ADHD Symptoms Research Articles

Exploring the pathways linking prenatal and early childhood greenness exposure to attention-deficit/hyperactivity disorder symptoms during childhood: An approach based on robust causal inference

BackgroundEpidemiological studies suggest that exposure to greenness during childhood may protect children from developing attention-deficit hyperactivity disorder (ADHD). ObjectiveWe analyzed the effect of both prenatal (pregnancy) and early childhood (4-5-year follow-up) residential greenness exposure and green space availability on ADHD symptoms during childhood (up to the age of 12 years) and further explored the potential mediating role of PM2.5 and physical activity in the association. MethodsThe study population included participants from the INfancia y Medio Ambiente (INMA) prospective birth cohort (Gipuzkoa, Sabadell, and Valencia). Average Normalized Difference Vegetation Index (NDVI) in buffers of 100-, 300- and 500-m around the residential addresses was used as an indicator of greenness, while green space availability was determined based on the presence of a major green space within 150-m from the residence. Childhood ADHD symptoms were assessed at the 6-8- and 10-12-year follow-ups using Conners Parents Rating Scale-Revised: Short Form. ResultsAlthough no association was found for the prenatal exposure period, increased early childhood NDVI inversely associated with the OR of clinically significant ADHD symptoms during the 6-8-year follow-up at the 100-m (OR 0.03, 95% CI: 0.003 to 0.44), 300-m (OR 0.04, 95% CI: 0.003 to 0.42) and 500-m (OR 0.08, 95% CI: 0.01 to 0.76) buffers, but exclusively in the context of direct effects. Additionally, the 10-12-year follow-up analysis found moderate to weak evidence of potential total and direct effects of NDVI at both 100- and 300-m buffers on inattention scores, as well as for NDVI at the 300-m buffer on ADHD index scores. The analysis did not reveal evidence of mediation through PM2.5 or physical activity. ConclusionsThe evidence suggests that early childhood greenness exposure may reduce the risk of developing ADHD symptoms later in childhood, and that this association is not mediated through PM2.5 and physical activity.

Subclinical attention-deficit hyperactivity disorder symptoms and unhealthy lifestyle behaviours.

Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations. The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored. This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors. The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms. Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.

Clinical characterization of children and adolescents with ADHD and sleep disturbances.

Sleep disturbances (SD) are commonly reported concerns among parents and caregivers of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). While it is widely acknowledged that SD can worsen various aspects of children and adolescents' well-being (e.g., academic performance and emotional/behavioral state), a comprehensive clinical characterization of ADHD and SD is currently lacking. To address this gap, 136 children and adolescents diagnosed with ADHD (aged 6 to 14 years) were retrospectively selected by reviewing electronic health records of hundreds of patients with neuropsychiatric disorders referred to the children's hospital. Participants were divided into two groups based on the presence of SD, assessed via a parent-report questionnaire (94 ADHD without SD and 42 ADHD with SD). Standardized measures of adaptive behavior, academic performance, ADHD-related and emotional/behavioral symptoms were collected. Results documented that the group of ADHD with SD obtained worse scores in specific aspects of adaptive behavior (conceptual and practical domains), academic performance (text comprehension, writing), ADHD symptoms (inattention) and emotional/behavioral difficulties (especially, mood/emotional regulation and stress) compared to those with ADHD without SD. In addition, our results established a relationship between sleep problems and diverse clinical aspects of children and adolescents with ADHD, while controlling for age, cognitive level, gender, ADHD symptoms severity, and Body Mass Index. From a clinical perspective, our study suggests that the presence of SD in patients with ADHD may serve as an indicator for strengths and weaknesses in this population, even demonstrating an independent relationship with specific clinical dimensions. Implications to improve clinical diagnostic and therapeutic interventions are discussed.

How accurate is the QbTest for measuring symptoms of ADHD in children and adults?

This literature review aimed to assess the reliability and validity of the quantified behavioural test (QbTest) to measure the symptoms of attention deficit hyperactivity disorder (ADHD), determining the extent to which results of the selected studies were accurate and generalisable. A literature review was undertaken, with each paper appraised using the Critical Appraisal Skills Programme randomised controlled trial checklist. Thematic analysis was also implemented to identify key themes and relationships between data sets. Three papers concluded that the QbTest increases clinical efficiency without compromising diagnostic accuracy, while others identified limitations relating to its ability to identify symptoms of impulsivity correctly. Additional issues were identified relating to external validity, generalisability and the extent to which the QbTest could differentiate ADHD from other conditions. It is concluded that the QbTest is an unreliable means of assessing ADHD in both children and adults, particularly when used as a stand-alone assessment tool. Thematic analysis highlighted concerns around diagnostic accuracy and the QbTest's inability to differentiate symptoms of ADHD from other conditions – fundamental flaws affecting the overarching fidelity of QbTesting.

Evaluation of Frontal QRS-T Angle in Children With ADHD and Healthy Controls.

Conflicting findings exist regarding the link between attention deficit hyperactivity disorder (ADHD) and cardiovascular diseases. This study aimed to evaluate the frontal QRS-T (fQRS-T) angle and its correlation with symptom severity in children diagnosed with ADHD. The study population consisted of 172 patients diagnosed with ADHD (120 drug naive and 52 drug positive) and 82 healthy controls. ADHD symptoms were assessed using the Atilla Turgay DSM-IV-Based Screening and Assessment Scale for Disruptive Conduct Disorders (T-DSM-IV-Scale). The fQRS-T angle and corrected QT (QTc) interval were obtained from the automated reports of 12-lead electrocardiography device for each patient. QTc interval and fQRS-T angle were significantly different among the groups. Post hoc analyses showed that QTc interval and fQRS-T angle of ADHD drug naive and ADHD drug positive patients were significantly higher than the healthy control groups. However, there was no significant difference between drug naive and drug positive patients regarding QTc interval and fQRS-T angle. Both QTc interval and fQRS-T angle showed positive correlations with the severity of ADHD symptoms (r = 0.263, p = .001 and r = 0.175, p = .023 respectively). We found that fQRS-T angle was significantly wider in children with ADHD. Therefore, we suggest that fQRS-T angle may help in cardiovascular risk assessment in children with ADHD.

Investigating Attention Deficit Hyperactivity Disorder Symptoms, Emotional Dysregulation and Family Functioning in Children: A Community-Based Study in Elementary Schools in Surabaya, Indonesia.

Research on emotional dysregulation related to attention deficit hyperactivity disorder (ADHD) symptoms and its effects on family functioning in children is scarce. This is the first study conducted in Indonesia to examine the intricate relationships between ADHD symptoms, emotional regulation, and family functioning in children. A cross-sectional survey was conducted involving primary caregivers of children aged 9-13 years old across three elementary schools in Surabaya, using validated questionnaires comprising the Indonesian ADHD Rating Scale, Emotion Regulation Checklist, and Family APGAR scale. The findings revealed a positive association between ADHD features and the emotional lability/negativity subscale (ERLN) (r=0.528; p<0.001), but not the emotion regulation subscale (EREG). Moreover, family functioning positively correlated with ERLN (r= -0.269; p=0.003) and negatively correlated with EREG (r=0.331; p<0.001). Parental education emerged as a significant demographic factor, with higher education levels linked to better emotion regulation (r=0.297; p=0.001). These findings underscore the importance of addressing ADHD symptoms and emotional dysregulation in children in order to enhance family functioning and overall well-being. Implications for future research and interventions targeting emotion regulation, especially in children with ADHD and their families, are also discussed.

Exploring correlations between Conners' Continuous Performance Test and subjective measures of attention deficit hyperactivity disorder symptoms in a paediatric clinical sample.

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental condition characterised by inattention and/or hyperactivity-impulsivity. The ADHD symptoms are often evaluated and quantified using various assessment tools, such as the Conners' Continuous Performance Test II (CCPT-II), ADHD Rating Scale (ADHD-RS), Child Behaviour Checklist (CBCL), Clinical Global Assessment Scale (CGAS) and Clinical Global Impression Scale (CGIS). This study sought to compare CCPT-II with parent- and clinician-rated rating scales (ADHD-RS, CBCL, CGAS and CGIS) in measuring the core ADHD symptoms within the paediatric ADHD population. The data, gathered from a large-scale randomised controlled trial involving 172 children aged 6-12 years with ADHD, was pooled, and a Pearson correlation analysis was conducted. No significant correlations were observed between CCPT-II and ADHD-RS, as well as the various subscales of CBCL, CGAS and CGIS. While CCPT-II may offer insights into ADHD symptomatology, its relationship with parent- and clinician-rated rating scales such as ADHD-RS, CBCL, CGAS and CGIS appears limited. Further research is warranted to elucidate the nuances of these assessment tools and their roles in evaluating ADHD.

Symptom Network Analysis in a Large Sample of Children and Adults with a Chronic Tic Disorder.

Chronic tic disorders (CTD) are multifaceted disorders characterized by multiple motor and/or vocal tics. They are often associated with complex tics including echophenomena, paliphenomena, and coprophenomena as well as psychiatric comorbidities such as attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Our goal was to uncover the inter-relational structure of CTD and comorbid symptoms in children and adults and to understand changes in symptom structure across development. We used network and graph analyses to uncover the structure of association of symptoms in childhood/adolescence (n = 529) and adulthood (n = 503) and how this structure might change from childhood to adulthood, pinpointing core symptoms as a main target for interventions. The analysis yielded core symptom networks in young and adult patients with CTD including complex tics and tic-related phenomena as well as touching people and objects. Core symptoms in childhood also included ADHD symptoms, whereas core symptoms in adults included symptoms of OCD instead. Interestingly, self-injurious behavior did not play a core role in the young CTD network, but became one of the central symptoms in adults with CDT. In addition, we found strong connections between complex motor and vocal tics as well as echolalia and echopraxia. Next to other complex tics, echophenomena, paliphenomena, and coprophenomena can be regarded core symptoms of CTD. ADHD symptoms are closely related to CTD in childhood, whereas symptoms of OCD and self-injurious behavior are closely associated with CTD in adults. Our results suggest that a differentiation between motor and vocal tics is somewhat arbitrary.

Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials: Antidepressants for Restricted and Repetitive Behaviors in Autism Spectrum Disorder.

In previously randomized controlled trials (RCTs) on the efficacy of antidepressants in restricted and repetitive behaviors (RRBs) in autism spectrum disorder (ASD), outcomes overwhelmingly showed no benefits of antidepressants studied in the larger multisite RCTs over placebo. However, the positive effect of antidepressants in the RRBs found in the small preliminary studies requires confirmation in larger trials. We aimed to systematically review the efficacy of antidepressants in the treatment of RRBs in ASD by including RCTs from the SCOPUS, PubMed, Embase, Cochrane Controlled Trials Register, Clinical Trials.gov, and other databases in January 2024. Analyzing data from 609 participants across nine RCTs showed no significant difference in the overall pooled mean-end score for RRBs between antidepressant- and placebo-treated groups [SMD (95% CI) of -0.25 (-0.53, 0.02), I2 = 54%, Tau2 = 0.10, prediction interval = -1.03, 0.53]. In small preliminary studies by one group, the clomipramine-treated group's pooled mean endpoint for obsessive-compulsive symptoms in ASD individuals showed a significantly better outcome than the desipramine-treated group, but in unconfirmed studies. Of the individual antidepressants investigated only clomipramine, and fluvoxamine illustrated some efficacy over placebo in small preliminary studies. These findings need confirmation in larger, multisite randomized controlled trials. There were no significant differences in the overall discontinuation rates or discontinuation due to adverse events between the antidepressant- and placebo-treated groups [RR (95% CI) of 1.30 (0.95, 1.78), I2 = 0%, and 1.33 (0.71, 2.47), I2=0%, respectively]. Common side effects included agitation, appetite disturbance, anorexia, gastrointestinal issues, and sleep disturbance, with no significant differences between the antidepressant and placebo groups. In conclusion, the results regarding the efficacy of antidepressants in the treatment of RRBs in ASD are inconsistent. Since previous evidence found a correlation between attention-deficit hyperactivity disorder (ADHD) symptoms including overactivity and impulsivity, and RRBs, further trials including the use of non-stimulants such as atomoxetine could be conducted.

Abnormal brain entropy dynamics in ADHD

BackgroundBrain entropy (BEN) is a novel measure for irregularity and complexity of brain activities, which has been used to characterize abnormal brain activities in many brain disorders including attention-deficit/hyperactivity disorder (ADHD). While most research assumes BEN is stationary during scan sessions, the brain in resting state is also a highly dynamic system. The BEN dynamics in ADHD has not been explored. MethodsWe used a sliding window approach to derive the dynamical brain entropy (dBEN) from resting-state functional magnetic resonance imaging (rfMRI) dataset that includes 98 ADHD patients and 111 healthy controls (HCs). We identified 3 reoccurring BEN states. We tested whether the BEN dynamics differ between ADHD and HC, and whether they are associated with ADHD symptom severity. ResultsOne BEN states, characterized by low overall BEN and low within-state BEN located in SMN (sensorimotor network) and VN (visual network), its FW (fractional window) and MDT (mean dwell time) were increased in ADHD and positively correlated with ADHD severity; another state characterized by high overall BEN and low within-state BEN located in DMN (default mode network) and ECN (executive control network), its FW and MDT were decreased in ADHD and negatively correlated with ADHD severity. LimitationsThe window length of dBEN analysis can be further optimized to suit more datasets. The co-variation between dBEN and other dynamical brain metrics was not explored. ConclusionOur findings revealed abnormal BEN dynamics in ADHD, providing new insights into clinical diagnosis and neuropathology of ADHD.

Application and expansion of an algorithm predicting attention-deficit/hyperactivity disorder and impairment in a predominantly White sample.

Current assessment protocols for attention-deficit/hyperactivity disorder (ADHD) focus heavily on a set of highly overlapping symptoms, with well-validated factors like cognitive disengagement syndrome (CDS), executive function (EF), age, sex, and race and ethnicity generally being ignored. Using machine learning techniques, the current study aimed to validate recent findings proposing a subset of ADHD symptoms that, together, predict ADHD diagnosis, severity, and impairment level better than the full symptom list, while also testing whether the inclusion of the factors listed above could further increase accuracy. Parents of 1,922 children (50.1% male) aged 6-17 years completed rating scales of ADHD, CDS, EF, and impairment. Results suggested nine symptoms as most important in predicting outcomes: (a) has difficulty sustaining attention in tasks or play activities; (b) does not follow through on instructions and fails to finish work; (c) avoids tasks (e.g., schoolwork, homework) that require sustained mental effort; (d) is often easily distracted; (e) has difficulty organizing tasks and activities; (f) is often forgetful in daily activities; (g) fidgets with hands or feet or squirms in seat; (h) interrupts/intrudes on others; and (i) shifts around excessively or feels restless or hemmed in. The abbreviated algorithm achieved accuracy rates that did not significantly differ compared to an algorithm comprising all 18 symptoms in predicting impairment, while also demonstrating excellent discriminative ability in predicting ADHD diagnosis. Adding CDS and EF to the abbreviated algorithm further improved the prediction of global impairment. Continued refinement of screening tools will be key to ensuring access to clinical services for youth at risk for ADHD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Association between ADHD Symptoms and Antisocial Behavior: Differential Effects of Maternal and Paternal Parenting Behaviors

The present study examined the moderating role of maternal and paternal behaviors on the association between ADHD symptoms and antisocial behavior. The data are from a Swedish community-based study with 2886 adolescent participants, aged 13–15. We analyzed the adolescents’ self-reports of negative and positive parental behavior, ADHD symptoms, and antisocial behavior. Results show that ADHD symptoms significantly predicted levels of antisocial behavior in both maternal- and paternal-moderated regression models. Also, several significant interaction effects emerged. Fathers’ attempted understanding and mothers’ warmth significantly buffered the association with antisocial behavior. In turn, mothers’ negative behaviors—both coldness and rejection and angry outbursts—significantly enhanced the association with antisocial behavior, whereas only fathers’ angry outbursts emerged as a significant moderator. Thus, there is support for differential effects of maternal and paternal behavior on the association between ADHD symptoms and adolescent antisocial behavior.

The Mediating Role of Emotion Regulation Strategies between Symptoms of Attention Deficit Hyperactivity Disorder and Anxiety-Depression Problems in Children

The purpose of this study was to investigate the mediating role of emotion regulation strategies of ADHD and anxiety-depression problems in children. Using a cross-sectional research design, this study collected a sample of children with ADHD and assessed their ADHD symptoms, anxiety-depression status, and emotion regulation strategies utilizing standardized tools. The data analysis results showed that emotion regulation strategies played a significant mediating role between ADHD symptoms and anxiety-depression problems, indicating that emotion regulation ability in children with ADHD may be an important factor affecting their anxiety and depression. This study not only provides a new perspective for understanding the emotional and behavioral problems of children with ADHD but also offers empirical evidence for developing targeted intervention measures. In the future, training in emotion regulation strategies is expected to become an important part of interventions for children with ADHD.

ADULT ADHD, SELF-EFFICACY, AND ACADEMIC PERFORMANCE IN LANGUAGE LEARNING: THE CASE OF FRESHMEN IN THE FACULTY OF ARTS AND HUMANITIES

The prevalence of ADHD in Morocco is still unknown. The paper sought to determine the extent to which this disorder may be prevalent in university students along with whether it would differ significantly among males and females. It also aimed to identify whether there would be a significant difference in both academic performance and self-efficacy among the ADHD and non-ADHD group. Three questionnaires were used to achieve this purpose. Cronbachs alpha was run followed by a chi-square test for independence and two independent-samples t-tests. There was no significant association between gender and ADHD symptoms (p = .12). In addition, there was no significant difference in academic performance (p = .39) and in self-efficacy scores (p = .46) for the ADHD and non-ADHD students. The study emphasized on the importance of a formal ADHD diagnosis as it could have provided insightful findings.

Treatments with versus without medication for children with behavioural difficulties in clinical practice: an economic evaluation with observational data.

Economic evaluations of treatments for children with behavioural difficulties (i.e., characteristics of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD)) usually rely on data of randomised controlled trials or are model-based. Findings of such studies may not be representative of cost-effectiveness and cost-utility in clinical practice. The current longitudinal study aimed to perform an economic evaluation of treatments for children with hyperactivity, impulsive behaviours, inattention, and/or behavioural difficulties using observational data that were obtained in clinical practice. Parents of 209 children (aged 5-12) who were referred to 1 of 10 Dutch youth mental healthcare institutions and who received treatment with (n = 108) or without (n = 101) the use of medication, filled out questionnaires at three timepoints (baseline, and ~ 6 and ~12 months later). Propensity score matching was used to make both groups comparable. Outcomes included quality-adjusted life years (QALYs), ADHD and ODD symptom severity, and impairment. Costs were measured from a societal perspective. Incremental cost-effectiveness ratios (ICERs) were estimated, and cost-effectiveness acceptability curves (CEACs) were derived to show uncertainty around the ICER. Results did not show statistically significant differences in costs and effects between children who were treated with medication (alone or in combination with non-medication treatment) and those who were treated without medication. CEAC suggested that medication treatment has a 55% probability of being cost-effective at the €80,000 threshold and 36% at the €20,000 threshold compared with treatment without medication. Using observational data, our study did not provide clear evidence of the cost-effectiveness and cost-utility of treatment with medication compared with treatment without medication in clinical practice.

Comparative analysis of electroencephalogram (EEG) data gathered from the frontal region with other brain regions affected by attention deficit hyperactivity disorder (ADHD) through multiresolution analysis and machine learning techniques

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by repeated patterns of hyperactivity, impulsivity, and inattention that limit daily functioning and development. Electroencephalography (EEG) anomalies correspond to changes in brain connection and activity. The authors propose utilizing empirical mode decomposition (EMD) and discrete wavelet transform (DWT) for feature extraction and machine learning (ML) algorithms to categorize ADHD and control subjects. For this study, the authors considered freely accessible ADHD data obtained from the IEEE data site. Studies have demonstrated a range of EEG anomalies in ADHD patients, such as variations in power spectra, coherence patterns, and event-related potentials (ERPs). Some of the studies claimed that the brain’s prefrontal cortex and frontal regions collaborate in intricate networks, and disorders in either of them exacerbate the symptoms of ADHD. , Based on the research that claimed the brain’s prefrontal cortex and frontal regions collaborate in intricate networks, and disorders in either of them exacerbate the symptoms of ADHD, the proposed study examines the optimal position of EEG electrode for identifying ADHD and in addition to monitoring accuracy on frontal/ prefrontal and other regions of brain our study also investigates the position groupings that have the highest effect on accurateness in identification of ADHD. The results demonstrate that the dataset classified with AdaBoost provided values for accuracy, precision, specificity, sensitivity, and F1-score as 1.00, 0.70, 0.70, 0.75, and 0.71, respectively, whereas using random forest (RF) it is 0.98, 0.64, 0.60, 0.81, and 0.71, respectively, in detecting ADHD. After detailed analysis, it is observed that the most accurate results included all electrodes. The authors believe the processes can detect various neurodevelopmental problems in children utilizing EEG signals.

A Psychometric Evaluation of the Revised Version of the Adult ADHD Self-Report Scale in Chinese Adolescents.

Adolescent-specific ADHD self-report screening measures can greatly increase the likelihood of correct diagnosis and timely treatment of ADHD in adolescents. This study provides preliminary evidence for evaluating the reliability and validity of the Adult ADHD Self-Report Scale-Revised (ASRS-R) in a school-based sample of Chinese adolescents. The ASRS-R and the Strengths and Difficulties Questionnaire (SDQ) were administered to 867 adolescents aged 12 to 16 years (Mage = 13.08 years). Construct validity was assessed using correlation analysis of the ASRS-R with the SDQ. Moreover, confirmatory factor analysis (CFA), internal consistency, retest reliability, and measurement invariance of the scales were examined by gender. CFA showed a two-dimensional factor structure of the ASRS-R, and the model fitted the data well (χ2/df = 4.370, RMSEA = 0.062, TLI = 0.932, CFI = 0.940, GFI = 0.927, AGFI = 0.907, and SRMR = 0.038). The ASRS-R scale was invariant across gender and had satisfactory internal consistency (Cronbach's alpha = .934) and test-retest reliability (intraclass correlation coefficient = .874). The construct validity, as calculated using the SDQ, was also acceptable. The ASRS-R can be a psychometrically reliable self-report instrument and provide preliminary support as a simple tool for identifying ADHD symptoms in Chinese adolescents. The findings provide evidence for extending the application of the ASRS, previously limited to adults, to the adolescent populations.

Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD

Objective: This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences. Method: The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average. Results: ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals. Conclusion: This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Emotional Dysregulation in Emerging Adult ADHD: A Key Consideration in Explaining and Classifying Impairment and Co-Occurring Internalizing Problems

Objective: The current study sought to clarify and harness the incremental validity of emotional dysregulation and unawareness (EDU) in emerging adulthood, beyond ADHD symptoms and with respect to concurrent classification of impairment and co-occurring problems, using machine learning techniques. Method: Participants were 1,539 college students (Mage = 19.5, 69% female) with self-reported ADHD diagnoses from a multisite study who completed questionnaires assessing ADHD symptoms, EDU, and co-occurring problems. Results: Random forest analyses suggested EDU dimensions significantly improved model performance (ps < .001) in classifying participants with impairment and internalizing problems versus those without, with the resulting ADHD + EDU classification model demonstrating acceptable to excellent performance (except in classification of Work Impairment) in a distinct sample. Variable importance analyses suggested inattention sum scores and the Limited Access to Emotional Regulation Strategies EDU dimension as the most important features for facilitating model classification. Conclusion: Results provided support for EDU as a key deficit in those with ADHD that, when present, helps explain ADHD’s co-occurrence with impairment and internalizing problems. Continued application of machine learning techniques may facilitate actuarial classification of ADHD-related outcomes while also incorporating multiple measures.

Attention-Deficit/Hyperactivity Disorder and Subsequent Trauma Exposure: The Mediating Role of Deviant Peer Affiliation.

Individuals with ADHD symptoms are at an increased risk of lifetime trauma exposure. However, research has yet to fully examine whether symptoms of ADHD function as a temporal risk factor for experiencing trauma and specific mechanisms that may explain the association between symptoms of ADHD and trauma exposure. Two constructs that may account for the relation between ADHD symptoms and trauma are deviant peer association and neighborhood disadvantage. The present study sought to 1) elucidate the temporal nature of ADHD symptoms and exposure to trauma and 2) examine whether peer deviancy and/or neighborhood disadvantage mediate the relation between childhood ADHD symptoms and subsequent trauma exposure across a 20-year longitudinal cohort study. Participants (N = 616) were predominantly Black/African American (86%; Male n = 389) from an urban school district. Using structural equation modeling, total trauma exposures during young adulthood (Years 17-20) were regressed on parent- and teacher-rated ADHD symptoms in Grade 1 (Year 1). A significant indirect path from ADHD symptoms to trauma exposure through deviant peer affiliation (Year 16) indicated that having childhood ADHD symptoms predicted deviant peer affiliation 16years later, which in turn predicted greater exposures to traumatic events during young adulthood, controlling for neighborhood disadvantage. Neighborhood disadvantage was not a significant mediator when accounting for peer deviancy. Taken together, findings contribute to a limited body of research that utilizes a prospective design to examine the association between childhood ADHD symptoms and trauma exposure in young adulthood among Black/African American youth. Potential targets for intervention are proposed.