Diagnosis Of ADHD Research Articles

3.13 Associations Between Adverse Childhood Experiences and Self-Reported ADHD Diagnosis During Young Adulthood: Findings From the National Longitudinal Study of Adolescent to Adult Health

Past studies have shown associations between adverse childhood experiences (ACEs) and ADHD diagnosis in childhood; however, few examined how ACEs relate to ADHD diagnosis in adults. This study investigates the associations between ACEs and self-reported ADHD diagnoses during young adulthood using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health).

3.91 Temperamental Dimensions of Pediatric OCD: Influence of ADHD and Tourette’s Disorder

3.91 Temperamental Dimensions of Pediatric OCD: Influence of ADHD and Tourette’s Disorder

3.17 The Impact of Executive Functioning Deficit on Illness Severity in Patients With an ADHD Diagnosis: A Real-World Data Study

Executive functioning (EF) is a multifaceted neuropsychological construct that allows individuals to engage in goal-directed and novel problem-solving behaviors. EF deficits have been identified in a subgroup of patients with ADHD. Heterogeneity in peer, family, and academic functioning among individuals with ADHD has been related to EF performance. Electronic health record (EHR) data captures the presentation of patients with ADHD in a real-world clinical setting and is therefore well suited to study the impact of EF deficits on ADHD illness severity.

2.14 Investigating the Relationship Between Community Agency Diagnoses and Gold-Standard Diagnoses for Adolescent ADHD

ADHD is the most prevalent behavioral condition among children (8.4%). Diagnosis involves thorough history taking, collateral ratings, and determining impairment. Community providers often do not diagnose ADHD based on current standards of best practice, which may create disparities. Our study aims to examine the concordance between gold-standard ADHD diagnoses and diagnoses made by providers in community mental health clinics, as well as to identify possible disparities in ADHD diagnosis (and comorbid diagnoses) regarding gender and race/ethnicity.

1.28 Differences in Vitamin D Deficiency in Depression, Anxiety, and ADHD During the COVID-19 Pandemic

The advent of the COVID-19 pandemic led to restrictions and lockdowns worldwide, resulting in children and adolescents staying at home. We postulate that this may have contributed to a high prevalence (82.18%) of vitamin D deficiency in patients hospitalized with MDD found in the Appalachian region in our recent study. This led us to further look at the median values of vitamin D in patients who had a single diagnosis of either MDD, anxiety disorders, or ADHD during the COVID-19 pandemic. We further assessed the differences in vitamin D deficiency among the 3 diagnoses.

23.3 Trends in the Diagnosis and Treatment of ADHD in Individuals with an Opioid Use Disorder

ADHD in childhood is a risk factor for the development of a substance use disorder (SUD). SUD, particularly opioid use disorders (OUDs), are associated with substantial morbidity and mortality. This study examines trends in the prevalence and treatment of ADHD among individuals with an OUD in the United States.

FEASIBILITY STUDY DEMONSTRATES PROMISING RESULTS FOR NONPHARMACOLOGIC WEARABLE DIGITAL THERAPY FOR ADHD IN YOUTH

An estimated 9.4% of children in the United States have received a diagnosis of ADHD, making it one of the most diagnosed childhood mental health conditions. First-line treatment includes stimulant and nonstimulant medications with side effects that limit their acceptability and have demonstrated poor adherence over time. Digital therapies have the potential to offer nonpharmacologic alternatives to treatment with minimal, if any, side effects. This feasibility study explored the efficacy of a wearable digital therapy for the treatment of ADHD symptoms and associated functional impairment in youth based on parent- and teacher-reported outcome measures.

3.16 Morning and Evening Behaviors of Transitional-Aged Youth and Young Adults With ADHD

As individuals with ADHD move to young adulthood, the morning and evening times of day increase in importance for evaluation of symptoms, impairment, and functional outcomes. We aim to describe the difference in daily ADHD symptoms between transitional-aged youth and young adults with and without pre-existing ADHD diagnoses.

3.6 The Cultural Adaptation of a Semi-Structured Interview for ADHD Diagnosis in China

This study describes the cultural adaption process of a diagnostic interview for ADHD for use in China. The interview is the Strength-Based Interview for Behavior, Parent Edition (SIB-PE), developed from the Parent Interview for Child Symptoms (PICS).

Factors Impacting Gender Diagnostic Differences in ADHD: A Review

ADHD is a neurodevelopmental disorder commonly diagnosed in children. To date, it is more commonly diagnosed in boys compared to girls although there has been no significant difference reported in adulthood. The objective of this review is to investigate various factors affecting gender differences in ADHD including, historical context, symptom presentation, age of onset, physician biases, and comorbidities. This review includes literature from a variety of academic databases such as Web of Science, MEDLINE, ERIC, PubMed as well as from grey literature. Our findings include systemic gender discrepancies that exist in the reported prevalence, diagnosis, and treatment of ADHD. Additionally, there are several gender-based factors that may contribute to the differences in ADHD presentation for girls including a more inattentive subtype, later age of onset, and misdiagnosis due to comorbidities. This discrepancy in diagnosis has been attributed to various factors which include ineffective diagnostic criteria, physician bias, and comorbidities. Limitations of this review include evident gaps in the literature on the association between ADHD and non-binary gender development, misdiagnosis of girls with comorbidities, as well as differences in the effectiveness of treatment on different genders. Furthermore, there is little standardization in methods and variables collected, especially the minimal recruitment of female participants. Lastly, future studies should investigate the impact of clinical versus community-based settings on children with ADHD.

Information System for Symptom Diagnosis and Improvement of Attention Deficit Hyperactivity Disorder: Protocol for a Nonrandomized Controlled Pilot Study.

BackgroundAttention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders during childhood; however, the diagnosis procedure remains challenging, as it is nonstandardized, multiparametric, and highly dependent on subjective evaluation of the perceived behavior.ObjectiveTo address the challenges of existing procedures for ADHD diagnosis, the ADHD360 project aims to develop a platform for (1) early detection of ADHD by assessing the user’s likelihood of having ADHD characteristics and (2) providing complementary training for ADHD management.MethodsA 2-phase nonrandomized controlled pilot study was designed to evaluate the ADHD360 platform, including ADHD and non-ADHD participants aged 7 to 16 years. At the first stage, an initial neuropsychological evaluation along with an interaction with the serious game developed (“Pizza on Time”) for approximately 30-45 minutes is performed. Subsequently, a 2-week behavior monitoring of the participants through the mADHD360 app is planned after a telephone conversation between the participants’ parents and the psychologist, where the existence of any behaviors characteristic of ADHD that affect daily functioning is assessed. Once behavior monitoring is complete, the research team invites the participants to the second stage, where they play the game for a mean duration of 10 weeks (2 times per week). Once the serious game is finished, a second round of behavior monitoring is performed following the same procedures as the initial one. During the study, gameplay data were collected and preprocessed. The protocol of the pilot trials was initially designed for in-person participation, but after the COVID-19 outbreak, it was adjusted for remote participation. State-of-the-art machine learning (ML) algorithms were used to analyze labeled gameplay data aiming to detect discriminative gameplay patterns among the 2 groups (ADHD and non-ADHD) and estimate a player’s likelihood of having ADHD characteristics. A schema including a train-test splitting with a 75:25 split ratio, k-fold cross-validation with k=3, an ML pipeline, and data evaluation were designed.ResultsA total of 43 participants were recruited for this study, where 18 were diagnosed with ADHD and the remaining 25 were controls. Initial neuropsychological assessment confirmed that the participants in the ADHD group showed a deviation from the participants without ADHD characteristics. A preliminary analysis of collected data consisting of 30 gameplay sessions showed that the trained ML models achieve high performance (ie, accuracy up to 0.85) in correctly predicting the users’ labels (ADHD or non-ADHD) from their gameplay session on the ADHD360 platform.ConclusionsADHD360 is characterized by its notable capacity to discriminate player gameplay behavior as either ADHD or non-ADHD. Therefore, the ADHD360 platform could be a valuable complementary tool for early ADHD detection.Trial RegistrationClinicalTrials.gov NCT04362982; https://clinicaltrials.gov/ct2/show/NCT04362982International Registered Report Identifier (IRRID)RR1-10.2196/40189

Adult attention-deficit hyperactivity disorder among patients with substance use disorders

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder that persists into adulthood. ADHD is a well-known risk factor for substance use disorder (SUD). However, the actual contribution of comorbidity is largely unknown. The current study investigated the prevalence of ADHD in a sample of abstinent patients compared to healthy controls.Compared to 51 healthy controls, 51 patients seeking medical treatment for SUD were abstinent from any substance for at least 1 month, interviewed by the use of the ICD-10 symptom checklist, the Social Classification Scale, the Addiction Severity Index, Conners adult ADHD Rating Scales Self-Report (CAARS-S:L), and the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL).ResultsUsing CAARS-S:L, the ADHD index showed that 9 subjects (17.6%) were diagnosed with adult ADHD. Using K-SADS-PL, 8 of the participants (15.7%) were found to have an adult ADHD diagnosis. Lower scores of the ADHD index are related to increased patients’ age, while increased scores of the ADHD index are related to more alcohol-related problems of the patients. The strongest predicting factors of increased ADHD index were drug problems and legal status.ConclusionsThe current study provides evidence of an increased diagnosis of adult ADHD in patients with substance use disorder, regardless of the type of substance abuse.

An Ensemble Deep Learning Approach Combining Phenotypic Data and fMRI for ADHD Diagnosis

An Ensemble Deep Learning Approach Combining Phenotypic Data and fMRI for ADHD Diagnosis

Maternal Urinary Fluoride levels during pregnancy and ADHD symptoms during childhood

Background and aim. There is little evidence linking fluoride in urinary levels and symptoms or diagnosis of ADHD. In the Basque Country, the fluoridation of drinking water is compulsory for municipalities >30,000 inhabitants. The objective is to analyze the relationships between fluoride levels in urine collected during pregnancy and ADHD symptomatology at 4, 8 and 11 y Methods. Data from 201 to 255 mother-child pairs from the Infancia y Medio Ambiente (INMA) birth cohort with maternal urinary F adjusted for creatinine (MUFcr) during pregnancy and child assessments of ADHD-like behaviors at age of 4, 8 and 11 years was available. ADHD symptoms were reported by ADHD-DSM-IV checklist at age 4, and Conners' Rating Scales-Revised at age 8 and 11. Clinical approach was also carried out using the cut offs of each test. Multiple linear regression and zero inflated binomial regression were used when the outcomes were analyzed as continuous; for a clinical approach, logistic regression was used. Covariates, and biomarkers of neurotoxicants were available. Results: MUFcr levels in pregnancy varied according to the source of drinking water [(mean (95% CI)] being 0.85 (0.77, 0.93) in mothers drinking fluoridated water and 0.45 (0.40, 0.51) in those drinking non-fluoridated water (p<0.01). No association was found between MUFcr levels during pregnancy and inattention, hyperactivity or ADHD score of symptoms at 4, 8 or 11 years. E.g. at the age of 4, for each 1 mg F/g increase across the whole pregnancy, inattention, hyperactivity-impulsivity and ADHD scores did not change significantly: (β =0.16, CI 95%:-1.58, 1.90), (β =0.19, CI 95%: 1.56, 1.95) and (β = 0.35, CI 95%: -2.75, 3.46). Nor was any association observed when a clinical approximation of the problem was used. Conclusions: Higher levels of MUFcr in pregnant women were not associated with global measures of ADHD during childhood

Evidence from "big data" for the default-mode hypothesis of ADHD: a mega-analysis of multiple large samples.

We sought to identify resting-state characteristics related to attention deficit/hyperactivity disorder, both as a categorical diagnosis and as a trait feature, using large-scale samples which were processed according to a standardized pipeline. In categorical analyses, we considered 1301 subjects with diagnosed ADHD, contrasted against 1301 unaffected controls (total N = 2602; 1710 males (65.72%); mean age = 10.86 years, sd = 2.05). Cases and controls were 1:1 nearest neighbor matched on in-scanner motion and key demographic variables and drawn from multiple large cohorts. Associations between ADHD-traits and resting-state connectivity were also assessed in a large multi-cohort sample (N = 10,113). ADHD diagnosis was associated with less anticorrelation between the default mode and salience/ventral attention (B = 0.009, t = 3.45, p-FDR = 0.004, d = 0.14, 95% CI = 0.004, 0.014), somatomotor (B = 0.008, t = 3.49, p-FDR = 0.004, d = 0.14, 95% CI = 0.004, 0.013), and dorsal attention networks (B = 0.01, t = 4.28, p-FDR < 0.001, d = 0.17, 95% CI = 0.006, 0.015). These results were robust to sensitivity analyses considering comorbid internalizing problems, externalizing problems and psychostimulant medication. Similar findings were observed when examining ADHD traits, with the largest effect size observed for connectivity between the default mode network and the dorsal attention network (B = 0.0006, t = 5.57, p-FDR < 0.001, partial-r = 0.06, 95% CI = 0.0004, 0.0008). We report significant ADHD-related differences in interactions between the default mode network and task-positive networks, in line with default mode interference models of ADHD. Effect sizes (Cohen's d and partial-r, estimated from the mega-analytic models) were small, indicating subtle group differences. The overlap between the affected brain networks in the clinical and general population samples supports the notion of brain phenotypes operating along an ADHD continuum.

Increased diagnosis of attention-deficit hyperactivity disorder despite stable hyperactive/inattentive behaviours: evidence from two birth cohorts of Australian children.

Globally, ADHD diagnoses have increased substantially and there is concern that this trend does not necessarily reflect improved detection of cases but that overdiagnosis may be occurring. We directly compared ADHD diagnoses with ADHD-related behaviours and looked for changes across time among Australian children in a large, population-based prospective cohort study. We conducted a secondary analysis of the Longitudinal Study of Australian Children, including 4,699 children born 1999/2000 (cohort 1) and 4,425 children born 2003/2004 (cohort 2), followed from 4 to 13 years of age. We compared pre-diagnosis parent-reported hyperactive/inattentive behaviour scores between newly diagnosed (incident cases) and undiagnosed children and fitted Cox's proportional hazards regression models to examine the relationship between birth cohorts 1 and 2 and the risk of incident ADHD diagnosis. Cumulative incident ADHD diagnoses increased from 4.6% in cohort 1 (born in 1999/2000) to 5.6% in cohort 2 (born in 2003/2004), while hyperactive/inattentive behaviour scores remained steady. Among ADHD diagnosed children, 26.5% (88/334) recorded pre-diagnosis behaviours in the normal range, 27.6% (n = 92) had borderline scores and 45.8% (n = 153) scored within the clinical range. Children born in 2003/2004 were more likely to be diagnosed with ADHD compared with those born in 1999/2000 (aHR = 1.33, 95% CI = 1.06-1.67, p = .012), regardless of their ADHD behaviour score (p = .972). Diagnostic increases were not driven by rises in hyperactive/inattentive behaviours. A quarter of all children with an ADHD diagnosis recorded pre-diagnosis behaviours within the normal range. The increased likelihood of being diagnosed with ADHD for children from the later birth cohort was observed for children across the full range of ADHD-related behaviours.

Determinants of teachers’ attitudes toward inclusion of pupils with attention deficit hyperactivity disorder: The role of teacher education

Given that teachers’ attitudes are an essential constituent of most academic and social processes taking place in their classrooms, the authors of the current study examined teachers’ attitudes and their origins specifically toward the inclusion of pupils with ADHD, taking into account demographic variables, teachers’ professionalism, and either a personal diagnosis of ADHD or prior acquaintance with it through relatives. The data, gathered from 475 participants’ responses to questionnaires, revealed that professional teacher training was only a secondary factor influencing attitudes regarding the inclusion of children with ADHD. A more prominent factor was teachers’ own diagnosis of ADHD or prior experience with children/relatives with ADHD. Study results are followed by practical suggestions for improving teacher education based on these findings.

Preschool development, temperament and genetic liability as early markers of childhood ADHD: A cohort study.

ADHD is associated with multiple adverse outcomes and early identification is important. The present study sets out to identify early markers and developmental characteristics during the first 30months of life that are associated with ADHD 6years later. 9201 participants from the prospective Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were included. Outcome measures were parent-rated ADHD symptom scores (Strengths and Difficulties Questionnaire, SDQ) and ADHD diagnosis (Development and Wellbeing Assessment, DAWBA) at age 7. Seventeen putative markers were identified from previous literature and included: pre- and peri-natal risk factors, genetic liability (ADHD polygenic risk scores, PRS), early development, temperament scores and regulatory problems. Associations were examined using regression analysis. Univariable regression analysis showed that multiple early life factors were associated with future ADHD outcomes, even after controlling for sex and socio-economic status. In a multivariable linear regression model; temperament activity scores (B=0.107, CI=0.083-0.132), vocabulary delay (B=0.605, CI=0.211-0.988), fine motor delay (B=0.693, CI=0.360-1.025) and ADHD PRS (B=0.184, CI=0.074-0.294) were associated with future symptoms (R 2=10.7%). In a multivariable logistic regression model, ADHD PRS (OR=1.39, CI=1.10-1.77) and temperament activity scores (OR=1.09, CI=1.04-1.16) showed association with ADHD diagnosis. As well as male sex and lower socio-economic status, high temperament activity levels and motor and speech delays in the first 30months of life, are associated with childhood ADHD. Intriguingly, given that genetic risk scores are known to explain little of the variance of ADHD outcomes, we found that ADHD PRS added useful predictive information. Future research needs to test whether predictive models incorporating aspects of early development and genetic risk scores are useful for predicting ADHD in clinical practice.

Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability.

The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.

Challenges and opportunities for the early identification of ADHD across multiple levels of analysis - Areflection on Tobarra-Sanchez etal. (2022).

Challenges and opportunities for the early identification of ADHD across multiple levels of analysis - Areflection on Tobarra-Sanchez etal. (2022).