD and ADHD, based on the doctor's determination, using the DSM-IV diagnostic standards. The two groups then underwent Test of Variables of Attention (TOVA) and DS-ADHD testing. The survey and testing results underwent one-way ANOVA and split-half method statistical analysis, in order to further understand whether there were any differences between the DS-ADHD and the identification tools used in today's clinical trials. ResultsThe results of the study are as follows: 1) The ROC area between the TOVA and the clinical identification rate is 0.787 (95% confidence interval: 0.701–0.872); 2) The ROC area between the DS-ADHD and the clinical identification rate is 0.867 (95% confidence interval: 0.801–0.933). ConclusionsThe study results show that DS-ADHD has the characteristics of screening for ADHD, based on its reliability and validity. It does not display any statistical differences when compared with TOVA systems that are currently on the market. However, the system is more effective and the accuracy rate is better than TOVA. It is a good tool to screen ADHD not only in Chinese children, but also in western country.

Retrospective assessment of childhood ADHD symptoms for diagnosis in adults: validity of a short 8-item version of the Wender-Utah Rating Scale

The Wender-Utah Rating Scale (WURS) is a widely used self-report instrument for retrospective assessment of childhood ADHD. However, many WURS items are not specific to ADHD. Here, we investigated the effect of excluding these items on the performance of the WURS in predicting adult ADHD based on previous diagnosis and current clinically significant symptoms. The study was conducted on a sample of adults (n=1014; 48% male) participating in a family-based investigation of ADHD. Participants completed the 61-item WURS questionnaire and the 66-item Conners Adult ADHD Rating Scale. Receiver operating characteristic (ROC) curves were used to compare the performance of the eight-item WURS (WURS-8) and the longer WURS-25 in predicting previous ADHD diagnosis and current clinically significant ADHD symptoms. WURS-8 and WURS-25 have approximately the same power to predict adult ADHD, based on either previous diagnosis or current symptoms (area under the ROC curves >0.8). WURS-8 performs at least as well as the longer WURS-25 in predicting adult ADHD. This 8-item questionnaire is thus a valid instrument and is especially useful for screening for ADHD in large epidemiological samples.

Diagnostic Utility of the Pediatric Attention Disorders Diagnostic Screener

Objective: The Pediatric Attention Disorders Diagnostic Screener (PADDS) is an evidence-based screener of attention and executive functioning that combines computer-based Target Tests of Executive Function (TTEFs; Target Recognition, Target Sequencing, and Target Tracking) with parent and teacher behavioral reports to efficiently screen children ages 6 to 12 for ADHD. The present study is the first to examine the utility of the TTEFs in predicting ADHD status. Method: The PADDS TTEFs were administered to 76 children (age = 6-12) with ADHD and 76 matched controls. Logistic regression and diagnostic efficiency statistics were used to evaluate the ability of the three TTEFs to predicted ADHD status. Results: All three TTEFs significantly discriminated ADHD participants from controls, but each had a different diagnostic efficiency profile. Classification accuracy was improved when results of all three TTEFs were combined. Conclusion: The PADDS is a promising tool for quickly and reliably screening for ADHD in clinic and school settings.

Association Between Adult Attention Deficit Hyperactivity Disorder and Helmet Use Among Motorcycle Riders

BackgroundUse of helmets plays a major role in preventing injuries or decreasing injury severity among motorcycle riders. Use of helmets may depend on personal factors such as psychological factors.ObjectivesThe aim of this study was to independently assess the association between helmet use among motorcycle riders and ADHD scores, with controlling the accident history and was taken more sensitive measures if helmet use was different between motorcycle riders, according to their ADHD scores.Patients and MethodsA cross-sectional study was done on 205 motorcycle riders referred to Kerman Referral Injury Hospital after a motorcycle traffic accident. Friends and family members possessing motorcycles who visited the patient in this facility were included in our sample. The Persian version of the Conner’s Adult ADHD Rating Scale (CAARS) self-report (screening version) was used in order to screen for adult ADHD. CAARS scores were compared between those who usually used helmets and those who did not.ResultsUnivariable analysis showed the mean of the age variable was significantly higher in the helmeted group, 26.94 ± 7.72 vs. 23.08 ± 7.7.32, (P < 0.001). The majority of the non-helmeted group was single (P < 0.001). Subjects with secondary educational level were more often in the helmeted group (P = 0.007). Daily and weekly driving hours were higher in the non-helmeted group (P = 0.002 and P = 0.004). Most of the subjects in the helmeted group had a driving license in comparison with the other group (P < 0.001). There was not a significant association between SES and having hyperactive children and helmet use (P = 0.159). In all ADHD subscales, a significant association was found and scores were higher in the non-helmeted group (P < 0.05). Nevertheless, multivariable analysis did not confirm the association of the ADHD screening score with helmet use.ConclusionsThe result of this study did not find an independent association between ADHD and helmet use.

ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders

Objective: To estimate the prevalence of ADHD and determine an effective screening test for ADHD in a population-seeking treatment for cannabis use disorders. Method: The Conners Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; CAADID) was used to generate sensitivity and specificity data for ADHD screening tests, which were then administered to 99 participants seeking treatment for cannabis use disorders to estimate ADHD prevalence. Results: The prevalence estimated from the Wender Utah Rating Scale (WURS) was 45% (sensitivity = 0.88, sensitivity of 0.75), from the Conners Adult ADHD Rating Scale (CAARS) 34% (sensitivity = 0.80, specificity = 0.91), from the WURS + CAARS 36% (sensitivity = 0.71, specificity = 0.95), and from the Adult ADHD Self-Report Scale (ASRS) 46% (sensitivity = 0.61, specificity = 0.86). Conclusion: The prevalence of ADHD in adults seeking treatment for cannabis use disorders is estimated to be between 34% and 46%. The WURS paired with the CAARS provides excellent sensitivity and specificity for the diagnosis of ADHD in this population.

Persistence and Subtype Stability of ADHD Among Substance Use Disorder Treatment Seekers

Objective: To examine ADHD symptom persistence and subtype stability among substance use disorder (SUD) treatment seekers. Method: In all, 1,276 adult SUD treatment seekers were assessed for childhood and adult ADHD using Conners’ Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; CAADID). A total of 290 (22.7%) participants met CAADID criteria for childhood ADHD and comprise the current study sample. Results: Childhood ADHD persisted into adulthood in 72.8% (n = 211) of cases. ADHD persistence was significantly associated with a family history of ADHD, and the presence of conduct disorder and antisocial personality disorder. The combined subtype was the most stable into adulthood (78.6%) and this stability was significantly associated with conduct disorder and past treatment of ADHD. Conclusion: ADHD is highly prevalent and persistent among SUD treatment seekers and is associated with the more severe phenotype that is also less likely to remit. Routine screening and follow-up assessment for ADHD is indicated to enhance treatment management and outcomes.