ADHD Symptoms Research Articles

Sleep and functional outcomes in children and adolescents with epilepsy: A scoping review

AimIn children and adolescents with epilepsy (CAWE), disturbed sleep and functional difficulties are frequently present, but their relationship is unclear. In this scoping review we aimed to explore associations between sleep and functional outcomes in CAWE. MethodWe registered the protocol with open science framework and conducted the review according to the PRISMA Extension for Scoping Reviews. We searched Medline, Embase, PsycINFO and PubMed for original studies reporting on relations between sleep and functional outcomes (adaptive/quality of life, behavioural/mood, cognitive & academic) in CAWE. To assess the quality of studies we used an extended version of the checklist employed by Winsor and colleagues [1]. ResultsWe identified 14 studies that included 1,785 CAWE and 1,260 control children, with a mean age of 9.94 and 10.13 years, respectively. The studies were highly heterogeneous with respect to samples, epilepsy variables, and methods used to assess sleep and functional outcomes. The quality of studies was medium. Associations between sleep and adaptive/quality of life, behavioural/mood, cognitive and academic outcomes were examined in 2, 10, 6, and 0 studies, respectively. Across studies, in CAWE, greater sleep disturbances were related to worse behavioural/mood outcomes, ranging from depression/anxiety to ADHD symptoms. Sleep disturbances did not consistently relate to cognitive outcomes, but they related to worse adaptive outcomes in both studies that examined their relationship. ConclusionsOur study provides evidence of relationship between disturbed sleep and behavioural/mood difficulties, which alerts to the need for careful evaluation and treatment of sleep disturbances in CAWE. Our study also highlights the need to examine relationships between sleep and other functional outcomes in CAWE, as studies conducted in the general population suggest that sleep disturbances may be modifiable and associated with improved functional outcomes.

Polygenic Scores and Networks of Psychopathology Symptoms

Studies on polygenic risk for psychiatric traits commonly use a disorder-level approach to phenotyping, implicitly considering disorders as homogeneous constructs; however, symptom heterogeneity is ubiquitous, with many possible combinations of symptoms falling under the same disorder umbrella. Focusing on individual symptoms may shed light on the role of polygenic risk in psychopathology. To determine whether polygenic scores are associated with all symptoms of psychiatric disorders or with a subset of indicators and whether polygenic scores are associated with comorbid phenotypes via specific sets of relevant symptoms. Data from 2 population-based cohort studies were used in this cross-sectional study. Data from children in the Avon Longitudinal Study of Parents and Children (ALSPAC) were included in the primary analysis, and data from children in the Twins Early Development Study (TEDS) were included in confirmatory analyses. Data analysis was conducted from October 2021 to January 2024. Pregnant women based in the Southwest of England due to deliver in 1991 to 1992 were recruited in ALSPAC. Twins born in 1994 to 1996 were recruited in TEDS from population-based records. Participants with available genetic data and whose mothers completed the Short Mood and Feelings Questionnaire and the Strength and Difficulties Questionnaire when children were 11 years of age were included. Psychopathology relevant symptoms, such as hyperactivity, prosociality, depression, anxiety, and peer and conduct problems at age 11 years. Psychological networks were constructed including individual symptoms and polygenic scores for depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), body mass index (BMI), and educational attainment in ALSPAC. Following a preregistered confirmatory analysis, network models were cross-validated in TEDS. Included were 5521 participants from ALSPAC (mean [SD] age, 11.8 [0.14] years; 2777 [50.3%] female) and 4625 participants from TEDS (mean [SD] age, 11.27 [0.69] years; 2460 [53.2%] female). Polygenic scores were preferentially associated with restricted subsets of core symptoms and indirectly associated with other, more distal symptoms of psychopathology (network edges ranged between r = -0.074 and r = 0.073). Psychiatric polygenic scores were associated with specific cross-disorder symptoms, and nonpsychiatric polygenic scores were associated with a variety of indicators across disorders, suggesting a potential contribution of nonpsychiatric traits to comorbidity. For example, the polygenic score for ADHD was associated with a core ADHD symptom, being easily distracted (r = 0.07), and the polygenic score for BMI was associated with symptoms across disorders, including being bullied (r = 0.053) and not thinking things out (r = 0.041). Genetic associations observed at the disorder level may hide symptom-level heterogeneity. A symptom-level approach may enable a better understanding of the role of polygenic risk in shaping psychopathology and comorbidity.

The psychometric properties of the ADHD rating scale-5 for children and adolescents, home version for Sudan.

There is a lack of universal scales for tracking ADHD symptoms in the home for children/adolescents in the Sudanese context. For this reason, this study aimed to validate the ADHD Rating Scale-5 for Children and Adolescents, Home Version for use by parents in Sudan to assess their children for ADHD. This scale is widely used by parents to assess their children aged 5-17 years for ADHD in the home environment. The current study involved 3,742 Sudanese parents of school-aged children and adolescents, each asked to complete the instrument for one child in their family; only one parent per family participated in the study. The authors then examined the psychometric properties of the scale from the completed assessments. The results indicated acceptable to high reliability for the total scale and both the symptom and impairment items. Exploratory and confirmatory factor analyses demonstrated high external and construct validity when applying the scale to the Sudanese sample. the factor structure resembled that of the normative U.S. sample in terms of the number of extractable factors and the strength of factor loadings. Based on the results, this adaptation of the home version of the ADHD Scale-5 for Children and Adolescents is both valid and reliable for use by Sudanese parents in the home environment.

Association between early-life mosquito repellents exposure and ADHD-like behaviours.

Limited research has explored the impact of mosquito repellents exposure during early life on ADHD symptoms. This study aimed to explore the associations of exposure to mosquito repellents from pregnancy to 3years old and the prevalence of ADHD-like behaviours among children aged 3-9years, and further identify the sensitive exposure period. A cross-sectional study was conducted, including 12275 children in Hefei City, China. Exposure was self-reported via primary caregivers. ADHD-like behaviours were measured by the Swanson, Nolan and Pelham, version IV scale (SNAP-IV), and Conners' Parent Rating Scale (CPRS). Cross-over analysis, binary logistic regression and linear regression were employed. After adjusting for confounding variables, early-life exposure to mosquito repellents was associated with a higher risk of ADHD-like behaviours (OR=1.81, 95% CI=1.49-2.19). By comparing the strength of the association for each subgroup, we found exposure during 1-3years old was a sensitive period (OR=1.89, 95% CI=1.25-2.87) by the cross-over analysis. Furthermore, we found a dose-response relationship in which the likelihood of ADHD-like behaviours increased with children's early-life mosquito repellents exposure dose. Early-life exposure to mosquito repellents is linked with an elevated risk of ADHD-like behaviours in children, with a sensitive period identified during 1-3years old.

ADHD Symptoms in Middle Childhood: The Role of Child Attachment and Maternal Emotional Availability in an Inpatient Clinical Sample.

Child ADHD symptoms are highly prevalent in middle childhood, alongside impairment in social functioning. The parent-child relationship has been shown to play an important role; however, studies investigating specific facets of the parent-child relationship in ADHD symptomatology in middle childhood have been neglected. We assumed that higher ADHD symptoms were associated with both (1) lower maternal emotional availability (EA) and (2) lower child attachment security. Moreover, (3) we aimed to explore which specific EA dimensions were associated with ADHD symptoms. In a socio-pediatric clinic in Germany, 71 inpatient mother-child dyads (child age: M = 7.70, SD = 1.06; n = 54 boys) were assessed. Clinical data about child ADHD symptoms (Child Behavior Checklist 6-18 subscale "attention deficit/hyperactivity problems"), maternal EA (free play), and child attachment representation (Attachment Story Completion Task, GEV-B) were analyzed cross-sectionally. Controlling for child oppositional behavior and sex, child ADHD symptoms were associated with overall maternal EA, and more specifically non-hostility, but not with child attachment representation. Our results imply that the role of parent-child interaction quality should be considered in the treatment of ADHD. Bidirectional effects cannot be ruled out.

Friendship matters—An interview study with adolescents with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a condition diagnosed in 5% of children and adolescents. This neurodevelopmental condition causes impaired academic, social, and occupational functioning. Adolescents with ADHD symptoms have lower health-related quality of life and children with ADHD have been described as having difficulties forming positive friendships. Therefore, the aim was to describe how 15–17-year-old adolescents with ADHD experience friendship with peers. A semi-structured interview study was conducted with twelve adolescents about their experiences of friendships. The adolescents were recruited from a Swedish psychiatry clinic. A qualitative content analysis was used. In the results, three main categories were constructed: "Bonding with Friends" underscores the importance of understanding, shared interests, and adaptability. The "One’s own role" category emphasises the dynamic interplay of self-perception and interpersonal behaviours in interaction with friends. The "How Friendship Matters" category describes the complex nature of friendships, involving both support and conflicts. The adolescents’ relationships improved with age, influenced by self-awareness, ADHD medication and support from adults. In conclusion, friendships play a crucial role in the well-being of the participants, providing vital support when navigating ADHD associated challenges. It is essential that the adolescents themselves, but also adults and healthcare providers, recognise and address their impulsivity issues and need for daily planning. We should assist adolescents in developing effective interaction strategies with friends. The study highlights the significance of friendships and peer support for the adolescents’ health and functioning.

Aperiodic and periodic components of oscillatory brain activity in relation to cognition and symptoms in pediatric ADHD

Abstract Children with attention-deficit/hyperactivity disorder show deficits in processing speed, as well as aberrant neural oscillations, including both periodic (oscillatory) and aperiodic (1/f-like) activity, reflecting the pattern of power across frequencies. Both components were suggested as underlying neural mechanisms of cognitive dysfunctions in attention-deficit/hyperactivity disorder. Here, we examined differences in processing speed and resting-state-Electroencephalogram neural oscillations and their associations between 6- and 12-year-old children with (n = 33) and without (n = 33) attention-deficit/hyperactivity disorder. Spectral analyses of the resting-state EEG signal using fast Fourier transform revealed increased power in fronto-central theta and beta oscillations for the attention-deficit/hyperactivity disorder group, but no differences in the theta/beta ratio. Using the parameterization method, we found a higher aperiodic exponent, which has been suggested to reflect lower neuronal excitation-inhibition, in the attention-deficit/hyperactivity disorder group. While fast Fourier transform–based theta power correlated with clinical symptoms for the attention-deficit/hyperactivity disorder group only, the aperiodic exponent was negatively correlated with processing speed across the entire sample. Finally, the aperiodic exponent was correlated with fast Fourier transform–based beta power. These results highlight the different and complementary contribution of periodic and aperiodic components of the neural spectrum as metrics for evaluation of processing speed in attention-deficit/hyperactivity disorder. Future studies should further clarify the roles of periodic and aperiodic components in additional cognitive functions and in relation to clinical status.

The Effect of Neurodevelopmental Disorders Characteristics on Aspects of Social Functioning

Aim The purpose of this study was to estimate the extent to which neurodevelopmental disorders (NDD's) symptoms (motor, sensory, attention and executive function) are associated with aspects of social function among school aged children. Methods This cross-sectional study included 39 children aged 6–9 years old (71.8% boys) who were referred to child development centers due to motor, sensory, and/or cognitive difficulties. The parents completed NDD's symptoms questionnaires: Developmental Coordination Disorder Questionnaire; Child Sensory Profile-2; Attention Deficit Hyperactive Disorder (ADHD) Rating Scale and the Behavior Rating Inventory of Executive Function. They also completed the Social Skills Improvement System and a social participation measure. Results Analysis demonstrated low to moderate correlations between social functioning aspects and the majority of NDD's symptoms. Executive functioning was the only predictor of social skills and social participation and accounted for most of the variability of behavioral problems, alongside a small contribution of ADHD symptoms. Conclusion The findings contribute to the accumulating body of knowledge regarding social abilities of children with NDD's and suggest new information as to the effect of executive functions in this domain. Along with conducting a routine evaluation of social skills among children suspected to have NDD's, executive functions should also be comprehensively evaluated.

The neural and genetic underpinnings of different developmental trajectories of Attention-Deficit/Hyperactivity Symptoms in children and adolescents

BackgroundThe trajectory of attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents, encompassing descending, stable, and ascending patterns, delineates their ADHD status as remission, persistence or late onset. However, the neural and genetic underpinnings governing the trajectory of ADHD remain inadequately elucidated.MethodsIn this study, we employed neuroimaging techniques, behavioral assessments, and genetic analyses on a cohort of 487 children aged 6–15 from the Children School Functions and Brain Development project at baseline and two follow-up tests for 1 year each (interval 1: 1.14 ± 0.32 years; interval 2: 1.14 ± 0.30 years). We applied a Latent class mixed model (LCMM) to identify the developmental trajectory of ADHD symptoms in children and adolescents, while investigating the neural correlates through gray matter volume (GMV) analysis and exploring the genetic underpinnings using polygenic risk scores (PRS).ResultsThis study identified three distinct trajectories (ascending-high, stable-low, and descending-medium) of ADHD symptoms from childhood through adolescence. Utilizing the linear mixed-effects (LME) model, we discovered that attention hub regions served as the neural basis for these three developmental trajectories. These regions encompassed the left anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC), responsible for inhibitory control; the right inferior parietal lobule (IPL), which facilitated conscious focus on exogenous stimuli; and the bilateral middle frontal gyrus/precentral gyrus (MFG/PCG), accountable for regulating both dorsal and ventral attention networks while playing a crucial role in flexible modulation of endogenous and extrinsic attention. Furthermore, our findings revealed that individuals in the ascending-high group exhibited the highest PRS for ADHD, followed by those in the descending-medium group, with individuals in the stable-low group displaying the lowest PRS. Notably, both ascending-high and descending-medium groups had significantly higher PRS compared to the stable-low group.ConclusionsThe developmental trajectory of ADHD symptoms in the general population throughout childhood and adolescence can be reliably classified into ascending-high, stable-low, and descending-medium groups. The bilateral MFG/PCG, left ACC/mPFC, and right IPL may serve as crucial brain regions involved in attention processing, potentially determining these trajectories. Furthermore, the ascending-high pattern of ADHD symptoms exhibited the highest PRS for ADHD.

INHIBITORY CONTROL IN CHILDREN WITH ATTENTİON DEFİCİT AND HYPERACTİVİTY DİSORDER

The article talks about inhibitory control, which is one of the executive functions in children with ADHD. These children always have impaired executive functions. However, executive dysfunction does not always mean ADHD. Evaluation of executive functions can help diagnose this neurodevelopmental disorder. One of the most common executive function deficits associated with ADHD is problems with inhibitory control. They find it difficult to control inappropriate or impulsive behavior, external interference, and therefore have trouble concentrating. Inhibition plays an important role in successful behavior, requiring the suppression of extraneous interference to focus attention, the ignoring of irrelevant cues to recall stored information, and the suppression of habitual responses to adaptive decision making. Impaired response inhibition directly affects four executive functions: working memory, self-regulation, language internalization, and restructuring. This, in turn, leads to difficulties with complex movements and goal-directed behavior, especially those related to motor control, verbal fluency, and syntax. Given the influence of inhibitory control on ADHD, the author argues that training that enhances inhibition may improve ADHD symptoms. A number of studies in this area have demonstrated the effectiveness of trainings designed to enhance inhibitory control.

Shared symptomatology between atopic dermatitis, ADHD and autism spectrum disorder: a protocol for a systematic scoping review

IntroductionChildren with atopic dermatitis (AD) are more at risk for the neurodevelopmental disorders attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) with parallel increases in global prevalences. Children afflicted with...

Retrospective Study on the Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation Combined with Tiapride Hydrochloride Tablets in Children with Attention Deficit Hyperactivity Disorder.

This study aimed to explore the application effect of repetitive transcranial magnetic stimulation (rTMS) combined with tiapride hydrochloride tablets in children with attention deficit hyperactivity disorder (ADHD). The medical records of 197 children with ADHD in our hospital from January 2022 to January 2023 were retrospectively analysed. Seven children who did not meet the inclusion criteria were excluded, and 190 children were finally included in this retrospective study. Based on the different clinical therapeutic methods, these children were divided into tiapride (n = 64), rTMS (n = 64), and combination (n = 62) groups. The clinical effects of different therapeutic schemes were compared. The clinical effectiveness and the scores of Swanson, Nolan, and Pelham Rating Scale Version IV (SNAP-IV), Conners Parent Symptom Questionnaire (PSQ), and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) were compared among the 3 groups. There was no significant difference in gender, age, course of disease, weight, and WISC-IV score among the combination, tiapride, and rTMS groups (all P > .05). The effective rate of treatment in the combination group (93.55%) was significantly higher than that in the tiapride group (78.13%) and the rTMS group (81.25%). There was a significant difference in the comparison of the combination group with the tiapride group (P = .013) and the rTMS group (P = .038). Before treatment, no significant difference existed in the scores of attention deficit symptoms and hyperactivity disorder symptoms among the 3 groups (all P > .05). After 3 months of treatment, the difference score of the combination group before and after treatment was significantly higher than that of other 2 groups (all P < .001). Before treatment, no significant difference was found in the scores of conduct problems, learning problems, psychosomatic disorders, impulsive hyperactivity, anxiety and hyperactivity index among the 3 groups (all P > .05). After treatment, the combination group had significantly higher difference score before and after treatment than other 2 groups (all P < .001). There was no significant difference in WFIRS-P scores among the 3 groups before treatment (all P > .05). After treatment, the difference score in the combination group before and after treatment was significantly higher compared with other 2 groups (all P < .001). Transcranial magnetic stimulation combined with tiapride hydrochloride tablets had a positive effect on improving the condition of children with ADHD, with certain clinical promotion value.

Symptoms and Pathogenesis of ADHD

Diagnosis of ADHD in adulthood is increasing rapidly in Japan. The ADHD symptoms occur on a continuum with those of normal development and are likely to fluctuate with the growth process and environment at the time of diagnosis. Especially in adult cases, comorbid psychiatric disorders tend to influence the characteristics of ADHD. ADHD has diverse clinical manifestations and a heterogeneous biological background. In addition to the RDoC approach to elucidate the pathogenesis and etiology of the disorder, we expect that attempts will be made to classify the disorder into relatively homogeneous biological subcategories.

Prevalence, Correlates, and Comorbidities Among Young Adults Who Screened Positive for ADHD in South Korea During the COVID-19 Pandemic

Objective: This study examined the prevalence, associated factors, and psychiatric comorbidities of adult ADHD during the COVID-19 pandemic by analyzing nationally representative data. Methods: Among the 5,511 respondents of the 2021 National Mental Health Survey, South Korea, 2,764 (18–49 years) were selected. The Korean versions of the Adult ADHD Self-Report Scale, Composite International Diagnostic Interview, and Structured Clinical Interview for Internet Gaming Disorder were used as diagnostic assessments. Results: The 6-month prevalence of positive screens for adult ADHD was 3.1%. In individuals aged 18 to 29 years exhibiting adult ADHD symptoms, high prevalence rates of alcohol use, depression, and Internet gaming disorders were observed in the last 12 months. Adults who screened positive for ADHD reported significantly lower life satisfaction and resilience, and higher loneliness and social isolation (vs. non-ADHD group). Conclusion: Adult ADHD symptoms significantly influenced mental well-being, highlighting the need for an appropriate treatment/prevention system, particularly for individuals aged 18 to 29 years.

Reduced temporal and spatial stability of neural activity patterns predict cognitive control deficits in children with ADHD.

This study explores the neural underpinnings of cognitive control deficits in ADHD, focusing on overlooked aspects of trial-level variability of neural coding. We employed a novel computational approach to neural decoding on a single-trial basis alongside a cued stop-signal task which allowed us to distinctly probe both proactive and reactive cognitive control. Typically developing (TD) children exhibited stable neural response patterns for efficient proactive and reactive dual control mechanisms. However, neural coding was compromised in children with ADHD. Children with ADHD showed increased temporal variability and diminished spatial stability in neural responses in salience and frontal-parietal network regions, indicating disrupted neural coding during both proactive and reactive control. Moreover, this variability correlated with fluctuating task performance and with more severe symptoms of ADHD. These findings underscore the significance of modeling single-trial variability and representational similarity in understanding distinct components of cognitive control in ADHD, highlighting new perspectives on neurocognitive dysfunction in psychiatric disorders.

ADHD Symptoms in Childhood and Big Five Personality Traits in Adolescence: A Five-Year Longitudinal Study in Girls

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental condition characterized by developmentally extreme and impairing symptoms of inattention and/or hyperactivity/impulsivity. Great interest has emerged in the ways ADHD and its underlying symptom dimensions relate to the development of personality traits. Much extant research on this topic is cross-sectional, relying on self-report measures and male samples. Herein, we present data from a prospective, longitudinal study of a socioeconomically and racially diverse sample of girls, including those with ADHD and a matched neurotypical comparison sample. We examined how parent- and teacher-reported ADHD in middle childhood relate to self-reported Big Five personality traits in adolescence. As expected, childhood ADHD diagnosis prospectively predicted lower self-reported Conscientiousness, lower Agreeableness, and higher Neuroticism in adolescence. With ADHD diagnosis covaried, Inattention (IA) predicted only low Conscientiousness, Hyperactivity/Impulsivity (HI) predicted only low Agreeableness, and neither predicted adolescent Neuroticism. An exploratory moderator analysis showed that family income moderated the effects of IA and HI on the negativity of adolescent self-descriptions of their own personalities, with more pronounced negative effects for girls in families with higher (rather than lower) income. Familial pressures to achieve in higher-income families may be linked to more pronounced negative ramifications of ADHD on personality development.

Relations Between Social Camouflaging, Life Satisfaction, and Depression Among Polish Women with ADHD.

This study investigated the relationship between social camouflaging, life satisfaction, and depression symptoms in Polish women with ADHD. It aimed to fill a research gap in understanding ADHD manifestations in women, particularly focusing on social camouflaging-a concept known in autism, referring to strategies used to mask symptoms in social interactions. A total of 329 women with ADHD took part in an online survey. The survey measured ADHD symptoms using the ADHD Self Report Scale (ASRS-vI.I), life satisfaction with the Satisfaction With Life Scale (SWLS), and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Additionally, a novel set of questions, inspired by the Camouflaging Autistic Traits Questionnaire (CAT-Q) but tailored for ADHD, was utilized to assess social camouflaging. Results indicated a significant negative association between social camouflaging and life satisfaction and a positive correlation with depressive symptoms, even after controlling for demographic variables. Additionally, factors like being in a relationship and having a positive subjective financial situation correlated with higher well-being. Reliance on self-report measures, the cross-sectional design, and participants' self-reported ADHD diagnosis are the main limitations of the study. The research underscores the importance of social camouflaging in understanding ADHD in women, suggesting that efforts to mask symptoms and meet societal expectations may link to lower life satisfaction and increased depressive symptoms. These findings advocate for continued research into these dynamics to develop more effective support for women with ADHD.

Interactive Effects of Racism and Racial Centrality on ADHD Symptoms.

Although race-related stress is associated with numerous mental health outcomes, no previous research has examined associations with ADHD symptoms. We examine how such associations differ in Black Americans based on racial identity to allow for more nuanced understandings of racial discrimination's association with ADHD symptoms. This study asked a sample of Black Americans to answer questionnaires assessing race-related stress, ADHD symptoms, and racial centrality. In predicting ADHD symptoms, we found a positive effect of race-related stress and a negative effect of centrality. At low levels of centrality, the association between ADHD symptoms and race-related stress was stronger than at mean and high levels of centrality. Through additional sub-group analyses we found the interaction effect not replicating in one of our conditions. These results suggest experiences of race-related stress and racial identity are important factors for consideration in the treatment of ADHD symptoms.

Associations between repetitive head impact exposure and midlife mental health wellbeing in former amateur athletes.

Repetitive head impacts (RHI) have been suggested to increase the risk of developing a neurodegenerative disease, and many of these individuals develop a preceding mental health diagnosis. Given the lack of studies among amateur athletes, this study aimed to examine mental health outcomes in middle-aged amateur athletes who have been exposed to RHI through contact sport participation. This is a single site, cohort study involving former amateur athletes aged between 30 and 60 with at least 10 years of organized contact or non-contact sport participation. All participants completed demographic and mental health questionnaires. Mental health outcomes included symptoms related to depression, anxiety, post-traumatic stress disorder (PTSD), attention deficit hyperactive disorder (ADHD), and aggression. Self-reported data on mental health diagnoses and associated prescription were elicited and used to estimate odds ratios (OR). Data from 41 contact athletes and 22 age/sex-matched non-contact athletes were available for analysis. The contact group exhibited a 2.25-fold higher likelihood of being diagnosed with mental health disorders and 1.29-fold higher likelihood of using associated medications compared to the non-contact group. The contact group reported significantly higher PTSD-related symptoms [4.61 (0.03,9.2), p=0.05] compared to the non-contact control group. While not statistically significant, the contact group showed increased depressive [2.37 (0.05, 4.79), p=0.07] and ADHD symptoms [4.53 (0.51, 9.57), p=0.08] compared to controls. In a secondary analysis, a distinct trend emerged within the contact group, revealing pronounced elevations in mental health symptoms among individuals with lower socioeconomic status (<$50,000/year) compared to higher income subgroups, and these symptoms decreased as income levels rose [depression: -3.08 (-4.47, -1.7), p<0.001; anxiety: -1.95 (-3.15, -0.76), p=0.002; ADHD: -4.99 (-8.28, -1.69), p=0.004; PTSD: -4.42 (-7.28, -1.57), p=0.003; aggression: -6.19 (-11.02, -1.36), p=0.01]. This trend was absent in the non-contact control group. Our data suggest that even individuals at the amateur level of contact sports have an increased likelihood of being diagnosed with mental health disorders or experiencing mental health symptoms compared to non-contact athletes. Our findings indicate that socioeconomic status may have an interactive effect on individuals' mental health, particularly among those with a long history of RHI exposure.

A 5-week Digital Intervention to Reduce Attention Problems in Children With ADHD: A Double-Blind Randomized Controlled Trial

Objective: Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. Method: In this double-blind randomized controlled trial 55 children with ADHD (5–9 years) were allocated to the intervention (N = 28) or control program (N = 27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. Results: Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p < .044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. Conclusion: Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD.