Attention Deficit Hyperactivity Disorder In Adolescents Research Articles

The use of telehealth in attention-deficit/hyperactivity disorder: a survey of parents and caregivers.

The use of telehealth became widespread during the COVID-19 pandemic, including in child and adolescent attention-deficit/hyperactivity disorder (ADHD) services. Telehealth is defined as live, synchronous phone and video appointments between a healthcare provider and a parent and/or child with ADHD. There is a dearth of research on the use of telehealth within this population. The aim of this study was to examine parents' and caregivers' perceptions of telehealth for children and adolescents with ADHD. A cross-sectional survey design was employed. Recruitment of parents and caregivers of children and adolescents with ADHD was conducted online. The survey asked participants about their views of telehealth, previous experience, and willingness to use telehealth. Quantitative data were analysed using STATA. Qualitative data were analysed using content analysis. One hundred and twelve respondents participated in the survey. Participants were mostly female (n = 97, 86.6%) and aged between 45 and 54 (n = 64, 57.1%). Of the 61 (54.5%) participants with experience of telehealth, the majority reported that that they were at least satisfied with telehealth visits (n = 36, 59%), whilst approximately half rated their quality more poorly than in-person visits (n = 31, 50.8%). The majority of respondents (n = 91, 81.3%) reported that they would be willing to use telehealth for their child's future appointments. Most common reasons selected for wanting to use telehealth included saving time, improvements to the family routine, and reducing costs. Reasons selected for not wanting to use telehealth included not being able to receive hands-on care, belief that the quality of care is poorer than in-person consultations, and distraction of the child during telehealth visits. The study demonstrates that parents recognise deficits and benefits of telehealth, suggesting a need to build their trust and confidence in remote ADHD care.

Attention-deficit/hyperactivity disorder: clinical phenotypes, polymorphism of life-course manifestations, and therapeutic strategies

Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder that manifests in childhood and persists into adulthood. The prevalence of ADHD (USA/worldwide) in children and adolescents is 9.5/5.29 %, in adults — 4.4/2.5 %. The disorder has strong genetic correlations with numerous mental disorders and neurological diseases, in particular with post-traumatic stress disorder, addiction to cannabis, cocaine, recurrent and bipolar affective disorders, behavioral disorders, which is the biological basis of its clinical polymorbidity. Symptoms of ADHD overlap with other clinical manifestations of neurodevelopmental disorders (symptoms of autistic spectrum disorders, speech disorders, movement disorders, dyslexia, cognitive impairment), forming a polymorphic spectrum of pervasive developmental variants. Psychostimulants have been the standard of ADHD treatment for over 50 years. In 2002, atomoxetine became the first nonstimulant medication approved by the Food and Drug Administration for the treatment of ADHD, first in children and later in adult patients. Stimulant and nonstimulant medications have been shown to be effective in different phenotypes of ADHD (comorbidity with other mental and neurological disorders). In case of comorbidity of ADHD with anxiety, tics, atomoxetine has an advantage over stimulants and, together with alpha-2-adrenergic receptor agonists, can be recommended as the first drug. The presence of comorbid anxiety disorder or recurrent depression does not impact the efficacy and side effects of atomoxetine. Thus, atomoxetine is an effective drug and not only improves the symptoms of ADHD, but also plays a certain role in the treatment of patients with comorbid depression and anxiety.

Smartphone Addiction and Attention Deficit-Hyperactivity Disorder in Adolescents: Chicken or the Egg

Smartphone Addiction and Attention Deficit-Hyperactivity Disorder in Adolescents: Chicken or the Egg

Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review.

Correct diagnosis is essential for the appropriate clinical management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. This systematic review provides an overview of the available diagnostic tools. We identified diagnostic accuracy studies in 12 databases published from 1980 through June 2023. Any ADHD tool evaluation for the diagnosis of ADHD, requiring a reference standard of a clinical diagnosis by a mental health specialist. Data were abstracted and critically appraised by 1 reviewer and checked by a methodologist. Strength of evidence and applicability assessments followed Evidence-based Practice Center standards. In total, 231 studies met eligibility criteria. Studies evaluated parental ratings, teacher ratings, youth self-reports, clinician tools, neuropsychological tests, biospecimen, EEG, and neuroimaging. Multiple tools showed promising diagnostic performance, but estimates varied considerably across studies, with a generally low strength of evidence. Performance depended on whether ADHD youth were being differentiated from neurotypically developing children or from clinically referred children. Studies used different components of available tools and did not report sufficient data for meta-analytic models. A valid and reliable diagnosis of ADHD requires the judgment of a clinician who is experienced in the evaluation of youth with and without ADHD, along with the aid of standardized rating scales and input from multiple informants across multiple settings, including parents, teachers, and youth themselves.

ADHD-AID: Aiding Tool for Detecting Children's Attention Deficit Hyperactivity Disorder via EEG-Based Multi-Resolution Analysis and Feature Selection.

The severe effects of attention deficit hyperactivity disorder (ADHD) among adolescents can be prevented by timely identification and prompt therapeutic intervention. Traditional diagnostic techniques are complicated and time-consuming because they are subjective-based assessments. Machine learning (ML) techniques can automate this process and prevent the limitations of manual evaluation. However, most of the ML-based models extract few features from a single domain. Furthermore, most ML-based studies have not examined the most effective electrode placement on the skull, which affects the identification process, while others have not employed feature selection approaches to reduce the feature space dimension and consequently the complexity of the training models. This study presents an ML-based tool for automatically identifying ADHD entitled "ADHD-AID". The present study uses several multi-resolution analysis techniques including variational mode decomposition, discrete wavelet transform, and empirical wavelet decomposition. ADHD-AID extracts thirty features from the time and time-frequency domains to identify ADHD, including nonlinear features, band-power features, entropy-based features, and statistical features. The present study also looks at the best EEG electrode placement for detecting ADHD. Additionally, it looks into the location combinations that have the most significant impact on identification accuracy. Additionally, it uses a variety of feature selection methods to choose those features that have the greatest influence on the diagnosis of ADHD, reducing the classification's complexity and training time. The results show that ADHD-AID has provided scores for accuracy, sensitivity, specificity, F1-score, and Mathew correlation coefficients of 0.991, 0.989, 0.992, 0.989, and 0.982, respectively, in identifying ADHD with 10-fold cross-validation. Also, the area under the curve has reached 0.9958. ADHD-AID's results are significantly higher than those of all earlier studies for the detection of ADHD in adolescents. These notable and trustworthy findings support the use of such an automated tool as a means of assistance for doctors in the prompt identification of ADHD in youngsters.

Prevalence and Clinical Picture of Diamine Oxidase Gene Variants in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Pilot Study.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder worldwide. The diamine oxidase enzyme (DAO) is responsible for the histamine gastrointestinal degradation. Its deficient functioning may implicate an excess of histamine in the body. The excess of histamine (histamine intolerance, HIT) has been related with a growing number of diseases and pseudo-allergic symptomatology. However, data on the relationship between the DAO enzyme, HIT, and ADHD are lacking. The main objective of this pilot is to study the prevalence of the four most relevant SNP variants of the AOC1 gene affecting DAO enzyme functionality in a sample of patients diagnosed with ADHD attending child and adolescent mental health services. Methods: In a cohort of 303 participants, we measured the SNP variants of the AOC1 gene. Results: The prevalence of having at least one minor dysfunctional allele was 78.8%. No relationship between ADHD severity and DAO deficiency was found. However, some AOC1 gene variants associated with DAO deficiency were related to several meaningful medical comorbidities. Furthermore, we found a strong association between DAO activity and the intelligence quotient, particularly in working memory. Conclusions: Some SNP variants of the AOC1 gene associated with DAO deficiency are related to some medical comorbidities and cognitive dysfunction in ADHD children and adolescents. Studies including patients with other diagnoses and healthy controls and bigger samples are warranted to confirm our preliminary results.

Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder

Few studies have characterized the nature of sleep problems among adolescents with attention-deficit/hyperactivity disorder (ADHD) using polysomnography (PSG). Additionally, although adolescents with ADHD and adolescents with sleep disturbances display similar neurocognitive deficits, the role of sleep in contributing to neurocognitive impairment in adolescent ADHD is unknown. This study investigated differences in PSG-measured sleep among adolescents with ADHD compared with non-psychiatric controls and associations with neurocognition. Medication-free adolescents aged 13 to 17 (N = 62, n= 31 with ADHD; mean age= 15.3 years; 50% female) completed a diagnostic evaluation, 3 nights of ambulatory PSG, the Cambridge Neuropsychological Test Automated Battery, and subjective reports of sleep and executive functioning. Linear regressions covarying for age, sex, and pubertal status examined group differences in sleep indices, and partial Pearson correlations assessed relations between sleep and neurocognition. Although adolescents with ADHD did not exhibit differences in PSG-measured sleep duration, awakenings, or latency (ps > .05) compared with non-psychiatric controls, they displayed lower slow wave sleep percentage (β=-.40) and non-rapid eye movement (NREM) electroencephalogram (EEG) delta power (β=-.29). They also exhibited greater stage 2 percentage (β= .41), NREM EEG sigma power (β= .41), and elevated self-reported sleep disturbances (ps< .05). Lower NREM EEG delta power, increased high-frequency power, and slower decline in NREM EEG delta power overnight were associated with poorer neurocognition among adolescents with ADHD. Adolescents with ADHD reported more sleep disturbances than non-psychiatric controls and exhibited differences in sleep stage distribution and NREM sleep EEG frequency. Sleep-EEG spectral indices were associated with impaired neurocognition, suggesting that physiological sleep processes may underlie neurocognitive deficits in ADHD. Future studies may clarify whether sleep plays a causal role in neurocognitive impairments in adolescent ADHD and whether interventions normalizing sleep improve neurocognition. Sleep Dysfunction and Neurocognitive Outcomes in Adolescent ADHD; https://clinicaltrials.gov/; NCT02897362. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Insomnia Polygenic Component on Attention Deficit-Hyperactivity Disorder: Exploring this Association Using Genomic Data from Brazilian Families

Abstract Introduction Insomnia is highly prevalent among individuals with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the biological mechanisms shared between both conditions is still elusive. We aimed to investigate whether insomnia's genomic component is able to predict ADHD in childhood and adolescence. Methods A Brazilian sample of 259 ADHD probands and their biological parents were included in the study. Their genomic DNA genotypes were used to construct the polygenic risk score for insomnia (Insomnia PRS), using the largest GWAS summary statistics as a discovery sample. The association was tested using logistic regression, under a case-pseudocontrol design. Results Insomnia PRS was nominally associated with ADHD (OR = 1.228, p = 0.022), showing that the alleles that increase the risk for insomnia also increase the risk for ADHD. Discussion Our results suggest that genetic factors associated with insomnia may play a role in the ADHD genetic etiology, with both phenotypes likely to have a shared genetic mechanism.

Increased risk of attention-deficit/hyperactivity disorder in adolescents with high salivary levels of copper, manganese, and zinc.

Exposure to toxic heavy metals has been associated with the development of attention-deficit/hyperactivity disorder (ADHD). However, fewer studies have examined the associations between abnormal levels of essential trace metals and ADHD, and none have done so using saliva. We investigated whether salivary metals were associated with ADHD in adolescents aged 12 from the Family Life Project (FLP) using a nested case-control study design that included 110 adolescents who met diagnostic criteria for inattentive (ADHD-I), hyperactive-impulsive (ADHD-H), or combined type ADHD (ADHD-C) (cases) and 173 children who did not (controls). We used inductively coupled plasma optical emission spectrophotometry to measure chromium, copper, manganese, and zinc in saliva samples. We employed logistic regression models to examine associations between quartile levels of individual metals and ADHD outcomes by subtype. Salivary copper levels were significantly associated with increased odds of any ADHD diagnosis (OR=3.31, 95% CI: 1.08-10.12; p=0.04) and with increased odds of ADHD-C diagnosis (OR=8.44, 95% CI: 1.58-45.12; p=0.01). Salivary zinc levels were significantly associated with increased odds of ADHD-C diagnosis (OR=4.06, 95% CI: 1.21-13.69; p=0.02). Salivary manganese levels were also significantly associated with increased odds of ADHD-C diagnosis (OR=5.43, 95% CI: 1.08-27.27, p=0.04). This is the first study using saliva to assess metal exposure and provide a potential link between salivary levels of copper, manganese, and zinc and ADHD diagnoses in adolescents. Public health interventions focused on metal exposures might reduce ADHD incidence in low-income, minority communities.

Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use.

The diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on the presence of pervasive, persistent symptoms of inattention and/or hyperactivity/impulsivity typically emerging early in life and resulting in significant functional impairment. In contrast to a worldwide epidemiological prevalence of approximately 5% in children and 2-3% in adults, there are significant variations in the prevalence of administrative ADHD diagnoses and medication use. We assert that in order to explore the underlying dynamics of this phenomenon, a thorough understanding of the construct ADHD is necessary. We contend that ADHD is not a natural entity that unfolds within an individual and can be understood independent from societal and environmental factors, but rather that ADHD as a diagnosis can better be conceptualized as a valid and pragmatically useful social construct. Decisions to diagnose and treat ADHD should follow a person-centered approach and be focused on functional impairment within a socially constructed, context-dependent and environmentally contingent model.

Prevalence of attention-deficit hyperactivity disorder in children, adolescents and adults in the Middle East and North Africa region: a systematic review and meta-analysis

ObjectivesTo systematically estimate the overall prevalence of attention-deficit hyperactivity disorder (ADHD) in children, adolescents and adults across the Middle East and North Africa (MENA) region.DesignSystematic review and meta-analysis conducted according...

Impaired flexible reward learning in ADHD patients is associated with blunted reinforcement sensitivity and neural signals in ventral striatum and parietal cortex

Reward-based learning and decision-making are prime candidates to understand symptoms of attention deficit hyperactivity disorder (ADHD). However, only limited evidence is available regarding the neurocomputational underpinnings of the alterations seen in ADHD. This concerns flexible behavioral adaption in dynamically changing environments, which is challenging for individuals with ADHD. One previous study points to elevated choice switching in adolescent ADHD, which was accompanied by disrupted learning signals in medial prefrontal cortex.Here, we investigated young adults with ADHD (n = 17) as compared to age- and sex-matched controls (n = 17) using a probabilistic reversal learning experiment during functional magnetic resonance imaging (fMRI). The task requires continuous learning to guide flexible behavioral adaptation to changing reward contingencies. To disentangle the neurocomputational underpinnings of the behavioral data, we used reinforcement learning (RL) models, which informed the analysis of fMRI data.ADHD patients performed worse than controls particularly in trials before reversals, i.e., when reward contingencies were stable. This pattern resulted from ‘noisy’ choice switching regardless of previous feedback. RL modelling showed decreased reinforcement sensitivity and enhanced learning rates for negative feedback in ADHD patients. At the neural level, this was reflected in a diminished representation of choice probability in the left posterior parietal cortex in ADHD. Moreover, modelling showed a marginal reduction of learning about the unchosen option, which was paralleled by a marginal reduction in learning signals incorporating the unchosen option in the left ventral striatum.Taken together, we show that impaired flexible behavior in ADHD is due to excessive choice switching (‘hyper-flexibility’), which can be detrimental or beneficial depending on the learning environment. Computationally, this resulted from blunted sensitivity to reinforcement of which we detected neural correlates in the attention-control network, specifically in the parietal cortex. These neurocomputational findings remain preliminary due to the relatively small sample size.

자애(Metta)명상과 ADHD 청소년의 또래 관계 개선에 관한 연관성 연구

This paper is a study that revealed that Metta meditation helps improve peer relationships among young people with ADHD (Attention Deficit Hyperactivity Disorder). I hope that young people living with ADHD symptoms can recognize differences in viewpoints of people around them with a negative perspective, recognize differences for themselves through psychological and emotional stability by combining medication and Buddhist meditation to solve external problems, and they will live a happy life as a member of society by improving their self-esteem and developing interpersonal skills by utilizing their strengths and weaknesses with people around them. &#x0D; Its purpose is to find out how Buddhist meditation can influence healing in ADHD adolescents in relation to peer relationships. Countries, local communities, and private institutions are studying various methods and establishing new organizations to try to solve problems. But It seems difficult to find a fundamental solution. Therefore, this study aims to approach solutions for young people with ADHD through Buddhist meditation from a Buddhist perspective.&#x0D; In this article, I first examined the theoretical background of improving peer relationships and Metta meditation, and considered Metta meditation. We also discussed whether there is a possibility of improving peer relationships among young people with ADHD. Metta meditation is a literature review that reveals that emotional composure has the opposite effect of improving interpersonal skills due to excellent coping ability.&#x0D; Through this study, it has been revealed that adolescents with ADHD are immature in interaction in peer relationships due to lack of performance in social skills due to lack of attention deficit hyperactivity, and impulsiveness characteristics. Also, adolescents with they have difficulty controlling their emotions and have a tendency to be less responsive to questions than efficiently communicating information. On the other hand, it has been proven that charity meditation stimulates the right brain, activates parasympathetic nerves, increases endorphins in the brain, and is effective in improving peer relationships with positive emotions. Through Metta meditation, ADHD adolescents can look forward to the effect of developing personal resources and helping them resolve conflicts in relationships with peers or people around them by looking at their minds.

Pharmacotherapy for ADHD in children and adolescents: A summary and overview of different European guidelines.

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a persistent pattern of inattention, hyperactivity, and impulsivity. It is the most common neurodevelopmental disorder presenting to pediatric services, and pediatricians are often involved in the early assessment, diagnosis, and treatment of children with ADHD. The treatment of ADHD typically involves a multimodal approach that encompasses a combination of psychoeducation, parent/teacher training, psychosocial/psychotherapeutic interventions, and pharmacotherapy. Concerning pharmacotherapy, guidelines vary in drug choice and sequencing, with psychostimulants, such as methylphenidate and (lis)dexamfetamine, generally being the favored initial treatment. Alternatives include atomoxetine and guanfacine. Pharmacotherapy has been proven effective, but close follow-up focusing on physical growth, cardiovascular monitoring, and the surveillance of potential side effects including tics, mood fluctuations, and psychotic symptoms, is essential. This paper presents an overview of current pharmacological treatment options for ADHD and explores disparities in treatment guidelines across different European countries. Conclusion: Pharmacological treatment options for ADHD in children and adolescents are effective and generally well-tolerated.Pharmacotherapy for ADHDis alwayspart of a multimodal approach.While there is a considerableconsensus among European guidelines on pharmacotherapy for ADHD, notable differences exist, particularly concerning the selection and sequencing of various medications. What is Known: • There is a significant base of evidence for pharmacological treatment for ADHD in children and adolescents. • Pediatricians are often involved in assessment, diagnosis and management of children with ADHD. What is New: • Our overview of different European guidelines reveals significant agreement in the context of pharmacotherapy for ADHD in children and adolescents. • Discrepancies exist primarily in terms of selection and sequencing of different medications.

The Relationship between Gene SLC6A3 Variable Number of Tandem Repeat (VNTR) and Attention-Deficit/Hyperactivity Disorder.

Objective : This research investigates the alleles of Variable Number of Tandem Repeats (VNTR) intron 8 of the gene SLC6A3 with attention-deficit / hyperactivity disorder (ADHD) in children and adolescents. Method : The study's target population consisted of children and adolescents referred to the specialized clinic, as well as students attending school in Rasht city during 2021-2022. A sample of 95 children between the ages of 6 and 10 with ADHD was selected as the ADHD group, and 95 healthy children were selected as the control group using purposive sampling. The subjects completed the Child Symptom Inventory-4 (CSI-4) checklist after a clinical interview, and demographic information was collected. Genetic sampling was carried out through hair follicles. The sequence of interest was proliferated using the Polymerase Chain Reaction technique )PCR(; afterward, the samples were used for genotype identification on polyacrylamide gel electrophoresis. Results: The chi-square test results indicated that the 5R / 5R genotype (P = 0.026, χ2 = 7.26) and the 5R allele (P = 0.002, χ2 = 9.35) had a higher frequency compared to the control group. Additionally, the odds ratio test indicated that, compared to other genotypes and alleles, the 5R / 5R genotype (OR = 2.75, 95% CI = 1.29-5.82, P = 0.01) and the 5R allele (OR = 2.02, 95% CI = 1.28-3.19, P = 0.002) increase the odds of developing ADHD by 2.7 and 2 times higher, respectively. Conclusion: The present study successfully showed the association between intron 8 gene polymorphism, which is responsible for encoding the dopamine transporter as well as ADHD in children and adolescents in Iran.

Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents.

Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.

Using Hot and Cool Measures to Phenotype and Predict Functional Outcomes Across Dimensions of ADHD and Typical Development in Adolescents.

Multiple pathway models propose that attention deficit hyperactivity disorder (ADHD) arises from dysfunction in separate systems comprised of a "cool" or cognitive pathway versus a "hot" or emotional/reward pathway. Interactions between these pathways and the degree of maturation may further determine functional outcomes for adolescents ranging from those diagnosed with ADHD to typical development (TD). We used a latent profile analysis on rating scales and behavioral task performance assessing emotion, irritability, impulsivity, risk-taking, future orientation, and processing speed (PS) to identify subgroups of TD adolescents and adolescents with ADHD (N = 152) based on the hot and cool pathway model. We identified four classes: 1) High-Complex Challenges; 2) Moderate-Mixed Challenges; 3) Non-Emotive Impulsivity; and 4) High Regulation and Control. A multiple pathway model of ADHD is supported with classes differing in degree of emotional lability and irritability, types of impulsivity, and ability to use future consequences to modulate impulsivity and PS. The classes differed regarding functional behavior, with the High-Complex class demonstrating the most severe functional challenges in academic-related functioning. The Moderate-Mixed class also displayed significant functional challenges but with moderate emotional lability and irritability ratings. The Non-Emotive Impulsivity class exhibited low emotionality and low irritability, yet high impulsivity with limited negative functional consequences, and was composed of a mix of ADHD and TD adolescents. Differences between classes suggest ADHD symptomatology may represent both categorical and dimensional differences. Precision health interventions may be more effective in addressing the specific challenges associated with the classes rather than a one-size-fits-all approach to treating ADHD.

Lowered social motivation is associated with adolescent attention deficit hyperactivity disorder and social anxiety symptoms.

Difficulties in social skills are highly prevalent in children and adolescents with attention deficit hyperactivity disorder (ADHD), however, the reasons for these social difficulties are poorly understood. This study aimed to understand social motivation in children (aged 5-8) and adolescents (aged 13-17) with and without ADHD, and the relationship between social anxiety and social motivation in youth with ADHD. 204 parents of children and adolescents with and without ADHD completed online questionnaires on social motivation, social anxiety, and ADHD symptoms. Adolescents with ADHD had significantly lower social motivation than typically developing adolescents, and children with ADHD. Higher social anxiety significantly predicted lowered social motivation in participants with ADHD. These findings indicate a unique pattern of social motivation in ADHD, specifically a reduction during adolescence, reflecting social intervention inefficacy. Additionally, these findings establish a link between social motivation and social anxiety, suggesting that they may act as barriers to social intervention.

Neuropsychological Assessment of the Relationship of Working Memory with K-BIT Matrices and Vocabulary in Normal Development and ADHD Children and Adolescents.

The present report tries to understand the possible relationship between working memory (WM) and intelligence measurements, using the direct scores of the Working Memory Test Battery for Children (WMTBC) and Kaufman's Brief Intelligence Test (K-BIT), in normal development (ND) and diagnosed attention deficit hyperactivity disorder (ADHD) children and adolescents. Partial correlations, discounting the effect of age, showed a significant correlation in ND subjects between the central executive (CE) component of WM and the WM visuospatial sketchpad (VSS) component and the WM phonological loop (PL); also, significant correlations were obtained for the WM VSS with the K-BIT Matrices scores, the WM PL with the K-BIT Vocabulary, and the K-BIT Matrices scores with the K-BIT Vocabulary. For ADHD subjects, there were significant correlations between WM VSS and WM CE, and WM VSS and K-BIT Matrices. We tested the robustness of these correlations by selecting a small number of subjects through permutations; a robust correlation between WM CE and WM PL in ND, and between WM VSS and WM CE and WM VSS and K-BIT Matrices scores was obtained. These results were also supported by mediation analysis. There is a relationship during development between WM as measured with WMTBC and general intelligence as measured with K-BIT in ND and ADHD subjects. The dysexecutive character of ADHD has been shown, given that by controlling for intelligence, the differences in WM performance between ND and ADHD disappear, except for WM CE. The results suggest that in ADHD subjects, the WM VSS component presents a more pivotal role during cognitive processing compared to ND subjects.

The Relationship Between Emotion Dysregulation and Error Monitoring in Adolescents with ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the limitations of existing diagnostic categories. One potential solution, consistent with the Research Domain Criteria (RDoC) initiative, is to interrogate psychological mechanisms at the behavioral and physiological level together to try and identify meaningful subgroups within existing categories. Such approaches provide a way to revise diagnostic boundaries and clarify individual variation in mechanisms. Here, we illustrate this approach to help resolve heterogeneity in ADHD using a combination of behaviorally-rated temperament measures from the Early Adolescent Temperament Questionnaire; cognitive performance on three difference conditions of an emotional go/no-go task; and electroencephalogram (EEG)-measured variation in multiple stages of error processing, including the error-related negativity (ERN) and positivity (Pe). In a large (N = 342), well-characterized sample of adolescents with ADHD, latent profile analysis identified two ADHD temperament subgroups: 1) emotionally regulated and 2) emotionally dysregulated (with high negative affect). Cognitive and EEG assessment in a subset of 272 adolescents (nADHD = 151) found that the emotionally dysregulated group showed distinct patterns of change in early neural response to errors (ERN) across emotional task conditions as compared to emotionally-regulated ADHD adolescents and typically-developing controls. Both ADHD groups showed blunted later response to errors (Pe) that was stable across emotional task conditions. Overall, neural response patterns identified important differences in how trait and state emotion interact to affect cognitive processing. Results highlight important temperament variation within ADHD that helps clarify its relationship to the ERN, one of the most prominent putative neural biomarkers for psychopathology.