Cognitive disengagement syndrome (CDS) is associated with internalizing symptoms, emotion regulation (ER) difficulties, daytime sleepiness, and impulsivity; however, their interrelations in adolescents with subthreshold attention-deficit/hyperactivity disorder (ADHD) remain underexamined. This study aimed to evaluate the relationships between CDS, ADHD symptoms, ER problems, daytime sleepiness, trait impulsivity, and internalizing symptoms and to determine the mediating roles of ER problems and daytime sleepiness. This cross-sectional, clinic-based study included 144 treatment-naïve adolescents (12-18 years) referred for inattention and/or hyperactivity/impulsivity complaints. Parent-reported measures (Conners Parent Rating Scale-Revised-Short Form (CPRS-R-SF); Child and Adolescent Behavior Inventory-Sluggish Cognitive Tempo Scale [(CABI-SCT]) and adolescent self-reports (Pediatric Daytime Sleepiness Scale [PDSS], Revised Child Anxiety and Depression Scale-Child Version [RCADS-CV], Difficulties in Emotion Regulation Scale-Short Form [DERS-16], Barratt Impulsiveness Scale-Brief) were administered. Pearson correlations with Bonferroni-Holm correction and structural equation modeling were performed. The CPRS ADHD index and CABI-SCT served as predictors, DERS-16 and PDSS as mediators, RCADS-CV-Total as the outcome, and trait impulsivity, sex, and socioeconomic status were included as confounders. CDS showed moderate-to-high correlations with ADHD indices and significant associations with all internalizing domains except separation anxiety. CDS and daytime sleepiness were moderately correlated, and both were significantly associated with ER difficulties. Trait impulsivity correlated with CDS, ER problems, and internalizing symptoms. CDS was associated with internalizing symptoms through an indirect pathway involving ER difficulties, whereas daytime sleepiness did not a significant mediating effect. Trait impulsivity significantly predicted CDS, ADHD symptoms, ER difficulties, and daytime sleepiness, supporting its role as a shared vulnerability factor. CDS symptoms appear more closely related to ER difficulties and internalizing symptoms than subthreshold ADHD symptoms in clinically referred adolescents. ER problems may represent a key mechanism linking CDS to internalizing psychopathology. Routine assessment of CDS symptoms, ER skills, and sleep-related problems may facilitate early identification of at-risk youth. Interventions targeting ER skills and sleep-related processes may represent potential targets for future interventional research, and that longitudinal studies using multimethod assessments are needed to clarify causal pathways.

Background Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction (IA) are common among college students and often co-exist. This study investigated the relationship between ADHD symptoms, executive dysfunction, insomnia, and IA in Chinese college students. Methods A cross-sectional study was conducted in June 2024 at six universities in Hunan Province, China. Demographic data and symptoms of ADHD, IA, executive dysfunction, insomnia, and physical activity were collected via interviews and self-reported questionnaires. Physical activity level was further quantified and categorized using metabolic equivalents (METs) method. Mediation models were performed to explore the path from ADHD to IA and the role of physical activity in IA symptoms. Results Among 1925 students, 12.52% had ADHD symptoms, and 14.03% had IA symptoms. ADHD symptoms were related to IA symptoms (total effects: 0.38, p < 0.001; direct effect: 0.111, p = 0.003), mediated by insomnia (0.161, p < 0.001) and executive dysfunction (0.108, p < 0.001). Compared with no physical activity, moderate-level and high-level physical activities were negatively correlated with IA symptoms, with total relative standardized effects of -0.18 (p = 0.001) and -0.42 (p<0.001), respectively. The relative direct effect of high physical activity levels on IA symptoms was -0.29 (p<0.001), regardless of mediation by insomnia (-0.056 (95%CI, -0.094 to -0.021)) and executive dysfunction (-0.067 (95%CI, -0.105 to -0.033)). Conclusion ADHD and IA symptoms are prevalent among Chinese college students. Executive dysfunction and insomnia mediate the relationship between ADHD and IA symptoms. Moderate and high-level physical activities were associated with reduced risk of IA symptoms, mediated by executive dysfunction and insomnia. Physical activity may help mitigate IA symptoms in college students.

ADHD in females: Survey findings on symptoms across hormonal life stages.

Association of childhood adversities on the persistence and remission of drug-naïve attention-deficit/hyperactivity disorder in a longitudinal community-based sample.

Effects of computerized cognitive training on brain function in children with ADHD: A longitudinal neuroimaging study based on fALFF.

Perceptions of adults with ADHD on pharmacological treatment initiation and subsequent adherence: a thematic analysis.

The effects of mindfulness and cognitive strategy interventions on core symptoms in children with ADHD: A randomized controlled trial.

The effects of computerized executive function training on the youth with ADHD: A systematic review and meta-analysis.

Exploring the interplay between child and parental ADHD symptoms on academic achievement through homework support: A moderated mediation model

Aims: Anxiety frequently co-occurs with Attention-Deficit/Hyperactivity Disorder (ADHD) and may exacerbate core ADHD symptoms such as inattention, hyperactivity, and impulsivity. This study aimed to evaluate the association and risk of anxiety with ADHD symptoms among primary school students. Study Design: An analytical observational study with a quantitative cross-sectional design to assess the association between anxiety and ADHD symptoms. Place and Duration of Study: This study was conducted at a public elementary school in Jakarta from November 10 to 28, 2025. Methodology: A total of 120 students aged 10–12 years participated in this study, selected using consecutive non-random sampling. Sociodemographic data were collected using a structured questionnaire. ADHD symptoms were assessed using the Indonesian Hyperactive Child Behavior Rating Scale (SPPHAI). Anxiety levels were measured using the Revised Children’s Manifest Anxiety Scale (RCMAS). Odds ratio (OR) was used to determine risk. The association between anxiety and ADHD symptoms was analyzed using the chi-square test, with a P-value <0.05 considered statistically significant. Results: Most participants were female (59.2%), aged 11 years old (51.7%), and in fifth grade (53.3%). Parental characteristics were relatively homogeneous, with most parents being adults and having a secondary level of education. Low-risk ADHD was observed in (74.2%) of participants, while (67.5%) showed typical anxiety levels. A significant association was found between high anxiety and ADHD symptoms (p = 0.028; OR = 2.539; 95% CI = 1.090–5.916). Conclusion: This research found a significant association between anxiety and ADHD symptoms; students with higher anxiety levels were more likely to exhibit ADHD symptoms. These results underscore the need for early detection and mental health education, involving families, schools, and healthcare professionals, to address anxiety's potential impact on ADHD in children, though further validation of these predictors is necessary.

Metacognition refers to the awareness and regulation of one's cognitive processes, including self-monitoring, planning, and controlling thoughts. In individuals with attention deficit hyperactivity disorder (ADHD), although research is limited, deficits in metacognitive skills are commonly observed, which contribute to difficulties in attention, task completion, and self-regulation. The aim of this study is to identify metacognitive characteristics in adolescents diagnosed with ADHD and to explore the relationship between these characteristics and the metacognitions of their parents. The study included 107 adolescents, aged 12-18 years, who were newly diagnosed with ADHD, as well as 100 healthy control participants. A sociodemographic form, The Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime version for DSM-5 (K-SADS-PL DSM-5), Metacognitions Questionnaire for Children (MCQ-C) were applied, while their parents completed the Metacognitions Questionnaire-30 (MCQ-30), Turgay DSM-IV Disruptive Behavior Disorders Rating Scale Form (T-DSM-IV-S) and the Adult ADHD Self-Report Scale for DSM-5 (ASRS-5). Based on ASRS-5 scores, parents were categorized into two groups: those at increased risk of ADHD (ASRS ≥ 14) and those at low risk of ADHD (ASRS < 14). Group differences were examined using multivariate analyses (MANCOVA/MANOVA), while associations between adolescent and parental variables were assessed using correlation analyses. In adolescents with ADHD, scores on the negative meta-worry, superstitious, punishment and responsibility beliefs and cognitive monitoring subscales -as well as the MCQ-C total score- were significantly higher compared to the control group, while no difference was found for positive meta-worry, regardless of subtype. On the parental MCQ-30, all subscale and total scores were significantly higher in the ADHD group. Parents categorized as being at increased risk of ADHD had significantly higher MCQ-30 total scores compared to those at low risk. Furthermore, the severity of ADHD symptoms in adolescents, particularly inattention and hyperactivity-impulsivity, was positively and weakly correlated with the MCQ-C total score. In addition, a weak negative correlation was observed between adolescents' positive meta-worry and parents' cognitive confidence. Our study suggests that metacognitive impairment is prevalent among adolescents with ADHD and their parents. Enhancing metacognitive awareness in individuals with ADHD may facilitate their adaptation to treatment and preparedness for alternative forms of therapeutic intervention.

BackgroundRaising a child with Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with significant parental stress. However, the complex relationships between factors in the child and family in shaping this stress are not well understood. This study aimed to elucidate these interrelationships and identify the key determinants of parental stress.MethodsA cross-sectional study included 127 children and adolescents with ADHD (70.9% males; mean age 9.6 ± 3.3 years) and their caregivers, recruited from the ADHD Registry at Ramathibodi Hospital, Bangkok (2019–2023). Caregivers completed standardized measures of parental stress, child ADHD symptoms, child functional impairment, family functioning, and parental ADHD symptoms. Structural equation modeling was used to examine pathways from child and parental ADHD symptoms to parental stress, with functional impairment and family functioning specified as mediators.ResultsExamining child- and family-related factors separately, child ADHD symptoms indirectly influenced parental stress via functional impairment, whereas parental ADHD symptoms significantly influenced parental stress both directly and indirectly via family functioning. In the integrated model examining both child- and family-related factors concurrently, the direct and indirect pathways from parental ADHD symptoms to parental stress via family functioning remained significant, but not the pathway from child ADHD symptoms to parental stress via functional impairment.ConclusionsFunctional impairment, parental ADHD, and family functioning, rather than child ADHD symptoms, are key determinants of parental stress in families of children with ADHD. These factors should be routinely assessed and targeted to alleviate parental stress more effectively than focusing on child ADHD symptoms alone.

The aim of the study is to examine (i) if young children with a family history of autism and/or ADHD differ on executive functions and deferred gratification in comparison to peers with no family history of autism or ADHD, (ii) the specificity of these domains in relation to early-life autistic and ADHD symptoms and adaptive functioning, and (iii) if deferred gratification and strong EF skills may function as protective factors in the association between symptoms and adaptive behaviour. A total of 77 infant siblings at 3years of age with a family history of autism only, autism and co-occurring ADHD, or no family history of these conditions (FH-TL) were assessed on behavioural lab-tasks (EF and deferred gratification), parent-rated adaptive behaviour using Vineland, and clinician ratings using ADOS-2 (autistic symptoms) and ADHD DSM-5 symptom rating scale (ADHD RS). Group comparisons showed that FH-autism and FH-autism + ADHD groups received lower scores on common EF, but not on deferred gratification in comparison to the FH-TL group. Lower levels of deferred gratification related to autistic symptoms, while lower level on EF was specific to ADHD symptoms. Finally, deferred gratification moderated the association between autistic symptoms and adaptive behaviour, in that stronger ability to defer gratification attenuated the association between autistic symptoms and adaptive functions. These results are in line with the idea that strong ability to inhibit and defer gratification may act as a protective factor for children with a family history of autism and/or ADHD pointing to affective aspects of EF as particularly important.

Objective: To evaluate whether classical music exposure can reduce symptoms of attention deficit hyperactivity disorder (ADHD) in elementary school children. Study Design: A quasi-experimental studyPlace and Duration of Study: This study was conducted at the SDN Klampis Ngasem 1, Surabaya, Indonesia, from July 2024 to July 2025, encompassing preparation, data collection, and analysis over one year, with each participant completing a two-week intervention period. Methods: A quasi-experimental pre–post study was performed among 121 third-grade students screened using the Abbreviated Conners’ Teacher Rating Scale (ACTRS). Children scoring ≥12 were considered to have ADHD-related symptoms, and 26 met inclusion criteria after parental consent. Participants were randomly assigned to an intervention group (n = 13), who listened to classical music for 20 minutes over five sessions, or a control group (n = 13), who continued regular activities. Teachers completed the ACTRS before and after the intervention. Results: The intervention group showed a significant decrease in ACTRS scores from 14.61 ± 2.98 to 10.46 ± 3.55 (p = 0.005), whereas the control group showed no significant change (median 12.00 pre- vs 12.00 post-intervention, p = 0.59). Between-group analysis confirmed greater improvement in the intervention group (p = 0.004). Conclusion: Short-term classical music listening significantly reduced ADHD-related symptoms based on teacher ratings. This low-cost, non-invasive approach shows promise as a complementary strategy, though confirmation through larger and diagnostically verified studies is needed.

ADHD (Attention Deficit Hyperactive Disorder) is a mental disorder that causes children to have difficulty concentrating, as well as impulsive and hyperactive behavior. ADHD generally appears in children under 12 years of age, but ADHD that occurs in children can be carried into adulthood. This condition can impact a child's achievement if not treated early. Soeprapto Mental Hospital is one of the specialized hospitals that provides facilities and infrastructure in mental health and drug services for the community in Bengkulu Province. Based on the results of observations conducted at Soeprapto Mental Hospital Bengkulu, an average of 2-5 children per month are found to experience ADHD. One way to diagnose this disorder is to consult with an expert. The Expert System for Early Detection of Attention Deficit Hyperactive Disorder (ADHD) at Soeprapto Mental Hospital Using the Certainty Factor Method was created using the PHP programming language and MySQL database, and can be accessed online through the link https://adhdrsjksoepraptobkl.online/. This expert system for early detection of Attention Deficit Hyperactive Disorder (ADHD) can help the public, especially in Bengkulu Province, to consult by entering the patient's symptoms to obtain information on early detection of Attention Deficit Hyperactive Disorder. Based on testing conducted using the black box method both offline and online, it was found that the application's functionality ran well in terms of input, output, and the applied CF method. From the results of alpha testing conducted at Soeprapto Mental Hospital, it can be concluded that this expert system application can be a solution in the process of early identification of ADHD symptoms so that it can be used as a further consideration and faster intervention.

Parenting interventions are a front-line treatment for children with attention-deficit/hyperactivity disorder (ADHD). However, many parents of children with ADHD have elevated ADHD or depressive symptoms, which may impede their ability to engage in and benefit from such interventions. This secondary data analysis examined associations between parent mental health, treatment engagement, and parenting-related treatment outcomes within a randomized trial of 172 families of children with ADHD. Families received either Parental Friendship Coaching (PFC; a behavioral parent training program) or Coping with ADHD through Relationships and Education (CARE; a parent psychoeducation and social support intervention); both were parenting interventions that aimed to support parents to improve children's ADHD-related social impairments. Higher parent self-reported ADHD symptoms at baseline were associated with lower home practice completion in PFC, potentially greater perceived group social support in PFC, and higher attendance in CARE. In contrast, parent depressive symptoms were not associated with engagement in either intervention. Overall, higher parent ADHD or depressive symptoms demonstrated few associations with parenting behavior treatment outcomes at post-treatment or 8-month follow-up, and observed effects were both positive and negative in PFC and CARE. It is possible that accessibility-focused adaptations to PFC and CARE reduced the impact of higher parent mental health symptoms on poorer engagement and parenting treatment outcomes. Nevertheless, the generally low levels of ADHD and depressive symptoms in the sample limit the ability to detect possible stronger associations.

Physical youth-to-parent aggression (PYPA) is among the most understudied forms of family aggression in the general population. This study examined the prevalence and developmental course of PYPA from adolescence into young adulthood and investigated childhood behavioral and interpersonal risk (e.g., ADHD symptoms, low self-control, harsh parenting) as well as protective factors (e.g., conflict coping, parental involvement). Data came from six assessments of the prospective-longitudinal Zurich Project on Social Development from Childhood to Adulthood (z-proso), including N = 1522 participants. Participants reported PYPA at ages 11, 13, 15, 17, 20, and 24. Risk and protective factors were measured at or before age 11. Generalized estimating equations were used to examine the developmental course of PYPA, and logistic regression analyses examined its risk and protective factors. One in three youth (32.5%) reported engaging in PYPA at least once. Prevalence followed a cubic trajectory: increasing from age 11 to 13, then declining at varying rates through age 24. ADHD symptoms (OR (95%CI) = 1.26 (1.10, 1.45)), harsh parenting (OR (95%CI) = 1.24 (1.08, 1.42)), and interparental disagreement (OR (95%CI) = 1.17 (1.01, 1.35)) were associated with higher odds of PYPA; whereas competent conflict coping (OR (95%CI) = 0.83 (0.72, 0.96)) and parental involvement (OR (95%CI) = 0.83 (0.72, 0.95)) were associated with lower odds after accounting for participants' aggressive tendencies during childhood. Reducing children's aggressive tendencies and exposure to aggression and conflict, while fostering competent coping skills and supportive family environments could decrease PYPA and the burden of family aggression.

This study aims to investigate the complex relation between adult ADHD symptoms, procrastination, and mediating factors, in light of leading procrastination theories: the Temporal Motivation Theory (TMT), emotion regulation, and a General Architecture for Modeling the Dynamics of Goal-Directed Motivation and Decision-Making - the GOAL architecture. The study was preregistered. A survey was conducted with 640 adults recruited online to examine the associations between ADHD symptoms, procrastination, and seven mediating factors. Participants completed measures assessing ADHD symptoms, procrastination tendencies, emotion regulation, motivation, and goal-related behaviors. Structural equation modeling (SEM) was used to test the direct and indirect pathways among the variables. A positive association was revealed between ADHD inattention symptoms and procrastination tendencies. The mediating factors that significantly contributed to this relations were sensitivity to delay, perceived low value of the task, and flexible goal adjustment. While ADHD inattention symptoms was associated with all seven variables, three variables directly contributed to increased procrastination behavior, thus explaining the link between inattention symptoms and procrastination. The study highlights the relations between procrastination and adult ADHD symptoms and underscores the need to address mediating factors in intervention strategies. Understanding these mechanisms is essential for developing targeted interventions to improve functional outcomes for individuals with ADHD.

This study evaluated the efficacy and acceptability of Ireland's National Clinical Programme for ADHD in Adults (NCPAA), providing public assessment and supports for adults with ADHD. Overall, 249 adults (51% women, 42% men, 4% non-binary, 1% other gender) were recruited from three NCPAA services usingconsecutive sampling. Participants completed the Adult Self-Report Scale (ASRS) and the Weiss Functional Impairment Rating Scale (WFIRS-S) at baseline, 6, and 12 months; service satisfaction was measured with the Service Satisfaction Scale (SSS). Reflexive thematic analysis explored responses to two open-ended questions. Service users presented with high baseline symptomatology and life challenges. Significant improvements were observed in ASRS and WFIRS-S (except education) in the first six months. Improvements were retained at 12 months in ASRS and WFIRS-S domains of work, life skills, self-concept and social. but not family, risk or education. Service satisfaction was high, particularly among those diagnosed with ADHD. Thematic analysis identified three positive themes: feeling affirmed, benefits of supports, and person-centred care; and three improvement areas: access barriers, resource gaps, and need for ongoing support. Engagement with NCPAA services is associated with improvements in ADHD symptoms and life challenges and is acceptable to adults with ADHD in the short term. Service limitations, particularly staffing constraints, warrant attention. Recommendations include strengthening resources, improving communication and appointment systems, and enhancing links to external supports. Given the absence of a control group, findings should be considered preliminary.

BackgroundSecondhand smoke (SHS) and thirdhand smoke (THS) have been shown to increase the risk of physical health and mental health. However, the impact of SHS and THS exposure on ADHD symptoms and executive function remain to be elucidated.MethodsOnline surveys were used to recruit participants at a Chinese vocational college. The frequency of contact with smokers or detecting tobacco odors in residential environments was used to define SHS exposure, whereas the frequency of contact with surfaces contaminated by smokers was used to define THS exposure. The associations of SHS and THS exposure with the risk of ADHD symptoms and the executive function (Behavioral Regulation Index, BRI; Metacognitive Index, MI; Global Executive Composite, GEC) scores were evaluated by logistic regression analysis or linear regression analysis.ResultsThe rate of SHS and THS exposure was 87.7% and 76.9%, with 8.2% stating SHS exposure ≥15 min at least 1 day/week. After adjustment for confounding variables, SHS exposure (≥15 minutes on ≥1 day/week) had higher odds of ADHD symptoms (OR, 1.31; 95% CI, 1.02–1.67), and higher BRI score (β, 2.34; 95% CI, 0.95–3.73), higher MI score (β, 3.12; 95% CI, 1.29–4.95), higher GEC score (β, 5.46; 95% CI, 2.26–8.66). Additionally, the higher the frequency of SHS/THS exposure and the greater the number of surrounding smoker, the higher risk of ADHD symptoms and the poorer executive function (P trend <0.001).ConclusionsSHS and THS exposure were related to the occurrence of ADHD symptoms and impaired executive function among young adults at a Chinese vocational college in this cross-sectional study. Further researches are warranted to validate these associations in more diverse populations.