Although Attention-deficit/hyperactivity Disorder Symptoms Research Articles

Association between ADHD symptoms and illicit stimulants use following 1 year among French university students of the i-Share cohort.

Although attention deficit hyperactivity disorder (ADHD) has been associated with illicit stimulants use, less is known about their prospective association in university students. We aimed to examine the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year among university students. The i-Share cohort recruited French students from February 2013 to July 2020. The study included 4270 participants. The Adult ADHD Self-Report Scale (ASRS) was used to evaluate ADHD symptoms at inclusion. Illicit stimulants use was assessed at inclusion and 1 year after inclusion. Multivariable logistic regressions were conducted to assess the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year. High levels of ADHD symptoms at inclusion were associated with a greater probability of illicit stimulants use following 1 year (adjusted OR: 2.42 (1.51-3.8)). The adjusted odds ratio was 2.7 (1.08-7.84) among participants who had used illicit stimulant at least once (continuation) and 2.25 (1.04-4.37) among participants who had never used illicit stimulants at inclusion (initiation). High levels of ADHD symptoms are a feature that may promote both initiation and continuation of illicit stimulants use among university students. Our findings suggest that university students with high levels of ADHD symptoms may benefit from screening to help identify those at risk of illicit stimulants use.

Effects of methylphenidate on cognitive functions in boys with attention deficit hyperactivity disorder: Does baseline performance matter?

Objective: Although attention deficit hyperactivity disorder (ADHD) is associated with cognitive deficits, there is considerable heterogeneity and only a minority of individuals with the disorder demonstrate a deficit in any cognitive domain. Recent studies indicate that the relationships between ADHD symptoms and cognition are complex with a dissociation between medication responses across these two domains. Method: We examined whether methylphenidate (MPH) differentially impacts on cognition in those with and without pretreatment cognitive deficits in a 4-week randomized controlled crossover of high (0.6 mg/kg/dose) and low (0.3 mg/kg/dose) dose MPH and placebo in 75 medication-naive boys with ADHD. Cognition was assessed using tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Confirmatory factor analysis (CFA) was used to form latent cognitive factors of executive functioning, visual memory, and reaction time, as well as a general cognition factor. Results: Compared to placebo, both high and low MPH doses significantly improved performance on pattern recognition (PR), spatial recognition (SR), and simple reaction time. The low, but not the high, dose improved performance on the Stockings of Cambridge (SOC) and delayed matching-to-sample tasks. Both doses also significantly improved performance on the executive functioning, visual memory, reaction time skills, and general cognitive latent variables. There were however no differences in the effects of MPH on cognition between those with and without a baseline cognitive deficit, for either the observed task values or the latent cognitive factor scores. Conclusions: We conclude that MPH can enhance executive functioning, visual memory, reaction time, and general cognitive function in boys with ADHD. These improvements are not dependent on baseline cognitive performance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of attention‐deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: a 3‐year clinical cohort study

Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms. The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up. The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms. This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.

Invariance of parent ratings of attention deficit hyperactivity disorder symptoms for children with and without intellectual disability.

Although attention deficit hyperactivity disorder (ADHD) is considered a valid diagnosis for children with intellectual disability, no studies have evaluated the invariance of ADHD symptom ratings across children with and without intellectual disability. Parents completed ratings on the ADHD symptoms for 189 children with intellectual disability and for 474 children without intellectual disability. Differential item functioning analysis was used to determine the equivalence of the ADHD symptoms across the two groups. The symptoms loses things, talks too much, and blurts out answers showed significant bias against children with intellectual disability. The prevalence of ADHD in children with intellectual disability was 18% (according to the symptom criterion), and 7.4% when the academic and/or social impairment criterion was also considered. Most of the ADHD symptoms can be valid for the assessment of ADHD in children with mild and moderate intellectual disability. ADHD symptoms may be used in further studies to establish base rates of the disorder in the intellectual disability population.

The Prevalence of Attention Deficit-Hyperactivity Disorder Symptoms Among Students and Its Relation with Drug Consumption

Background: Although Attention Deficit-Hyperactivity Disorder (ADHD) is a common mental disorder among adults, until recently, it was seldom diagnosed in adults. The significance of this disorder as a disease afflicting adults is increasing on a daily basis due to the complications associated with it such as disrupting occupational and educational functionality, as well as increasing the probability of drug abuse among those suffering from it. Objectives: With due regard to the significance of the subject. This study was conducted with the purpose of investigating the ADHD symptoms exhibited by students at Zahedan University of Medical Sciences. Patients and Methods: The present investigation is a descriptive-analytical study conducted at Zahedan Universitsy of Medical Sciences. The consensus sampling method was implemented to a sample volume consisting of 1000 persons. Based on the goals set in this research, two questionnaires were presented to the students to be completed arbitrarily: the demographic questionnaire and the Conners Adult ADHD Rating Scale Screening Version (CAARS-O:SV) questionnaire. The obtained information was then fed as input to the SPSS Software for analysis. Results: Of the 1000 questionnaires, 913 were completely answered by participants: 589 (64.5%) by female and 324 (35.5%) by male students. The average age of the participants was 21.7 ± 3.2. About 8% of the students reported drug abuse during the previous month. Compared with the symptom-free group, 27.1% in the inattention group, 30.3% in the hyperactivity group, 28.1% in the impulsiveness group, and 36.7% in the self-image problem group mentioned cases of drug abuse. Conclusions: The obtained results seem to indicate frequent occurrences of ADHD symptoms among the students. This requires further clinical evaluation and, if possible, diagnosis and consequent medical treatment for preventing the loss of educational performance or possible drug abuse, as well as decreasing impulsiveness.

Gene-Environment Interactions in ADHD: The Roles of SES and Chaos.

Although attention-deficit/hyperactivity disorder (ADHD) is highly heritable, emerging evidence suggests symptoms are associated with interactions between genes and the environment (GxE) during development. This study tested whether heritability of ADHD symptoms is moderated by two environmental factors: socioeconomic status (SES) and chaos (household disorganisation). A population sample of 520 twin pairs (N=1040, 52.3% female) from 6 to 15years completed measures of behavior and home environment. Structural equation modelling was then used to test whether environmental factors were associated with a change in the extent to which genes explain variability in ADHD symptoms. Neither chaos nor SES moderated heritability, with consistent contributions from both genes and environment indicated across socioeconomic strata and levels of chaos. This finding contrasts with those of previous research, underlining the need to replicate results in the emerging field of GxE research across different populations and statistical methods. Robust findings may assist in developing targeted interventions for genetically vulnerable individuals.

Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents

Although attention-deficit/hyperactivity disorder (ADHD) is highly prevalent in adolescents and often persists into adulthood, most studies about treatment were performed in children. Less is known about ADHD treatment in adolescents. To review the evidence for pharmacological and psychosocial treatment of ADHD in adolescents. The databases of CINAHL Plus, MEDLINE, PsycINFO, ERIC, and the Cochrane Database of Systematic Reviews were searched for articles published between January 1, 1999, and January 31, 2016, on ADHD treatment in adolescents. Additional studies were identified by hand-searching reference lists of retrieved articles. Study quality was rated using McMaster University Effective Public Health Practice Project criteria. The evidence level for treatment recommendations was based on Oxford Centre for Evidence-Based Medicine criteria. Sixteen randomized clinical trials and 1 meta-analysis, involving 2668 participants, of pharmacological and psychosocial treatments for ADHD in adolescents aged 12 years to 18 years were included. Evidence of efficacy was stronger for the extended-release methylphenidate and amphetamine class stimulant medications (level 1B based on Oxford Centre for Evidence-Based Medicine criteria) and atomoxetine than for the extended-release α2-adrenergic agonists guanfacine or clonidine (no studies). For the primary efficacy measure of total symptom score on the ADHD Rating Scale (score range, 0 [least symptomatic] to 54 [most symptomatic]), both stimulant and nonstimulant medications led to clinically significant reductions of 14.93 to 24.60 absolute points. The psychosocial treatments combining behavioral, cognitive behavioral, and skills training techniques demonstrated small- to medium-sized improvements (range for mean SD difference in Cohen d, 0.30-0.69) for parent-rated ADHD symptoms, co-occurring emotional or behavioral symptoms, and interpersonal functioning. Psychosocial treatments were associated with more robust (Cohen d range, 0.51-5.15) improvements in academic and organizational skills, such as homework completion and planner use. Evidence supports the use of extended-release methylphenidate and amphetamine formulations, atomoxetine, and extended-release guanfacine to improve symptoms of ADHD in adolescents. Psychosocial treatments incorporating behavior contingency management, motivational enhancement, and academic, organizational, and social skills training techniques were associated with inconsistent effects on ADHD symptoms and greater benefit for academic and organizational skills. Additional treatment studies in adolescents, including combined pharmacological and psychosocial treatments, are needed.

Variation in an Iron Metabolism Gene Moderates the Association Between Blood Lead Levels and Attention-Deficit/Hyperactivity Disorder in Children

Although attention-deficit/hyperactivity disorder (ADHD) is a heritable neurodevelopmental condition, there is also considerable scientific and public interest in environmental modulators of its etiology. Exposure to neurotoxins is one potential source of perturbation of neural, and hence psychological, development. Exposure to lead in particular has been widely investigated and is correlated with neurodevelopmental outcomes, including ADHD. To investigate whether this effect is likely to be causal, we used a Mendelian randomization design with a functional gene variant. In a case-control study, we examined the association between ADHD symptoms in children and blood lead level as moderated by variants in the hemochromatosis (HFE) gene. The HFE gene regulates iron uptake and secondarily modulates lead metabolism. Statistical moderation was observed: The magnitude of the association of blood lead with symptoms of ADHD was altered by functional HFE genotype, which is consistent with a causal hypothesis.

A Population-Based Imaging Genetics Study of Inattention/Hyperactivity: Basal Ganglia and Genetic Pathways

Although attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common neurodevelopmental disorders, little is known about the neurobiology. Clinical studies suggest basal ganglia morphology plays a role. Furthermore, hyperactivity/impulsivity symptoms have recently been linked to genetic pathways involved in dopamine/norepinephrine and serotonin neurotransmission and neuritic outgrowth. We aimed to assess the association between ADHD symptoms, basal ganglia volume, and the 3 proposed genetic pathways in a pediatric population-based sample. With this, we aimed to investigate the generalizability of earlier clinical findings to the general population. This study included a population-based sample of 1,871 children with data on ADHD symptoms and genetic data, and 344 children with additional neuroimaging data. Regression analyses between ADHD symptom severity and volumetric data of the basal ganglia were performed. Also, gene-set analyses investigating the association between both ADHD symptom severity and basal ganglia volume with the dopamine/norepinephrine, serotonin, and neuritic outgrowth pathways were performed. More inattention and hyperactivity/impulsivity symptoms were associated with a smaller volume of the putamen (β = -0.13, p = .034), which was regarded as trend-level after correction for multiple testing. Stratified analyses showed a stronger putamen-hyperactivity association in children with clinical scores, although a similar trend was visible in the nonclinical subsample. The genetic pathways were not related to either ADHD symptoms or basal ganglia volume. ADHD symptoms were marginally related to putamen volume in our population-based sample. We found no evidence for a role of dopamine/norepinephrine, serotonin, or neuritic outgrowth genetic pathways in ADHD symptom severity.

Parent-reported Attention Deficit/Hyperactivity symptomatology in preschool-aged children: factor structure, developmental change, and early risk factors.

Although Attention Deficit/Hyperactivity Disorder (ADHD) has increasingly been studied in preschool-aged children, relatively few studies have provided a comprehensive evaluation of the factor structure and patterns of developmental changes in parent-reported ADHD symptomatology across the early childhood period. This study used confirmatory factor analyses to test for longitudinal measurement invariance of ADHD symptoms and semi-parametric finite mixture models to identify prototypic patterns of developmental changes in ADHD symptomatology from 3 to 5 years of age. Participants were 1155 children and their parents who participated in a prospective longitudinal study involving a representative sample of children who resided in six non-metropolitan counties in the United States. Results indicated that (1) ADHD symptomatology was best represented by a single latent factor that exhibited partial measurement invariance from 3 to 5 years of age, (2) 8.5 % of children exhibited sustained high levels of ADHD symptoms from age 3-5 years, and (3) a variety of risk factors differentiated children with sustained high from those with sustained low levels of ADHD, relatively few (most notably caregiver education) were able to differentiate children with sustained high levels of ADHD symptoms from all other groups. Children who exhibit persistent ADHD symptomatology across the early childhood period may define a clinically important group for etiologic research and/or early intervention efforts.

Sex Differences in the Functional Neuroanatomy of Working Memory in Adults With ADHD

Although attention deficit hyperactivity disorder (ADHD) in adults is associated with significant morbidity and dysfunction and afflicts both sexes, relatively few imaging studies have examined female subjects and none have had sufficient power to adequately examine sex differences. The authors examined sex differences in the neural functioning of adults with ADHD during performance of a verbal working memory task. The participants were 44 adults with ADHD matched on age, sex, and estimated IQ to 49 comparison subjects. Accuracy and reaction time on an N-back task were measured to assess working memory. The blood-oxygen-level-dependent functional MRI response was used as a measure of neural activity. A group-by-sex analysis of variance showed no between-group differences in either reaction time or percent correct for the working memory task. For both sexes combined, the adults with ADHD showed less activity than comparison subjects in prefrontal regions. However, sex-by-group analyses revealed an interaction, such that male ADHD subjects showed significantly less activity in right frontal, temporal, and subcortical regions and left occipital and cerebellar regions relative to male comparison subjects, whereas female ADHD subjects showed no differences from female comparison subjects. Exploratory correlation analyses revealed negative associations between working-memory-related activation and number of hyperactive symptoms for men and number of inattentive symptoms for women. Male but not female adults with ADHD showed significantly altered patterns of neural activity during a verbal working memory task. Men and women showed different associations between neural activity and ADHD symptoms.

A functional serotonin transporter promoter gene polymorphism increases ADHD symptoms in delinquents: Interaction with adverse childhood environment

Although attention-deficit/hyperactivity disorder (ADHD) is highly heritable, environmental conditions play an important role in its manifestation during childhood development. Here, we report the results of an investigation on the interaction of adverse childhood environment with a functional polymorphism of the serotonin transporter promoter gene (5-HTTLPR) and its impact on ADHD psychopathology in young adult delinquents. Standardized instruments were used to assess childhood and current ADHD and adverse childhood environment in 184 male delinquents. Each subject was genotyped for 5-HTTLPR long (L) and small (S) alleles. Logistic regression analysis revealed independent effects of high childhood environmental adversity and the 5-HTTLPR LL-genotype on self-reported childhood ADHD and on persistent ADHD. In addition, a significant gene by environment interaction was found, indicating that carriers of at least one 5-HTTLPR short allele are more sensitive to childhood environment adversity than carriers of the LL-genotype. The results support prior findings of association between ADHD and 5-HTTLPR LL-genotype and adverse childhood environment, and they underline the need for further investigation of gene by environment interaction with respect to ADHD.

Parenting Behavior and Cognitions in a Community Sample of Mothers with and without Symptoms of Attention-deficit/Hyperactivity Disorder

Although attention-deficit/hyperactivity disorder (ADHD) in adults has recently emerged as an important area of research, little attention has been given to the family functioning of women with ADHD, particularly in their role as mothers. We examined parenting self-esteem, locus of control, and disciplinary styles in a community sample of mothers with varying levels of ADHD symptoms. Women with high levels of ADHD symptoms reported more occupational and psychiatric problems than women with lower levels of ADHD symptoms. They also reported lower parenting self-esteem, a more external parenting locus of control, and less effective disciplinary styles. The findings suggest that women with ADHD symptoms may face a number of difficulties within the parenting domain.

Continuous Performance Test Results of Adults with Attention Deficit Hyperactivity Disorder

Although Attention Deficit Hyperactivity Disorder (ADHD) is well established as a diagnosis in childhood, the diagnosis in adults remains controversial. The present study compared the Continuous Performance Test (CPT) performance of 60 clinic-referred adults with current ADHD symptomatology to normal subjects. Adults with current ADHD symptoms were found to make more errors of omission and commission than did normal adults. The signal detection theory variable, d', indicated that patients with ADHD were less sensitive to stimulus features than were normals. Using several CPT measures to predict group status, the CPT appeared to be of moderate clinical utility. These CPT results lend convergent validity to similar results in child populations and help to establish ADHD as a valid disorder of adulthood.