Attention-deficit/hyperactivity Disorder Symptoms In Children Research Articles

A multi-factorial perspective on ADHD and ODD in school-aged children: What is the role of cognitive regulation, temperament, and parental support?

ABSTRACTIntroduction: It is well established that attention-deficit/hyperactivity disorder (ADHD) is a disorder of self-regulation. As such, ADHD is associated with disturbed cognitive regulation, extreme temperament traits, and deficient extrinsic regulation such as parenting. Despite these associations, cognitive regulation, temperament, and parenting have not previously been examined simultaneously in relation to ADHD symptoms in school-aged children. To bridge this gap of knowledge, we examined effects of these important aspects of self-regulation on symptoms of inattention, hyperactivity/impulsivity, and comorbid symptoms of oppositional defiant disorder (ODD) in children with and without a diagnosis of ADHD.Method: The sample consisted of 77 children aged 8 to 12 years (~40% had a diagnosis of ADHD). We assessed cognitive regulation (i.e., complex inhibition and working memory) during a lab visit and parents rated child temperament (negative affect, surgency, and effortful control) and parental support. Parents and teachers rated ADHD and ODD symptoms in the child. We performed continuous analyses, informed by a dimensional perspective on ADHD.Results: Working memory contributed independently to inattention (β = −.19, p < .05). Effortful control contributed independently to inattention and hyperactivity/impulsivity (βs = −.50 and −.49, ps < .01). Negative affect contributed to ODD symptoms as moderated by parental support (β = .58, p < .01). Specifically, for children who received lower levels of parental support there was a significant positive association between negative affect and ODD symptoms.Conclusions: The results propose that both cognitive regulation and effortful control influence ADHD symptoms. Moreover, different factors seem to be involved in ADHD and ODD, with regulatory deficits specifically related to ADHD symptoms, and elevated negative affect specifically related to ODD symptoms. Interestingly, parenting moderated the relationship between negative affect and ODD symptoms, with a suggested protective effect of high parental support for children with high levels of negative affect.

Study of Anxiety Symptoms in Mothers of ADHD Children

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood onset psychiatric disorders that is characterized by inattention, hyperactivity and impulsivity. ADHD can affect social, cognitive and academic performance of children. All these impairments of psychosocial functioning can affect the quality of life of both patients and their families. Based on that, it is suggested that parents, especially mothers of ADHD children, display higher levels of depression and anxiety. Aim of the work: This study aimed to compare anxiety symptoms in the mothers with ADHD children with control group. Patients and Methods: Fifty mothers of the ADHD children as study group and fifty mothers with children without any psychiatric disorder as control group. All were evaluated with to a semi-structured interview and Taylor Manifest Anxiety Scale. Results: This study showed that 19 in mothers of study group (32%) had no anxiety symptoms while 31(68%) had anxiety symptoms and 13 (26%) had above sever anxiety. In the control group 35 (70%) had no anxiety and 15(30%) had anxiety symptoms while 3 (6%) had above sever anxiety. There was statistically significant difference between the two groups (p value = 0 .05). There was no significant relation between intensity of maternal anxiety and the intensity of ADHD symptoms in their children. Conclusion: The present study suggested that the presence and intensity of anxiety symptoms in mothers of ADHD children are higher than the control group and there was no significant association with ADHD symptoms in children.

Study of Anxiety Symptoms in Mothers of ADHD Children

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood onset psychiatric disorders that is characterized by inattention, hyperactivity and impulsivity. ADHD can affect social, cognitive and academic performance of children. All these impairments of psychosocial functioning can affect the quality of life of both patients and their families. Based on that, it is suggested that parents, especially mothers of ADHD children, display higher levels of depression and anxiety. Aim of the work: This study aimed to compare anxiety symptoms in the mothers with ADHD children with control group. Patients and Methods: Fifty mothers of the ADHD children as study group and fifty mothers with children without any psychiatric disorder as control group. All were evaluated with to a semi-structured interview and Taylor Manifest Anxiety Scale. Results: This study showed that 19 in mothers of study group (32%) had no anxiety symptoms while 31(68%) had anxiety symptoms and 13 (26%) had above sever anxiety. In the control group 35 (70%) had no anxiety and 15(30%) had anxiety symptoms while 3 (6%) had above sever anxiety. There was statistically significant difference between the two groups (p value = 0 .05). There was no significant relation between intensity of maternal anxiety and the intensity of ADHD symptoms in their children. Conclusion: The present study suggested that the presence and intensity of anxiety symptoms in mothers of ADHD children are higher than the control group and there was no significant association with ADHD symptoms in children.

Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review.

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Mind–body therapies (MBTs) seem to be effective for improving health in different populations; however, whether a positive effect occurs in children and adolescents with ADHD is still controversial. The main aim of this systematic review was to analyse the interventions based on MBT aimed to improve the main ADHD symptoms in children and adolescents. Materials and Methods: A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify MBT studies on children and adolescents (4–18 years) with a clinical diagnosis of ADHD. Study quality was evaluated by the NIH quality tool (U.S. National Institute of Health). Results: There were positive results in eleven out of twelve included studies regarding the effect of the MBT interventions on ADHD symptoms. With respect to ADHD symptoms, we observed differences across studies. In relation to the studies’ quality, eleven studies were rated “poor” and one was rated as “fair”. Conclusions: MBTs, such as yoga or mindfulness, could be positive strategies to mitigate ADHD symptoms in children and adolescents. However, further research with high-quality designs, with randomization, greater sample sizes, and more intensive supervised practice programs are needed.

Attention deficit hyperactivity disorder (ADHD) in children with epilepsy.

Attention deficit hyperactivity disorder (ADHD) is a common comorbidity of childhood epilepsy. ADHD symptoms in children with epilepsy have been studied since 1970s in western countries. However, relative studies are still rather limited in China. To study the incidence rate of ADHD in children with epilepsy, and further analyze the relationship of epilepsy and ADHD in China. 206 children (age 6-16) with epilepsy and 58 healthy controls underwent assessment instruments (DSM-IV ADHD, ADHD Rating Scale-IV, and SNAP-IV Rating Scale). The prevalence of comorbid ADHD was significantly higher in children with epilepsy (24.76%) than that in controls (5.17%), and inattentive subtype (ADHD-I, 14.1%) was the most prevalent. ADHD in childhood epilepsy was associated with younger age, early first onset age, and high frequency of epileptic seizures. There was no significant difference of ADHD incidence rate regarding the seizure type and abnormal electroencephalogram (EEG) discharges. The ADHD comorbidity rate in children treated with antiepileptic drugs (AEDs) (27.6%) was higher than that without AEDs therapy (14.0%); multiple AEDs were associated with a higher rate of ADHD comorbidity as compared with single AEDs. The incidence of comorbid ADHD in epileptic children treated with traditional single AEDs was significantly higher than those treated with novel single AEDs. Children with epilepsy have more attention problems as compared with healthy controls. ADHD in childhood epilepsy is associated with male sex, younger age, early first onset age, high frequency of epileptic seizures, and multiple AEDs.

Dietary Profiles, Nutritional Biochemistry Status, and Attention-deficit/hyperactivity Disorder: Path Analysis for a Case-control Study (P18-106-19)

ObjectivesStudies suggested that attention-deficit/hyperactivity disorder (ADHD) is associated with multiple dietary factors. Earlier studies addressed issues related to dietary allergens and toxicants. Recent attention has turned to nutrient imbalance resulted from unhealthy dietary habit. This study aims to investigate dietary and nutritional biochemistry profiles of ADHD and to explore their potential relationship by path analysis. MethodsWe enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers, including several potential vitamins, minerals, and fatty acids. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. ResultsCompared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration (Table 1). Children with ADHD had more intakes of nutrient-poor foods such as high sugar and high fat foods, and had less intakes of vegetable, fruit, protein-rich foods than their counterpart (Table 2). SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD (Figure 1). ConclusionsWe found that lower serum levels of B-vitamins and imbalanced mineral and fatty acid distributions were risk factors of ADHD and path analysis suggests that unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status. Managing diet and nutrition conditions should be trialed and considered among methods to improve ADHD symptoms in children. Funding SourcesNational Science Council of Taiwan R.O.C.; Academia Sinica. Supporting Tables, Images and/or Graphs▪▪▪

Association between inflammatory cytokines and ADHD symptoms in children and adolescents with obesity: A pilot study

Whilst the association between Attention-Deficit/Hyperactivity Disorder (ADHD) and obesity is supported by meta-analytic evidence, the mechanisms underpinning this link need to be further elucidated. Inflammatory processes may increase the risk of ADHD symptoms in individuals with obesity. This pilot study set out to start testing this hypothesis by assessing the correlation between serum levels of inflammatory cytokines and ADHD symptoms severity in a sample of children and adolescents with obesity. We measured ADHD symptoms severity in 52 children/adolescents with obesity (BMI > 95th centile) with the Conners questionnaire, revised, short version, parent (CPRS-R:S) and teacher (CTRS-R:S) versions. Additionally, a categorical diagnosis of ADHD was established using the Kiddie-SADS-PL. Serum levels of IL-6, Il-10, and TNF-alpha were also obtained. The prevalence of ADHD was 9.6%. We found a significant correlation between IL-6, as well as TNF-alpha, and hyperactivity/impulsivity subscores of the CPRS-R:S and CTRS-R:S, that held even after controlling for BMI and oppositional symptoms. This study provides a rationale for larger, longitudinal studies to gain insight into inflammatory processes underpinning the link between obesity and ADHD. This line of research has the potential to lead to novel, pathophysiologically-based management strategies for individuals with obesity and ADHD.

Dietary Profiles, Nutritional Biochemistry Status, and Attention-Deficit/Hyperactivity Disorder: Path Analysis for a Case-Control Study.

This study aims to investigate dietary and nutritional biochemistry profiles of attention-deficit/hyperactivity disorder (ADHD) and to explore their potential relationship by path analysis. We enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. Compared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration. Children with ADHD had more intake of nutrient-poor foods such as high sugar and high fat foods, and had less intake of vegetable, fruit, protein-rich foods than their counterpart. SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD. In conclusion, an unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status, and managing diet and nutrition conditions should be considered to improve ADHD symptoms in children.

Children's Attention-Deficit/Hyperactivity Disorder Symptoms Predict Lower Diet Quality but Not Vice Versa: Results from Bidirectional Analyses in a Population-Based Cohort

As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.

The Relationship between Food Insecurity and Symptoms of Attention-Deficit Hyperactivity Disorder in Children: A Summary of the Literature.

Food insecurity is a major public health concern characterized by an individual or household lacking access to adequate food to support a healthy lifestyle. Food insecurity has been associated with predisposing or exacerbating mental health symptoms in children. However, the evidence is scarce with regards to Attention-Deficit Hyperactivity Disorder (ADHD) symptoms in children. The purpose of this review is to summarize and identify gaps in the existing literature, as well as to explore associations between food insecurity and symptoms of childhood ADHD. Literature for this review was pulled from Ovid MEDLINE and PubMed library databases, with a focus on food insecurity, food insufficiency, hunger, and ADHD symptoms such as inattention, hyperactivity, and impulsivity in children. The limited evidence to date shows a predictive and inverse relationship between childhood experience of food insecurity and symptoms of ADHD, with lasting impacts into adulthood. Evidence exists to hypothesize that childhood food insecurity is associated with predisposing or exacerbating ADHD symptoms in children, yet the literature needed to confirm this relationship is scarce and utilizes inconsistent methodology. Future research is needed to further characterize this complex relationship and inspire community or public health interventions addressing food insecurity in children with ADHD. Additionally, it may be clinically useful to routinely screen for food insecurity when assessing pediatric ADHD symptoms.

Association of symptoms of attention deficit-hyperactivity disorder and impulsive-aggression with severity of suicidal behavior in adult attempters

Literature emphasizes the relationship between attention deficit-hyperactivity disorder (ADHD) and suicidal behavior (SB). However, the link between ADHD and the severity of SB is yet to be determined. We investigated the association between a probable diagnosis of ADHD and the severity of SB in 539 hospitalized suicide attempters, and determined the role of comorbid psychiatric diagnoses. The severity of SB was defined as the number of suicide attempts, age at first suicide attempt, seriousness and violence of suicide attempts. A diagnosis of probable adult ADHD (probable ADHD) was defined as the presence of both current ADHD symptoms and ADHD symptoms in childhood. We evaluated the combined effect of high impulsive-aggression levels and probable ADHD. Probable ADHD was not associated with early or frequent suicide attempts after adjustment for psychiatric disorders and treatment intake. High levels of impulsive-aggression increased the risk of an early suicide attempt, particularly in patients with ADHD symptoms, and independently of other clinical factors. The association between serious suicide attempts and probable ADHD remained significant after adjustment. Although ADHD is involved in suicidal vulnerability, psychiatric comorbidities and impulsive-aggression appear to largely explain the severity of SB in adult attempters with ADHD symptoms.

Annual Research Review: Does late-onset attention-deficit/hyperactivity disorder exist?

Attention-deficit/hyperactivity disorder (ADHD) is conceptualized as an early onset childhood neurodevelopmental disorder. Prevalence in adults is around two-thirds that in childhood, yet longitudinal outcome studies of children with ADHD found a minority continue to meet full criteria in adulthood. This suggests that not all adult cases meet ADHD criteria as children, a conclusion supported by earlier studies relying on retrospective recall in adolescent and adult samples. More recently prospective follow-up of population and control samples suggest that adolescent and young adult ADHD is not always a continuation of childhood ADHD. Here, we review the literature on age of onset, to explore whether late-onset ADHD exists, and if so, examine the evidence for whether this should be considered the same or a different disorder as childhood onset ADHD. We conclude that current evidence supports the view that a significant proportion of young adults meeting criteria for ADHD would not have met full diagnostic criteria for ADHD as children. However, many in the late-onset group show some ADHD symptoms in childhood, or an externalizing disorder such as oppositional defiant disorder. Furthermore, the current studies suggest that most (but not all) cases of late-onset ADHD develop the disorder between the ages of 12-16 and can therefore be considered adolescent or early adult onset ADHD. There is a relative lack of data spanning young to older adulthood to address the question of adult-onset. Currently, there is insufficient data to clarify the extent to which early and late onset ADHD reflect a different balance of genetic and environmental risks or share the same underlying neural mechanisms. Clinicians should be aware that significantly impairing forms of ADHD can emerge beyond the age of 12years, although perhaps rarely in the context of a complete absence of precursors. The current evidence on treatment responses is limited.

Risk factors and an early prediction model for persistent methamphetamine-related psychiatric symptoms.

Methamphetamine (MA)-related psychiatric symptoms (MAP) are serious comorbidities of MA use and result in many social problems such as violence and suicide. We investigated the sociodemographic and genetic risk factors for persistent MAP of MA users (MUs) and constructed an early MAP prediction model. Derivation and replication samples had 1734 and 905 MUs, respectively. Symptom Checklist 90, Childhood Trauma Questionnaire, Attention-Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV, and Social Support Rating Scale were used to assess the past-year prevalence of general MAP and life events retrospectively. Genome-wide association study (GWAS) was used to analyze MAP-related genetic factors. The prediction model was constructed by integrating the risk life events and clinical and genetic features using logistic regression. Of the 2639 MUs, 1293 (48.83%) had past-year MAP. The severity of MA addiction (SMA), childhood trauma, childhood ADHD symptoms, and social support were reliable risk factors for persistent MAP. By integrating these risk factors and the polygenic risk score from GWAS from derivation samples, the area under the curve (AUC) of the predictive model for MAP was 0.754 (95% CI 0.717~0.771). The risk factors and prediction model were also verified in replication samples. In addition, SMA, ADHD, and social support were mediators for the effect of the risk genetic factor on persistent MAP. Our study identified several risk factors for persistent MAP and will be helpful for developing scalable tools for the prevention of persistent and general MAP.

Relationship between otorhinologic trauma and Attention Deficit Hyperactivity Disorder symptoms in children

ObjevtivesOtorhinologic trauma is an important condition at the ear, nose and throat (ENT) outpatient clinic in children. Attention deficit hyperactivity disorder (ADHD) has been identified as a potential risk factor that may contribute to the incidence of traumatic injuries. The aim of the study was to investigate whether there is an association between otorhinologic trauma and ADHD symptoms in children. MethodsA prospective study was conducted between September 2017 and March 2018. Fifty-six pediatric patients admitted to the Ear Nose and Throat (ENT) outpatient clinic of a research and training hospital aged between 4 and 18 years were included. The control group consisted of 56 age- and gender-similar children without otorhinologic trauma. Conner's parent Rating Scale (CPRS) was used to evaluate the ADHD symptoms. ResultsThe children with otorhinologic trauma had significantly higher mean scores in all subscales, including inattentiveness, hyperactivity, oppositional defiant disorder (ODD) (p < 0.05). Furthermore, analysis of the study group showed that the hyperactivity score in the subgroup with a history of repetitive injuries were significantly higher than those of the subgroup without a history of repetitive injuries (p < 0.05). ConclusionsThese findings suggest that patients admitted to the ENT outpatient clinic for otorhinologic trauma had a higher number of ADHD and ODD symptoms than those who did not have otorhinologic trauma. Psychiatric evaluation for ADHD and ODD should be considered for patients admitted to clinics with similar injuries, especially those who have a history of repetitive injuries.

Sex and racial/ethnic differences in the association between childhood attention-deficit/hyperactivity disorder symptom subtypes and body mass index in the transition from adolescence to adulthood in the United States.

While attention-deficit/hyperactivity disorder (ADHD) has been associated with higher body mass index (BMI), little research has focused on how this association differs by sex or race/ethnicity. To investigate the association between ADHD and BMI by sex and race/ethnicity (ie, European [EA], African [AA], and Hispanic American [HA]). Data came from the National Longitudinal Survey of Adolescent to Adult Health Waves II to IV (n=13332, age: 12-34years). On the basis of self-reported childhood ADHD symptoms between the ages of 5 and 12years, participants were categorized into: ADHD predominantly hyperactive/impulsive (ADHD-HI); ADHD predominantly inattentive (ADHD-I); ADHD combined (ADHD-C; a combination of ADHD-HI and ADHD-I symptoms); and non-ADHD. The patterns of ADHD-BMI associations in the transition period between adolescence and young adulthood differed by sex and race/ethnicity. Compared with non-ADHD, ADHD-HI was associated with higher BMI among EA males and females, while ADHD-I was associated with higher BMI among EA females. ADHD-C was associated with higher BMI for HA females. We found no evidence of an association among AA males and females and HA males. These study results suggest that the association between ADHD subtypes and BMI might differ across population subgroups in the United States.

Effect of zinc supplementation in zinc-deficient children with attention-deficit hyperactivity disorder

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder increasing in prevalence. Although there is limited evidence to support treating ADHD with mineral supplements, research does exist showing that patients with ADHD may have reduced levels of zinc, ferritin, and magnesium. These nutrients have important roles in neurologic function, including involvement in neurotransmitter synthesis. In spite of the good response of many patients with ADHD to stimulant drugs, a substantial percent do not respond to or develop significant side effects from stimulants. For this reason, zinc treatment has been considered to show positive results on various symptoms in ADHD patients with zinc deficiency. Objectives The aim of this study is to elucidate the effect of zinc supplementation on ADHD symptoms in zinc-deficient ADHD children. Patients and methods Thirty zinc-deficient children diagnosed with ADHD and on a fixed dose of methylphenidate were enrolled in this study. They were assigned to zinc supplementation (30 mg/day) as gluconate in an open-label follow-up trial for 10 weeks. Results There was a statistically significant difference among zinc-deficient ADHD children before and after zinc supplementation on all working memory index subtest scores and all Conner’s subscale scores. This result points to the effect of zinc supplementation on ADHD symptom domains.

Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior

Background and objectiveMounting evidence showed that lead exposure increased the risk of child attention-deficit-hyperactivity disorder (ADHD). Epidemiologic studies have typically used the blood-lead as a biomarker of lead exposure; blood-lead levels mostly reflect recent lead exposure. However, few studies have examined the relationship between bone-lead, a biomarker of cumulative exposure, and ADHD. Therefore, we aimed to compare the associations of bone-lead vs blood-lead levels with child ADHD symptoms and comorbidities. MethodsA total of 164 children aged 3–15 years were enrolled during 2014–2015. The Vanderbilt-ADHD-Diagnostic-Parent-Rating Scale (VADPRS) was used to evaluate the children's ADHD symptoms and comorbidities. Children's blood and bone lead concentrations were assessed, the latter using a non-invasive K-X-ray-fluorescence technique. According to blood-lead levels, children were classified into high (blood-lead ≥ 10.0 μg/dL) and low (blood-lead < 10.0 μg/dL) blood-lead groups. According to bone-lead levels, children were classified into high (bone-lead ≥ 2.66 μg/g) and low (bone-lead < 2.66 μg/g) bone-lead groups. We associated blood/bone lead with VADPRS data using multi-variable binary logistic regression models. ResultsChildren in the high blood-lead group had higher hyperactivity/impulsivity (P = 0.02) scores than the corresponding low blood-lead group. Children in the high bone-lead group had higher hyperactivity/impulsivity (P = 0.02) and oppositional-defiant-disorder (ODD) (P = 0.03) scores than the corresponding low bone-lead group. After adjusting for relevant confounders, children in the high bone-lead group were more likely to have ODD-behavior than the low group (OR = 6.7, 95%CI: 1.2–36.5). However, no adjusted association was observed between blood-lead and any ADHD-domain score. ConclusionHigh levels of cumulative lead exposure in children may be an independent risk factor of ODD-behavior.

The Longitudinal Relation between Observed Maternal Parenting in the Preschool Period and the Occurrence of Child ADHD Symptoms in Middle Childhood

In this longitudinal population-based cohort (N = 547) we examined the relation between maternal discipline and sensitivity in the preschool period and the occurrence of attention-deficit hyperactivity disorder (ADHD) symptoms in middle childhood, taking into account pre-existing child attention and executive function (EF) problems, and oppositional defiant disorder (ODD) symptom comorbidity. Maternal parenting was observed during a ‘do not touch task’ (positive and negative discipline) and a teaching task (sensitivity) at age 3. Parents reported on the occurrence of ADHD and ODD symptoms at age 8 using the Conners’ Parent Rating Scale. Attention and executive function problems were assessed using parent questionnaires at age 4. Important covariates such as harsh discipline and maternal depression were also taken into account. Maternal sensitivity significantly predicted later ADHD symptoms beyond pre-existing child attention and EF problems, and comorbid ODD symptoms. However, maternal negative and positive discipline did not significantly predict later ADHD symptoms over and above these covariates. This study demonstrates the importance of maternal sensitivity in the etiology of core ADHD symptoms above and beyond pre-existing child attention and EF problems, and comorbid ODD symptoms.

Assessment of associations between mitochondrial DNA haplogroups and attention deficit and hyperactivity disorder in Korean children

Attention deficit hyperactivity disorder (ADHD) is a multifactorial disorder with multiple environmental and biological etiologies, including genetic factors. Until now, several genetic variants have been reported to be significantly associated with ADHD. Recently, the relationship between mitochondrial DNA (mtDNA) haplogroups and psychiatric disorders such as schizophrenia has also been reported. However, currently there are no reports pertaining to the genetic association between mtDNA haplogroups and ADHD. Therefore, we performed an mtDNA haplogroup analysis of a total of 472 Korean children (150 Children with ADHD and 322 controls). The 20 East Asian specific mtDNA haplogroups were determined using the SNaPshot assay. We also sequenced the displacement loop (D-loop) region, position 15,971–613. Our results showed that haplogroup B4 was significantly associated with ADHD (OR, 1.90; 95% CI, 1.055–3.429; p = 0.031). A marginally significant association was found in subjects with ADHD and haplogroup B5 (OR, 0.26; 95% CI, 0.059–1.139; p = 0.041). When stratified based on gender, an association was also observed between haplogroup B5 and boys diagnosed with ADHD (OR, 0.17; 95% CI, 0.022–1.340; p = 0.048). Compared with boys, girls with ADHD carried an excess of the haplogroup D4b (OR, 4.83; 95% CI, 1.352–17.272; p = 0.014). Stratified analysis of subtypes also showed significant results (combined: haplogroup B4, p = 0.007; inattentive: haplogroup F, p = 0.022). Our results showed a possible role of mtDNA haplogroups in the genetic etiology of ADHD and ADHD symptoms in Korean children.

The role of genetic and environmental influences on the association between childhood ADHD symptoms and BMI.

Although childhood attention deficit hyperactivity disorder (ADHD) has been previously associated with concurrent and later obesity in adulthood, the etiology of this association remains unclear. The objective of this study is to determine the shared genetic effects of ADHD symptoms and BMI in a large sample of sibling pairs, consider how these shared effects may vary over time, and examine potential sex differences. Sibling pair data were obtained from the National Longitudinal Study of Adolescent to Adult Health (Add Health); childhood ADHD symptoms were reported retrospectively during young adulthood, while three prospective measurements of BMI were available from young adulthood to later adulthood. Cholesky decomposition models were fit to this data using Mx and maximum-likelihood estimation. The twin and sibling sample for these analyses included: 221 monozygotic (MZ) pairs (92 male-male, 139 female-female), 228 dizygotic (DZ) pairs (123 male-male, 105 female-female), 471 full-sibling (FS) pairs (289 male-male, 182 female-female), 106 male-female DZ twin pairs, and 234 male-female FS pairs. The magnitude of the association between childhood ADHD symptoms and BMI changed over time and by sex. The etiological relationship between childhood ADHD symptoms and the three prospective measurements of BMI differed for males and females, such that unique or non-shared environmental influences contributed to the relationship within males and genetic factors contributed to the relationship within females. Specifically, among females, genetic influences on childhood ADHD symptoms were partially shared with those effecting BMI and increased from adolescence to later adulthood (genetic correlation = 0.20 (95% CI: 0.07-0.36) in adolescence and 0.24 (95% CI: 0.10, 0.41) in adulthood). Genetic influences on ADHD symptoms in childhood are partially shared with those effecting obesity. However, future research is needed to determine why this association is limited to females.