Attention Complaints Research Articles

B - 126 Posttraumatic Stress Disorder Symptoms as a Predictor of Invalid Attention-Deficit/Hyperactivity Disorder and General Psychiatric Symptom Reporting among Adult Neuropsychology Referrals

Abstract Objective Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in adulthood is complicated by the nonspecific nature of attention complaints, which overlap with most forms of internalizing psychopathology as well as elevated rates of invalid symptom overreporting. This study assessed the relationship between posttraumatic stress disorder (PTSD) symptoms and overreporting of both ADHD and general psychological symptoms. Method Data from 308 consecutive adults (mean age = 29.0; mean education = 16.09; 57.5% female, 42.5% male; 35% White, 27% Hispanic, 18% Black, 13% Asian, 7% Other) referred for neuropsychological evaluation of possible ADHD were administered the PTSD Checklist for DSM-5 (PCL-5) and embedded symptom validity tests (SVTs) on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Patients were classified as overreporting/no overreporting ADHD and general psychiatric symptoms based on elevations on the CAT-A and MMPI-2-RF overreporting SVTs, respectively. Results Logistic regressions showed that higher PCL-5 scores significantly predicted overreporting of both ADHD symptoms on CAT-A (X2 = 7.47, p = 0.006; Classification Accuracy = 85.1%; Nagelkerke R2 = 0.04; B.025; p = 0.007) and psychiatric symptoms on MMPI-2-RF (X2 = 58.76, p < 0.001; Classification Accuracy = 71.4%; Nagelkerke R2 = 0.35; B = -1.92; p < 0.001), with significantly greater variance predicted for overreporting of psychiatric symptoms. Conclusions Higher PTSD symptoms predicted overreporting of ADHD symptoms (CAT-A) and, more significantly, broad psychopathology (MMPI-2-RF). Findings reinforce the necessity of SVTs when evaluating ADHD among adults, particularly in the context of elevated PTSD symptoms, and also indicate that neuropsychologists should consider routinely assessing patients’ trauma history/symptomatology during ADHD evaluations to improve diagnostic accuracy.

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus

Background and objectivesEvidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. MethodsThe study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). ResultsSignificant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. ConclusionThis study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus

Background and objectivesEvidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. MethodsThe study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). ResultsSignificant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. ConclusionThis study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Mental disorders during the pandemic of a new coronavirus infection: clinical features

Objective: to study the clinical features of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness.Material and methods. We examined 100 patients who turned to psychiatrist due to deterioration of their mental state on the background of a pandemic. Of these, 50 were new cases (1st group; 23 women and 27 men, mean age 34 years) and 50 were cases with previously diagnosed mental disorders (2nd group; 25 women and 25 men, mean age 37 years). 80% of patients of the 1st group, 54% of patients of the 2nd group had coronavirus infection. Anxiety and depressive disorders prevailed in the 1st group, endogenous diseases prevailed in the 2nd group: bipolar affective disorder, recurrent depressive disorder, schizophrenia. The study was conducted by the clinical method using a specially designed map; the severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale, and the severity of anxiety was assessed using the Hamilton Anxiety Rating Scale.Results. The clinical picture of primary and recurrent depressive episodes after infection was characterized by the presence of motor and associative retardation, severe apathy, hypersomnia and lack of sleep, fatigue, increased appetite, and complaints of impaired attention and memory. Depression in SARS-CoV-2 survivors was characterized by anxiety, anhedonia, irritability, somatic complaints, and hypochondriacal inclusions. Anxiety symptoms in those who were not ill included severe anxiety, reaching agitation, disturbed sleep with frequent awakenings, irritability, somatic complaints, and hypochondriacal fixation on one’s condition. In recovering patients, anxiety was accompanied by control of somatic functions, cognitive impairments, and fear of retention or even intensification.Conclusion. The results obtained indicate the existing differences between the mental disorders that first appeared and worsened during the pandemic, as well as the differences in the structure of the depressive and anxiety syndrome depending on the presence or absence of coronavirus infection.

The mediating role of attention deficit in relationship between insomnia and social cognition tasks among nurses in Saudi Arabia: A cross-sectional study.

Insomnia-related affective functional disorder may negatively affect social cognition such as empathy, altruism, and attitude toward providing care. No previous studies have ever investigated the mediating role of attention deficit in the relationship between insomnia and social cognition. A cross-sectional survey was carried out among 664 nurses (Mage = 33.03 years; SD ± 6.93 years) from December 2020 to September 2021. They completed the Scale of Attitude towards the Patient (SAtP), the Athens Insomnia Scale (AIS), a single-item numeric rating scale assessing the increasing severity of attention complaints, and questions relating to socio-demographic information. The analysis was carried out by examining the mediating role of attention deficit in the relationship between insomnia and social cognition. The prevalence of insomnia symptoms was high (52% insomnia using the AIS). Insomnia was significantly correlated with attention problems (b = 0.18, standard error (SE) = 0.02, p < 0.001). Attention problems were significantly negatively correlated with nurses' attitudes towards patients (b = -0.56, SE = 0.08, p < 0.001), respect for autonomy (b = -0.18, SE = 0.03, p < 0.001), holism (b = -0.14, SE = 0.03, p < 0.001), empathy (b = -0.15, SE = 0.03, p < 0.001), and altruism (b = -0.10, SE = 0.02, p < 0.001). Attention problems indirectly mediated the effect of insomnia on attitudes toward patients (99% CI = -0.10 [-0.16 to -0.05]), respect for autonomy (99% CI = -0.03 [-0.05 to -0.02]), holism (99% CI = -0.02 [-0.04 to -0.01]) empathy (99% CI = -0.03 [-0.04 to -0.01]), and altruism (99% CI = -0.02 [-0.03 to -0.01]). Nurses with insomnia-related attention problems are likely to have poor explicit social cognition such as attitude toward patients, altruism, empathy, respect for autonomy, and holism.

COVID-19 and Its Long-Term Neurological and Cognitive Implications: A Literature Review

Introduction: COVID-19 is an infectious disease resulting from severe acute respiratory syndrome. Individuals with prior COVID-19 infection have had neurological complaints of impaired attention, fatigue, and “brain fog”. This review seeks to summarize the associations between COVID-19 infection and the development of the neurocognitive elements of post-acute COVID syndrome (PACS) which is relevant to healthcare workers for the efficient treatment and management of the long-term effects of COVID. Methods: Literature that examines the neurocognitive complaints caused by COVID-19 infection, including brain fog, attention deficits, psychiatric impairment, and fatigue were selected. Google Scholar and PubMed were the primary databases used to obtain relevant literature. After preliminary searching, 21 articles were analyzed as part of this review. Results: The following symptoms of PACS were persistently reported by a large majority (approximately ⅓ to ½) of patients: breathlessness, cough, fatigue, and brain fog. PACS neurological symptoms were more prevalent in females than in males. Reported psychiatric symptoms from prior COVID-19 infection were ADHD, depression, and insomnia. Discussion: The causes of these neurocognitive symptoms were attributed to neuroinflammation of the choroid plexus, intracerebral hemorrhagic lesions, and hypoactivity in the anterior and posterior cingulate cortex. These possible pathways were confirmed with magnetic resonance imaging (MRI) findings, computed tomography (CT) scans, and positron emission tomography (PET) scans. Conclusion: This paper will add to the evidence regarding the association between COVID-19 and the development of neurocognitive PACS. It is hoped that future research will build on a clearer understanding of the etiology of neurocognitive issues associated with viral infection.

Linking aberrant pauses during object naming to letter and word decoding speed in elderly with attention complaints

Attention deficit and reading difficulty are often comorbid in neuropsychiatric disorders of childhood and adolescence. Although recent research has shown how these two domains may interact in children, knowledge about such interaction in elderly is lacking. The present study tested whether this association is also present in healthy elderly with undiagnosed attention problems. Thirty-two subjects (65+ years) with life-long complaints of attention and with a Mini Mental (MMSE) cutoff of 27 points were tested with MapCog Spectra (MCS), with a word recognition test (Word Chains test) and CANTAB subtests of attention. All tests were presented on a tablet, except for the Word Chains test. The participants mean MMSE score was 29 points and their mean age was 71.5 years. Strong correlations were seen between the Word Chains test and the MCS, suggesting that a high number of aberrantly long pauses during serial naming was associated with fewer identifications of letters, words and sentences. The number of aberrant pauses was also associated with slower Reaction Time and a lower score on the Attention Shifting task of the CANTAB. The results were not associated with either gender or general intelligence. This study shows that attention is linked to decoding speed irrespective of intelligence and gender. We therefore suggest that a clinical assessment of attention deficit should also include an assessment of decoding ability, and vice versa, as these cognitive functions are strongly interdependent.

Look who is complaining: Psychological factors predicting subjective cognitive complaints in a large community sample of older adults

Subjective cognitive complaints (SCCs) are not directly related to objective impairments in cognition. This study examines the role of psychological factors in predicting SCCs in the domains of executive functioning, memory, and attention in older adults. A community sample of 1,219 Dutch adults, aged 40 year or older, completed the BRIEF-A, MSEQ, FEDA, NEO-FFI, DASS-21, and a demographic questionnaire. Participants were randomly divided into exploratory (n = 813) and confirmatory samples (n = 406). In the exploratory sample, we analyzed whether personality factors, symptoms of depression and anxiety, perceived stress, and demographics could predict SCCs in the different cognitive domains. For this purpose, a two-step regression approach with bootstrapping was used. To independently validate the results, these analyses were repeated in the confirmatory sample. Concerning executive functioning, complaints regarding the ability to regulate behavior and emotional responses were predicted by lower agreeableness levels and higher levels of neuroticism and perceived stress. Complaints regarding the ability to actively solve problems in different circumstances were predicted by a lower conscientiousness level, higher agreeableness level, and more depressive symptoms. Attentional complaints were predicted by lower levels of conscientiousness and extraversion, together with a higher level of neuroticism. For memory, no significant predictors were consistently found. Psychological factors are of influence on the subjective experience of cognitive complaints. In particular personality factors, perceived stress, and symptoms of depression, seem to predict SCCs in the domains of executive functioning and attention. Clinicians should take these factors into account in older adults who have SCCs.

Predictive value of performance validity testing and symptom validity testing in psychoeducational assessment

Using archival data from 2463 psychoeducational assessments of postsecondary students we investigated whether failure on either symptom or performance validity tests (SVTs or PVTs) was associated with score differences on various cognitive, achievement, or executive functioning performance measures or on symptom report measures related to mental health or attention complaints. In total, 14.6% of students failed one or more PVT, 33.6% failed one or more SVT, and 41.6% failed at least one validity test. Individuals who failed SVTs tended to have the highest levels of self-reported symptoms relative to other groups but did not score worse on performance-based psychological tests. Those who failed PVTs scored worse on performance-based tests relative to other groups. Failure on at least one PVT and one SVT resulted in both performance and self-reported symptoms suggestive of greater impairment compared with those who passed all validity measures. Findings also highlight the need for domain-specific SVTs; failing ADHD SVTs was associated only with extreme reports of ADHD and executive functioning symptoms while failing mental health SVTs related only to extreme reports of mental health complaints. Results support using at least one PVT and one SVT in psychoeducational assessments to aid in diagnostic certainty, given the frequency of non-credible presentation in this population of postsecondary students.

Greater baseline subjective attentional complaints predict poorer 8-week antidepressant response in late-life depression

<h3>Introduction</h3> Late-life depression (LLD) is characterized by both subjective cognitive complaints and objective cognitive deficits, most notably in executive functions. Worse cognitive performance, including in the executive function domain, is associated with poor antidepressant treatment outcomes. While executive-based cognitive complaints are similarly associated with poor treatment outcomes, the relationship between other subjective cognitive complaints and antidepressant response is not as clear. This may be particularly relevant for subjective attentional complaints, a common finding and clinical diagnostic criterion for Major Depressive Disorder. <h3>Methods</h3> Eighty-eight adults with LLD were recruited (mean age = 66.07 ± 4.49, 61% female, baseline mean Montgomery-Asberg Depression Rating Scale (MADRS) = 26.38 ± 5.46) and underwent an 8-week antidepressant trial. Subjective cognitive complaints were assessed with the following scales: Attentional Control Scale (ACS, focusing in-depth on attention), the WHODAS 2.0, domain 1 (focusing largely on attentional abilities), and the PROMIS Cognitive Abilities and Concerns (focusing on general / broad-based cognitive abilities). Antidepressant response was determined via the change in MADRS scores from baseline to week 8. Separate linear regressions examined the relationship between subjective cognitive complaints and change in MADRS scores, controlling for age, sex, baseline MADRS, and treatment arm. <h3>Results</h3> After covariate adjustment, ACS and WHODAS scores significantly predicted antidepressant response (<i>ß =</i> -0.42<i>, p=</i> 0.02 and <i>ß =</i> 0.57<i>, p=</i> 0.03, respectively), such that greater subjective attentional complaints at baseline were related to less improvement in MADRS scores. General cognitive complaints via the PROMIS were not significantly associated with antidepressant response. Follow-up analyses decomposing the ACS into its two subscales found that the change in MADRS scores was significantly related to attentional shifting (<i>ß = -</i>0.79, <i>p</i> = 0.01), but not focusing (<i>ß =</i> -0.57, <i>p</i> = 0.06), complaints. <h3>Conclusions</h3> Results highlight the importance of assessing for subjective cognitive complaints in LLD, particularly in the domain of attention, as their presence at baseline may be related to treatment response. Further research is needed to better understand the relationship between subjective and objective cognition in LLD, their relationship with treatment response and other outcomes, as well as underlying mechanisms. <h3>Funding</h3> R01MH102246

Howtostayfocused.org Addressing attention-related health problems in higher education with an eTool

Abstract Background 20 to 30% of university students consistently report attention-related health problems (studenthealthcheck), such as depression, a less healthy lifestyle (e.g. alcohol/ drugs, sleep, etc.) or adhd. Students are healthcare avoiders and as such ideal candidates for eHealth. To sort out their attention problems, increase their knowledge and guide them to solutions, howtostayfocused.org/ has to be scientifically evaluated. Methods A qualitative study was conducted in 2019 at the Student Health Service of the UvA. A prototype eTool and interview guide were developed in accordance with CeHRes, contextual background and value specifications for attention-related issues. Semi-structured cognitive interviews were administered to students before, during and after completion of the Etool (i.e. think aloud method) (N = 9; 5 female; mean age 23.5) concerning its' system, content and service quality. (audio recorded, transcribed verbatim and thematically analyzed). Results They were triggered to conduct the test and appreciated the personal advice that advanced the acceptance and confirmation of their complaints. the system: User-friendliness, lay out and abundance of information were appreciated. Improvements included technical errors, too much text provision, low visualizations, unclear navigation.the content: Although appreciative of the content, improvements included experience stories, study tips, information clarity.the service quality: Self-sufficiency has added value. (perceived usefulness) Soon after the launch of the eTool, it was used about 1000 times. Conclusions An eTool to address, clarify and analyze attention-related health problems among university students is considered of added value to meet their self-sufficient ways. They appreciated the personal advice from the test for the acceptance and confirmation of their attentional complaints. These results are of value for the development of other health-related web-based innovations for students. Key messages eHealth is a suitable way to address (attention-related) health problems that are common in university students, who are typically healthcare avoiding. The eTool contributes to prevention in the sense that university students may identify their attention-related health problems at an earlier stage and prevent aggravation of their complaints.

Lifestyle Variables Do Not Predict Subjective Memory Performance Over and Above Depression and Anxiety.

The diagnostic value of subjective cognitive complaints for cognitive functioning in a clinical setting remains unresolved today. However, consensus exists on the relation between subjective cognitive complaints (SCC) and mood variables such as anxiety and depression. Hence, SCC have also been discussed as potential proxies of psychopathology rather than representing cognitive functioning. In order to shed more light on yet still unexplained variance in subjective cognitive complaints, the relation between lifestyle variables (such as nutrition habits, exercise, alcohol consumption, smoking, quality of sleep, and Body Mass Index) and subjective complaints of selective attention as well as subjective memory performance were assessed, additionally to the influence of objective memory performance, measures of anxiety, and depression. A sample of 877 (554 women) healthy, middle-aged individuals (51 years on average, age range 35–65) was assessed in the present study. In a logistic regression framework results revealed that the effect of lifestyle variables on subjective complaints of selective attention as well as subjective memory performance was rendered non-significant. Instead, subjective complaints of selective attention and subjective memory performance were significantly determined by measures of both, anxiety and depression. One unit increase in anxiety or depression led to an increase of 6 or 15% in subjective memory performance complaints, respectively. For subjective complaints of selective attention, a one unit increase in anxiety or depression led to an increase of 11 or 26%, respectively. The strong relation between SCC and measures of depression and anxiety corroborates the notion of SCC being indicative of mental health and general well-being.

BLAST paradigm: A new test to assess brief attentional fluctuations in children with epilepsy, ADHD, and normally developing children

BackgroundPure attentional deficits are still underdiagnosed in children with epilepsy. While attention-deficit hyperactivity disorder (ADHD) is historically the most studied cause of attentional disorders, an important number of children with epilepsy and attentional complaints do not fully meet the DSM-V (Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition) criteria for ADHD and may be excluded from specific care. Clinical tools currently available are insufficient to detect more subtle but clinically relevant attentional fluctuations. Objective/methodsThe recently developed Bron–Lyon Attention Stability Test (BLAST) was used to evaluate brief attentional fluctuations with a high temporal precision. Drawing on two new attentional indices, we evaluated spontaneous fluctuations of response accuracy and timing, underlying attentional stability. The main objective was to assess attentional stability in children with i) epilepsy with comorbid ADHD, ii) epilepsy without comorbid ADHD, iii) ADHD not medicated and without epilepsy, and iv) normal development. Further objectives were to assess the main determinants of attentional stability in those groups, including the effect of factors related to the epileptic condition. ResultsIn 122 children with epilepsy (67 with comorbid ADHD), 52 children with ADHD, and 53 healthy controls, we demonstrated lower attentional stability in both the groups with epilepsy and ADHD compared with healthy children. In children with epilepsy, BLAST scores were negatively associated with earlier seizure onset and AED (antiepileptic drug) polytherapy, while the seizure frequency, epilepsy duration, or type did not influence BLAST scores. ConclusionsThis study demonstrates that attentional stability is impaired in children with epilepsy and/or ADHD. Bron–Lyon Attention Stability Test seems to be a sensitive test to detect attentional stability deficit in children with epilepsy and with attentional complaints who did not meet all criteria of ADHD.We propose that BLAST could be a useful clinical neuropsychological tool to assess attentional disorders in children.

Depression is not the only cause of cognitive impairment in chronic migraine

Background. Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied.Objective – to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology. Materials and methods. We recruited 62 subjects with chronic migraine and 36 genderand age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18–59. All patients filled in the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20).Results. In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval – 1.59–16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment.Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine.

Attention impairments and ADHD symptoms in adult narcoleptic patients with and without hypocretin deficiency

BackgroundAttentional complaints are common in narcolepsy patients and can overlap with daytime sleepiness features. Few studies attempted to characterize attentional domains in narcolepsy leading to controversial results. We aimed to assess the impact of hypocretin deficiency on attentional functioning by comparing performances on the attention network test (ANT) of narcoleptic patients with hypocretin deficiency (narcolepsy type 1—NT1) versus patients without hypocretin deficiency (narcolepsy type 2—NT2) and healthy controls. We also addressed frequency and severity of psychopathological symptoms and their influence on performances on ANT.MethodsTwenty-one NT1 patients, fifteen NT2 patients and twenty-two healthy controls underwent the ANT, which allows assessing three separate attentional processes (alerting, orienting and executive control), and a psychometric assessment including questionnaires on attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, anxiety and depression symptoms.ResultsNT1 and NT2 patients presented with slower reaction times compared to controls. NT1 patients exhibited an impairment of alerting network relative to NT2 and healthy controls, while orienting and executive control networks efficiency were comparable between groups. NT1 and NT2 displayed higher severity of ADHD inattentive domain than controls, NT1 patients also displayed higher severity of ADHD hyperactive domain and depressive symptoms. In NT1, ADHD and depressive symptoms were positively correlated.ConclusionsDespite a shared slowing of reaction times in both NT1 and NT2, a selective impairment of alerting network was present only in hypocretin deficient patients. Clinicians should carefully consider attentional deficits and psychopathological symptoms, including ADHD symptoms, in the clinical assessment and management of patients with narcolepsy.

Effects of methylphenidate on auditory processing assessment: a case study

Model of the study: case report. Introduction: The Auditory Processing Disorder (APS) and Attention Deficit Hyperactivity Disorder (ADHD) show similarity for signs and symptoms, however are unique and comorbidities may be presented correlated. Importance of the study: APD and ADHD present similar symptoms and may be correlated, but there is a need for differential diagnosis between such comorbidities to improve the quality of life of the subject. Purpose: This study analyzed the results of the auditory processing assessment in a subject with attention deficit, before and after use of the Methylphenidate medicine. Methods: It was used a battery of behavioral tests of auditory processing and the LongLatency Auditory Evoked Potential (LLAEP) in two different moments, before and after pharmacological treatment for attention deficit disorder. Comments: Participated on this study a subject of 22 years assessed in the Audiology Clinic of a University Hospital, because reported comprehension difficulty of speech in noise. The clinical history showed perinatal complications (prematurity, low birth weight, remain in neonatal ICU) and attention complaints over the years. Results: The results tests showed that there was a subtle improvement in performance during behavioral assessment of auditory processing, as well as in the electrophysiological assessment after the medication methylphenidate. Conclusion: These results emphasize the speech therapists/audiologists about the need to consider the use of medication methylphenidate by the patient at the time of auditory processing evaluation, as well as therapeutic process

A-42What Is Related to Complaints of Attention Deficit/Hyperactivity Disorder (ADHD) Symptoms? The Forgotten Contribution of Sleep

A-42What Is Related to Complaints of Attention Deficit/Hyperactivity Disorder (ADHD) Symptoms? The Forgotten Contribution of Sleep

Children, computer exposure and musculoskeletal outcomes: the development of pathway models for school and home computer-related musculoskeletal outcomes

Children's computer use is rapidly growing, together with reports of related musculoskeletal outcomes. Models and theories of adult-related risk factors demonstrate multivariate risk factors associated with computer use. Children's use of computers is different from adult's computer use at work. This study developed and tested a child-specific model demonstrating multivariate relationships between musculoskeletal outcomes, computer exposure and child factors. Using pathway modelling, factors such as gender, age, television exposure, computer anxiety, sustained attention (flow), socio-economic status and somatic complaints (headache and stomach pain) were found to have effects on children's reports of musculoskeletal symptoms. The potential for children's computer exposure to follow a dose–response relationship was also evident. Developing a child-related model can assist in understanding risk factors for children's computer use and support the development of recommendations to encourage children to use this valuable resource in educational, recreational and communication environments in a safe and productive manner.Practitioner Summary: Computer use is an important part of children's school and home life. Application of this developed model, that encapsulates related risk factors, enables practitioners, researchers, teachers and parents to develop strategies that assist young people to use information technology for school, home and leisure in a safe and productive manner.

Clinical and neuropsychological assessment of attention and ADHD comorbidity in a sample of children and adolescents with idiopathic epilepsy.

Children with epilepsy present significant problems concerning attention and comorbidity with attention deficit hyperactivity disorder (ADHD). To determine the prevalence of attention complaints, ADHD diagnosis and attention profile in a sample of children and adolescents with idiopathic epilepsy. 36 children and adolescents with idiopathic epilepsy and 37 genre and age matched healthy controls underwent several procedures to diagnose their neuropsychological profile and comorbidity with ADHD. The prevalence of ADHD was higher in patients with epilepsy [χ2= 4.1, p = 0.043, 6 (16.7%) vs 1 (2.7%)], with worse results in attention related WISC items and factors in patients with epilepsy comparing to the controls, but not between patients with and without ADHD. Clinical characteristics did not influence those results. This study found a greater prevalence of problems wih attention in pediatric patients with idiopathic epilepsy, but not a distinct profile between those with or without ADHD.

Selective Attention and Mental Flexibility are Reduced during the Interictal Period in Migraine

Background:Headache patients frequently complain about difficulties in attention and concentration, even when they are headache free, and psychometric studies concerning attentional deficits in migraine patients between attacks are scarce.Objective:To evaluate selective attention of migraine patients interictally and compare them with healthy volunteers.Patients and Methods:We performed, between February 2011 and July 2011, a case-control study including 45 university students suffering from migraine matched with 45 healthy students as controls. Migraine patients were evaluated in an interictal state. Subjects with another headache type, history of brain injury, epilepsy and visual disturbances were excluded. Mood disorders were assessed using the Hospital Anxiety and Depression (HAD) questionnaire. Selective attention was evaluated using the Delis–Kaplan Executive Functions System (D-KEFS) colour-word interference test.Results:Mean age of patients was 23.29±2.55 years, versus 22.89±2.04 years for controls (p=0.2). The selective attention score was −4.04±7.08 for patients, versus −1.31±7.73 for controls (p=0.02). The mean mental flexibility score was lower in migraine patients compared with controls (36.67±6.79 versus 41.33±6.23; p=0.01). Gender, anxiety, depression scores and migraine characteristics had no correlation with the selective attention score.Conclusion:Selective attention and mental flexibility capacities are significantly reduced in migraine patients during the interictal period. These abnormalities probably contribute to frequent attentional complaints among these patients.