Inattentive Subtype Research Articles

Cognitive profiles and developmental variations in ADHD: A comparative analysis of childhood and adolescent diagnoses

This retrospective study investigates the cognitive profiles of individuals with ADHD, categorized by the age at which they were diagnosed—either during childhood or adolescence. The sample comprised 424 participants aged 6 to 20 years, with a predominance of males. Participants were assessed using a variety of neuropsychological standardized tests. The study found significant differences in cognitive performance between those diagnosed in childhood and those diagnosed in adolescence. Specifically, childhood diagnoses were associated with poorer performance in vigilance, selective attention, and motor control, while adolescent diagnoses were linked to lower scores in the environment’s perception of their flexibility, working memory, and planning. Binary logistic regression analyses indicated that the neuropsychological profile for the combined ADHD subtype did not vary by age group, in contrast with the inattentive subtype, in which different cognitive constructs were identified serving as significant predictors. Findings suggest that the cognitive challenges associated with ADHD evolve with development, highlighting the need for age-appropriate diagnostic criteria and interventions.

Executive functioning in adults with attention deficit hyperactivity disorder: A systematic review

Introduction: Executive function deficits are associated with attention deficit hyperactivity disorder (ADHD) in both children and adults. The inattentive subtype is primary related to “cold” executive functions, while the hyperactive subtype is related to “warm” executive functions. Objective: To systematically review studies on executive functioning in adults with attention deficit hyperactivity disorder published during the last decade. Methodology: A documentary research was conducted, encompassing 33 articles retrieved from PubMed, Web of Science and EBSCO platforms. The analysis considered years and countries of publication, attention deficit hyperactivity disorder diagnostic criteria, participants, comorbidities, subtypes, medication use, assessment tools, and processes of executive functions evaluated. Results: It was evidenced that there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests. However, the results varied depending on specific characteristics of the study and/or participants, which confirms the heterogeneity of the disorder. In addition, the main instruments for measuring executive functions and diagnostic criteria for adult attention deficit hyperactivity disorder were identified. Discussion: These results support the established links between attention deficit hyperactivity disorder , impaired executive functions, and major life activities found in the adult attention deficit hyperactivity disorder literature. However, some of the limitations were the poorly controlled variables such as comorbidities, attention deficit hyperactivity disorder subtypes that were not assessed, and usage of instruments that measure executive functions that can lead to reduced credibility of the results presented here. Conclusions: According to the results presented, there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests, compared to both neurotypical adults and those with other psychiatric disorders. Further research is recommended to continue studies on the topic and to include other variables.

Enhanced ADHD classification through deep learning and dynamic resting state fMRI analysis.

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by deficits in attention, hyperactivity, and/or impulsivity. Resting-state functional connectivity analysis has emerged as a promising approach for ADHD classification using resting-state functional magnetic resonance imaging (rs-fMRI), although with limited accuracy. Recent studies have highlighted dynamic changes in functional connectivity patterns among ADHD children. In this study, we introduce Skip-Vote-Net, a novel deep learning-based network designed for classifying ADHD from typically developing children (TDC) by leveraging dynamic connectivity analysis on rs-fMRI data collected from 222 participants included in the NYU dataset within the ADHD-200 database. Initially, for each subject, functional connectivity matrices were constructed from overlapping segments using Pearson's correlation between mean time series of 116 regions of interest defined by the Automated Anatomical Labeling (AAL) 116 atlas. Skip-Vote-Net was then developed, employing a majority voting mechanism to classify ADHD/TDC children, as well as distinguishing between the two main subtypes: the inattentive subtype (ADHDI) and the predominantly combined subtype (ADHDC). The proposed method was evaluated across four classification scenarios: (1) two-class classification of ADHD from TD children using balanced data, (2) two-class classification between ADHD and TD children using unbalanced data, (3) two-class classification between ADHDI and ADHDC, and (4) three-class classification among ADHDI, ADHDC, and TD children. Using Skip-Vote-Net, we achieved mean classification accuracies of 97% ± 1.87 and 97.7% ± 2.2 for the balanced and unbalanced classification cases, respectively. Furthermore, the mean classification accuracy for discriminating between ADHDI and ADHDC reached 99.4% ± 1.21. Finally, the proposed method demonstrated an average accuracy of 98.86% ± 1.03 in classifying ADHDI, ADHDC, and TD children collectively. Our findings highlight the superior performance of Skip-Vote-Net over existing methods in the classification of ADHD, showcasing its potential as an effective diagnostic tool for identifying ADHD subtypes and distinguishing ADHD from typically developing children.

Individual child factors affecting the diagnosis of attention deficit hyperactivity disorder (ADHD) in children and adolescents: a systematic review.

Attention deficit hyperactivity disorder (ADHD) is a prevalent condition characterised by patterns of inattention, hyperactivity, and impulsivity. This systematic literature review aims to identify the child clinical and sociodemographic factors related to the detection and diagnosis of ADHD in children and adolescents, given concerns about delays or failures in identifying ADHD as well as over-diagnosis, hindering appropriate and timely support for children and families. Through electronic and manual searches of peer-reviewed and grey literature, 5852 articles were identified and subjected to two stages of screening by independent reviewers. Due to the heterogeneity in study methods, a narrative approach was used to summarise study findings. Forty-one studies meeting eligibility criteria revealed sixteen child-related factors influencing the ADHD diagnostic process. These factors include ADHD subtype, ADHD symptom severity, comorbid mental disorders, behavior problems, internalizing symptoms, functional impairment, social and cognitive functioning, physical health, gender, age, relative age, race/ethnicity, socio-economic status, insurance coverage, residence urbanicity, and family structure. While the impact of many of these factors on ADHD diagnosis was inconsistent due to the substantial diversity in study designs and context, certain patterns emerged. Meeting the criteria for the inattentive subtype, lower functional impairment, female gender, Black or Latinx ethnicity, and being relatively young for their grade were consistently found to be associated with a delayed or absent ADHD diagnosis. Further research is needed to explore the intricate relationships between these child-level variables and their implications for ADHD recognition, referral, and evaluation, especially outside the USA.

Attention-deficit hyperactivity disorder symptoms and bullying victimization from childhood to adolescence - A within-person cross-lagged approach.

Attention-deficit hyperactivity disorder (ADHD) and subclinical symptoms of hyperactivity-impulsivity and inattentiveness coincide with an increased risk of peer victimization. What remains unclear are the developmental dynamics of these associations. In a sample drawn from two Norwegian birth cohorts (n = 872; 49.94 % girls), assessed biennially from age 6 to age 14, reciprocal relations between ADHD symptoms and victimization were examined while controlling for symptoms of anxiety and depression. ADHD symptoms were assessed through clinical interviews with parents, whereas victimization was reported by teachers using questionnaires. Random-intercept cross-lagged panel modeling revealed a consistent reciprocal within-person effect of increased ADHD symptoms on victimization, and vice versa. Analyses of subdimensions of ADHD projected a consistent cross-lagged bidirectional relationship between victimization and inattentiveness symptoms only, whereas no such reciprocity was found for hyperactivity-impulsivity symptoms. Results did not differ by gender. Findings suggest that the social context may constitute a vulnerability factor in the etiology of the inattentive subtype of ADHD, and at the same time, that inattentiveness symptoms pose a risk for becoming victimized.

Rhinorrhea and watery eyes in infancy and risk of attention-deficit hyperactivity disorder in school-age children.

Increased parasympathetic nervous system (PNS) activity is associated with attention-deficit/hyperactivity disorder (ADHD) inattentive symptoms, but not hyperactive-impulsive symptoms, and may contribute to inattentive subtype etiology. Guided by prior work linking infant rhinorrhea and watery eyes without a cold (RWWC) to PNS dysregulation, we examined associations between infant RWWC and childhood ADHD symptoms in a longitudinal cohort of Black and Latinx children living in the context of economic disadvantage (N=301 youth: 158 females, 143 males). Infant RWWC predicted higher inattentive (relative risk [RR] 2.16, p<.001) but not hyperactive-impulsive (RR 1.53, p=.065) ADHD symptoms (DuPaul scale), administered to caregivers at child age 8-14 years. Stratified analyses revealed that these associations were present in females but not males, who were three times more likely to have higher ADHD current total symptoms if they had infant RWWC than if they did not. Additionally, associations between RWWC and inattention symptoms were observed only in females. RWWC may thus serve as a novel risk marker of ADHD inattentive-type symptoms, especially for females.

Prevalence of attention deficit hyperactivity disorder in school-going children in rural Konkan region of Maharashtra.

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood characterised by attention deficit, hyperactivity and impulsiveness. The present study was designed to compute the prevalence of ADHD and assess the association of the predetermined demographic variables and ADHD in school-going children aged 6-12 years in rural areas of Konkan. The present study was a descriptive, cross-sectional study. Using the first edition of Vanderbilt's scale - D4 (Teacher's informant) by National Institute for Children's Health Quality (NICHQ) for identifying symptoms of ADHD in children, a questionnaire was filled out for each child with input from their class teacher. These data were then compiled and analysed. Out of the 133 participants in the study aged 6-12 years, the gender distribution was 69 boys and 64 girls. The mean age was 9.2 ± 2.3 years. Of which, one student (0.75%) was found to have a predominantly inattentive subtype of ADHD (ADHD-IA). The prevalence was found to be 1.5% (2/133). In addition, one student (0.75%) was found to have a combined ADHD-IA and hyperactive (ADHD-H/I) subtype of ADHD (ADHD-C). The latter was also positive for the anxiety/depression screening scale administered as part of the same questionnaire. The total symptom score for questions 1-18 was 8.44 ± 7.29. One of the most common neurodivergent conditions among school-age children is ADHD. Using an easy-to-use questionnaire, teachers and parents can report those experiencing symptoms of ADHD. Early diagnosis and treatment are recommended to avoid complications and aid in the improvement of quality of life.

Children with ADHD and EEG abnormalities at baseline assessment, risk of epileptic seizures and maintenance on methylphenidate three years later

PurposeThis study aimed to assess the incidence of EEG abnormalities (EEG-ab) in children diagnosed with ADHD, investigate the risk of epileptic seizures (SZ) and maintenance on methylphenidate (MPH) over a three-year period.MethodsA total of 517 ADHD children aged 6–14 years were included. Baseline assessments included the identification of EEG-ab, ADHD inattentive subtype (ADHD-I), comorbid epilepsy, the use of antiepileptic drugs (AEDs) and the use of MPH. At the 3-year follow-up, assessments included the presence of EEG-ab, maintenance on MPH, AED usage, SZ risk in cases with EEG-epileptiform abnormalities (EEG-epi-ab), compared with control ADHD cases without EEG-epi-ab matched for age and gender.ResultsEEG-ab were identified in 273 (52.8%) cases. No statistically significant differences were observed between the EEG-ab and EEG-non-ab groups in terms of age, gender, ADHD-I type or initial use of MPH. EEG non-epileptiform abnormalities (EEG-non-epi-ab) were found in 234 out of 478 (49%) cases without EEG-epi-ab. Notably, EEG-non-epi-ab occurred more frequently in the group of 39 cases with EEG-epi-ab (30/39 (76.9%) vs. 9/39, (21.3%), a subset selected for 3-year follow-up. At 3-year-follow-up no statistically significant difference was found in maintenance on MPH in ADHD cases with and without EEG-epi-ab. Nobody of ADHD cases without comorbid epilepsy or with comorbid epilepsy with achieved SZ freedom developed new SZ. Only 3 children with drug resistant epilepsy experienced SZs, without increase in SZ frequency. The disappearance rate of EEG-epi-ab was higher than that EEG-non-epi-ab (71.8% vs. 33.3%).ConclusionsChildren with and without EEG-ab exhibited similar patterns of MPH use (initial use, positive response, and maintenance on MPH). The presence of comorbid epilepsy and EEG-ab, with or without EEG-epi-ab, was not associated with an increased risk of SZ despite the use of MPH.

Language and reading in attention-deficit/hyperactivity disorder and comorbid attention-deficit/hyperactivity disorder+developmental language disorder.

The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD+ADHD. The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig etal., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner etal., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen etal., 2012) were examined in 441 children and adolescents between 6 and 16years of age. The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD+DLD than children with DLD only. The combination of comorbid ADHD+DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

Attention deficit hyperactivity disorder in children with epilepsy: a multicenter cross-sectional analysis in China.

The diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) comorbid with epilepsy have been insufficiently addressed in China. We conducted a study in China to investigate the current status, diagnosis, and treatment of ADHD in children to further our understanding of ADHD comorbid with epilepsy, strengthen its management, and improve patients' quality of life. We carried out a multicenter cross-sectional survey of children with epilepsy across China between March2022 and August2022. We screened all patients for ADHD and compared various demographic and clinical factors between children with and without ADHD, including gender, age, age at epilepsy onset, duration of epilepsy, seizure types, seizure frequency, presence of epileptiform discharges, and treatment status. Our objective was to explore any possible associations between these characteristics and the prevalence of ADHD. Overall, 395 epilepsy patients aged 6-18years were enrolled. The age at seizure onset and duration of epilepsy ranged from 0.1-18 to 0.5-15years, respectively. Focal onset seizures were observed in 212 (53.6%) patients, while 293 (76.3%) patients had epileptiform interictal electroencephalogram (EEG) abnormalities. Among the 370 patients treated with anti-seizure medications, 200 (54.1%) had monotherapy. Although 189 (47.8%) patients had ADHD, only 31 received treatment for it, with the inattentive subtype being the most common. ADHD was more common in children undergoing polytherapy compared to those on monotherapy. Additionally, poor seizure control and the presence of epileptiform interictal EEG abnormalities may be associated with a higher prevalence of ADHD. While the prevalence of ADHD was higher in children with epilepsy than in normal children, the treatment rate was notably low. This highlights the need to give more importance to the diagnosis and treatment of ADHD in children with epilepsy.

Attention-deficit/hyperactivity disorder in children with epilepsy: A systematic review and meta-analysis of prevalence and risk factors.

To evaluate the prevalence of and risk factors for attention-deficit/hyperactivity disorder (ADHD) in children with epilepsy (CWE). We conducted a systematic search in PubMed and Embase for the meta-analysis. The pooled prevalence of ADHD was calculated using a random-effects model; subgroup analyses were performed to explore heterogeneity. We collected raw data from articles reporting potential risk factors, which were included in the subsequent risk factor analysis. Forty-six articles met the inclusion criteria for the meta-analysis, which showed a pooled ADHD prevalence of 30.7% in CWE, with a predominance of the inattentive subtype of ADHD; the heterogeneity of prevalence was related to population source/study setting (clinic based, community based, or database based) and method of ADHD diagnosis (with or without clinical review). Risk factors for ADHD in epilepsy included younger age, intellectual/developmental disabilities, a family history of epilepsy, earlier epilepsy onset, absence epilepsy, more frequent seizures, and polytherapy; In contrast, risk factors such as sex, generalized epilepsy or seizures, epilepsy etiology, and electroencephalogram abnormalities were not significantly associated with the occurrence of ADHD. The prevalence of ADHD in CWE is high and several potential risk factors are associated with it. This study contributes to a better understanding of ADHD in epilepsy for screening and treatment. This systematic review summarizes the prevalence of attention-deficit/hyperactivity disorder (ADHD) occurring in children with epilepsy and analyses the risk factors for comorbid ADHD in epilepsy. By reviewing 46 articles, we concluded that the overall prevalence of ADHD in children with epilepsy was 30.7% and that intellectual/developmental disabilities were the most significant risk factor for combined ADHD in children with epilepsy. This study provides a wealth of information on comorbid ADHD in epilepsy, which will help clinicians identify and treat potential ADHD in children with epilepsy in a timely manner.

Sleep quality, PIU in adolescents with ADHD. Is there a relationship between sleep quality and problematic internet use in adolescents with attention deficit hyperactivity disorder?

AbstractThis research aimed to compare the sleep quality and problematic internet use (PIU) of adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) compared to the group of healthy control. There were 53 ADHD-diagnosed individuals (19 ADHD- combined type, 34 ADHD- inattentive type) in the research population, ages 12 to 18, and 53 healthy adolescents in the control group. A child psychiatrist applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) to each case, and sociodemographic information was collected. The Pittsburgh Sleep Quality Index (PSQI) and the Internet Addiction Test (IAT) were also applied to all the cases. The Turgay DSM-IV-Based Disruptive Behaviour Disorders, Child and Adolescent Evaluation and Screening Scale (T-DSM-IV-S) was completed by the parents of all the adolescents. The ADHD group's IAT and PSQI total points were found to be statistically significantly higher than those of the healthy control group (p &lt; 0.001). The results of the covariance analysis showed a significant positive correlation between the T-DSM-IV-S subscales and the IAT mood points in the ADHD patients. The T-DSM-IV-S attention deficit points were found to be significantly higher in the ADHD children with PIU (independently of age and gender) compared to those without PIU. The results of the study showed that adolescents with ADHD had greater rates of poor sleep quality and PIU than the control group. The study results also suggested that the severity of the inattentive subtype of ADHD could play a potential role in the development of PIU in children diagnosed with ADHD. Based on this foundation, it is crucial to acknowledge and address poor sleep quality and PIU in adolescents with ADHD.

Determining cutoff scores on the Conners’ adult ADHD rating scales that can definitively rule out the presence of ADHD in a clinical sample

In recent years, the prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) and the number of individuals seeking ADHD assessments has risen significantly, leading to an increased demand for accurate diagnostic tools. This study aimed to identify cutoff scores on the Conners’ Adult ADHD Rating Scales (CAARS-S:L) that can definitively rule out the presence of ADHD. Among 102 clinically diagnosed adult ADHD participants and 448 non-ADHD participants who completed the CAARS-S:L, a receiver operating characteristic curve analysis established a perfectly discriminant cutoff T-score of <44 on the ADHD Symptoms Total subscale when looking at any ADHD diagnosis and <54 on the Inattentive Symptoms subscale when looking at individuals diagnosed with the inattentive subtype of ADHD. Alternative cutoffs of <54 (ADHD Symptoms Total subscale) and <63 (Inattentive Symptoms subscale) were also identified, both with a sensitivity of 0.95 or higher. Furthermore, the analysis found the ADHD Index to be a poor predictor of a negative ADHD diagnosis, suggesting against the use of this scale for cutoff determination. Despite this limitation, these findings indicate that with specific cutoffs, the CAARS-S:L may have the potential to conclusively rule out ADHD, effectively streamlining the diagnostic process and reducing unnecessary comprehensive assessments in clear negative cases.

Temperamental differences in the Subtypes of Attention Deficit Hyperactivity Disorder

IntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support.ObjectivesOur aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD.MethodsOur study is conducted on patients (&gt;18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R).Results76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019).ConclusionsThe results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted.Disclosure of InterestNone Declared

Integrating Cognitive Factors and Eye Movement Data in Reading Predictive Models for Children with Dyslexia and ADHD-I.

This study reports on several specific neurocognitive processes and eye-tracking predictors of reading outcomes for a sample of children with Developmental Dyslexia (DD) and At-tention-Deficit/Hyperactivity Disorder - inattentive subtype (ADHD-I) compared to typical readers. Participants included 19 typical readers, 21 children diagnosed with ADHD-I and 19 children with DD. All participants were attending 4th grade and had a mean age of 9.08 years. The psycholinguistic profile of each group was assessed using a battery of neuropsy-chological and linguistic tests. Participants were submitted to a silent reading task with lex-ical manipulation of the text. Multinomial logistic regression was conducted to evaluate the predictive capability of developing dyslexia or ADHD-I based on the following measures: (a) a linguistic model that included measures of phonological awareness, rapid naming, and reading fluency and accuracy; (b) a cognitive neuropsychological model that included measures of memory, attention, visual processes, and cognitive or intellectual functioning, and (c) an additive model of lexical word properties with manipulation of word-frequency and word-length effects through eye-tracking. The additive model in conjunction with the neuropsychological model classification improved the prediction of who develops dyslexia or ADHD-I having as baseline normal readers. Several of the neuropsychological and eye-tracking variables have power to predict the degree of reading outcomes in children with learning disabilities.

The ADHD Phenotype in Black and White Girls From Childhood to Adolescence: Results From the Community-Based Pittsburgh Girls Study

Objective: The goal of the present study is to describe the ADHD phenotype from childhood to adolescence in Black and White girls in a community sample. Method: Primary caregivers enrolled in the population-based, longitudinal Pittsburgh Girls Study reported on girls’ ADHD symptoms and impairment from ages 7 to 17; diagnostic subtypes were estimated based on meeting symptom criteria. Results: The prevalence of any subtype of ADHD ranged from 6.4 to 9.2% and from 2.3 to 6.4% for Black and White girls respectively; the inattentive subtype was most endorsed. A relatively equal number of new diagnoses at each age was observed. Persistence of ADHD diagnoses was typically 1 to 2 years. Conclusions: ADHD in the community is relatively common, with the inattentive subtype as the most common phenotype for Black and White girls. Research on developmentally sensitive periods for symptom exacerbation or new onset of ADHD in girls is needed.

Differential neurocognitive profiles in adult attention-deficit/hyperactivity disorder subtypes revealed by the Cambridge Neuropsychological Test Automated Battery.

Adult attention-deficit/hyperactivity disorder (aADHD) represents a heterogeneous entity incorporating different subgroups in terms of symptomatology, course, and neurocognition. Although neurocognitive dysfunction is generally associated with aADHD, its severity, association with self-reported symptoms, and differences between subtypes remain unclear. We investigated 61 outpatients (65.6% male, mean age 31.5 ± 9.5) diagnosed using DSM-5 criteria together with age-, sex-, and education-matched healthy controls (HC) (n = 58, 63.8% male, mean age 32.3 ± 9.6). Neurocognitive alterations were assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and compared between groups using the generalized linear model (GLM) method. Multivariate effects were tested by principal component analysis combined with multivariate pattern analysis. Self-reported symptom severity was tested for correlations with neurocognitive performance. GLM analyses revealed nominally significant differences between the aADHD and HC groups in several domains, however, only the Rapid Visual Information Processing measures survived correction, indicating impaired sustained attention and response inhibition in the aADHD group. Comparison of the predominantly inattentive and the hyperactive-impulsive/combined subtypes yielded nominally significant differences with higher levels of dysfunction in the inattentive group. In the stepwise discriminant analysis aADHD and HC groups were best separated with 2 factors representing sustained attention and reaction time. We found only weak correlations between symptom severity and CANTAB factors. aADHD patients are neuropsychologically heterogeneous and subtypes show different neurocognitive profiles. Differences between the aADHD and HC groups were driven primarily by the inattentive subtype. Sustained attention and its factor derivative showed the most significant alterations in aADHD patients.

Frequency characteristics of temporal and spatial concordance among dynamic indices in inattentive and combined subtypes of attention deficit hyperactivity disorder.

Numerous voxel-based resting-state functional magnetic resonance imaging (rs-fMRI) measurements have been used to characterize spontaneous brain activity in attention deficit hyperactivity disorder (ADHD). However, the practical distinctions and commonalities among these intrinsic brain activity measures remain to be fully explored, and whether the functional concordance is related to frequency is still unknown. The study included 25 ADHD, combined type (ADHD-C); 26 ADHD, inattentive type (ADHD-I); and 28 typically developing (TD) children. We calculated the voxel-wise (temporal) and volume-wise (spatial) concordance among dynamic rs-fMRI indices in the slow-5 (0.01-0.027 Hz) and slow-4 (0.027-0.073 Hz) frequency bands, respectively. The spatiotemporal concordance within the slow-4 and slow-5 bands among the ADHD-C, ADHD-I, and TD groups was compared. Although the ADHD-C and ADHD-I groups showed similar volume-wise concordance, comparison analysis revealed that compared with ADHD-C patients, ADHD-I patients exhibited decreased voxel-wise concordance in the right median cingulate and paracingulate gyrus (MCC) and right supplementary motor area (SMA) in the slow-5 band. In addition, the voxel-wise concordance was negatively correlated with the diagnostic scores of ADHD subtypes. Our results suggest that functional concordance is frequency dependent, and dynamic concordance analysis based on specific frequency bands may provide a novel approach for investigating the pathophysiological differences among ADHD subtypes.

The mesocortical dopaminergic system cannot explain hyperactivity in an animal model of attention deficit hyperactivity disorder (ADHD)- Spontaneously hypertensive rats (SHR)

BackgroundAttention deficit hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders with morphological brain abnormalities. There is a growing body of evidence that abnormalities in the dopaminergic system may account for ADHD pathogenesis. However, it is not clear whether the dopaminergic system is hyper or hypoactive. To determine whether the DA neurons and/or axons deficiency might be the cause of the postulated dopaminergic hypofunction in spontaneously hypertensive rats (SHR, animal model of ADHD), this study examined the dopaminergic neurons and fibers in the brain tissues of SHRs and Wistar Kyoto rats (WKY, control animals). Here, we performed immunohistochemical tyrosine hydroxylase (TH) and dopamine-beta-hydroxylase (DBH) staining on brain sections collected on juveniles from SHR and WKY. Moreover, behavioral testing to examine the hyperactivity in the open field area was also elucidated.ResultsThe mesocortical dopaminergic system appears to be normal in juvenile SHR, as suggested by (i) no alteration in the area density of TH-immunoreactive (TH-ir) dopaminergic neurons in the ventral tegmental area (VTA), (ii) no alterations in the volume density of TH-ir fibers in layer I of the prelimbic (PrL) subregion of medial PFC (mPFC), (iii) no alteration in the percentage of TH-ir dopaminergic fibers in layer I of the PrL subregion of mPFC as revealed by TH and/or DBH immunoreactivity. Furthermore, the SHR showed increased locomotor activity than WKY in the open field test.ConclusionsThe demonstration of no alteration in mesocortical dopaminergic neurons and fiber in SHR raises some concern about the position of SHR as an animal model of the inattentive subtype of ADHD. However, these results strengthen this strain as an animal model of hyperactive/impulsive subtype ADHD for future studies that may elucidate the underlying mechanism mediating hyperactivity and test various treatment strategies.

Distraction in road traffic: How Czech media covers the issue

Road users' inattention is one of the leading factors that contribute to crashes. It has been thoroughly researched from many perspectives, but there is limited information about the factors that influence risk perception and road users' attitudes. These factors are formed by personal and mediated experience, but education and public awareness play important roles. In this context, media seems to significantly influence risk perception and it may result in behavioural changes. This study aimed to review the coverage of driver inattention in the Czech media to analyse how it covers different types of inattention. Both quantitative and qualitative content analyses were conducted, and the sources of inattention mentioned in media reports were coded. We found the following: distraction is the most often reported inattention subtype; the media often communicates illegal behaviour, such as mobile phone handling; the preventive and educational potential of media coverage seems to not be fully utilized; and media reports are often focused on specific crashes, consequences, and immediate causes. Other risky aspects or inattention contributory factors tend to be neglected.