Occupational Functioning In Adults Research Articles

Prediction of Educational Attainment and Occupational Functioning in Young Adults With a Childhood Diagnosis of ADHD: Results from the Cologne Adaptive Multimodal Treatment (CAMT) Study

Objective: This longitudinal study examined early predictors of educational attainment and occupational functioning in adults with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD). Method: Participants (n = 70) of the Cologne Adaptive Multimodal Treatment (CAMT) Study were diagnosed with ADHD and received adaptive multimodal ADHD treatment during childhood. They were then followed through adolescence into adulthood. Results: Hierarchical regression analysis revealed that poor reading skill and externalizing behaviors in childhood were early predictors of educational and occupational difficulties in adulthood. The use of stimulant medication in childhood predicted lower high school achievement, probably because medication use was confounded by indication. The regression models improved when intelligence scores and/or externalizing behaviors, especially delinquency, assessed in adolescence were considered as additional predictors. Conclusion: Children with ADHD, who continue to show reading difficulties and externalizing behavior problems after initial treatment, are at risk for educational and occupational difficulties and may need additional support.

A Web-Based Mental Health Intervention to Improve Social and Occupational Functioning in Adults With Type 2 Diabetes (The Springboard Trial): 12-Month Outcomes of a Randomized Controlled Trial.

BackgroundPeople with type 2 diabetes mellitus (T2DM) often experience mental health symptoms that exacerbate illness and increase mortality risk. Access to psychological support is low in people with T2DM. Detection of depression is variable in primary care and can be further hampered by mental health stigma. Electronic mental health (eMH) programs may provide an accessible, private, nonstigmatizing mental health solution for this group.ObjectiveThis study aims to evaluate the efficacy over 12 months of follow-up of an eMH program (myCompass) for improving social and occupational functioning in a community sample of people with T2DM and self-reported mild-to-moderate depressive symptoms. myCompass is a fully automated and self-guided web-based public health program for people with depression or anxiety. The effects of myCompass on depressive symptoms, diabetes-related distress, anxiety symptoms, and self-care behavior were also examined.MethodsAdults with T2DM and mild-to-moderate depressive symptoms (N=780) were recruited via online advertisements, community organizations, and general practices. Screening, consent, and self-report questionnaires were administered online. Eligible participants were randomized to receive either myCompass (n=391) or an attention control generic health literacy program (Healthy Lifestyles; n=379) for 8 weeks. At baseline and at 3, 6, and 12 months postintervention, participants completed the Work and Social Adjustment Scale, the Patient Health Questionnaire-9 item, the Diabetes Distress Scale, the Generalized Anxiety Disorder Questionnaire-7 item, and items from the Self-Management Profile for Type 2 Diabetes. Glycosylated hemoglobin measurements were obtained at baseline and 6 and 12 months postintervention.ResultsA total of 38.9% (304/780) of the trial participants completed all postintervention assessments. myCompass users logged in on an average of 6 times and completed an average of 0.29 modules. Healthy Lifestyles users logged in on an average of 4 times and completed an average of 1.37 modules. At baseline, the mean scores on several outcome measures, including the primary outcome of work and social functioning, were close to the normal range, despite a varied and extensive recruitment process. Intention-to-treat analyses revealed slightly greater improvement at 12 months in work and social functioning for the Healthy Lifestyles group relative to the myCompass group. All participants reported equivalent improvements in depression anxiety, diabetes distress, diabetes self-management, and glycemic control across the trial.ConclusionsThe Healthy Lifestyles group reported higher ratings of social and occupational functioning than the myCompass group, but no differences were observed for any secondary outcome. Although these findings should be interpreted in light of the near-floor symptom scores at baseline, the trial yields important insights into how people with T2DM might be engaged in eMH programs and the challenges of focusing specifically on mental health. Several avenues emerge for continued investigation into how best to deal with the growing mental health burden in adults with T2DM.Trial RegistrationAustralian New Zealand Clinical Trials Registry Number (ACTRN) 12615000931572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368109&isReview=true

A Web-Based Cognitive Behavior Therapy Intervention to Improve Social and Occupational Functioning in Adults With Type 2 Diabetes (The SpringboarD Trial): Randomized Controlled Trial

BackgroundDepressive symptoms are common in people with type 2 diabetes mellitus (T2DM). Effective depression treatments exist; however, access to psychological support is characteristically low. Web-based cognitive behavioral therapy (CBT) is accessible, nonstigmatizing, and may help address substantial personal and public health impact of comorbid T2DM and depression.ObjectiveThe aim of this study was to evaluate the Web-based CBT program, myCompass, for improving social and occupational functioning in adults with T2DM and mild-to-moderate depressive symptoms. myCompass is a fully automated, self-guided public health treatment program for common mental health problems. The impact of treatment on depressive symptoms, diabetes-related distress, anxiety symptoms, and self-care behavior was also examined.MethodsParticipants with T2DM and mild-to-moderate depressive symptoms (N=780) were recruited online via Google and Facebook advertisements targeting adults with T2DM and via community and general practice settings. Screening, consent, and self-report scales were all self-administered online. Participants were randomized using double-blind computerized block randomization to either myCompass (n=391) for 8 weeks plus a 4-week tailing-off period or an active placebo intervention (n=379). At baseline and postintervention (3 months), participants completed the Work and Social Adjustment Scale, the primary outcome measure. Secondary outcome measures included the Patient Health Questionnaire-9 item, Diabetes Distress Scale, Generalized Anxiety Disorder Questionnaire-7 item, and items from the Self-Management Profile for Type 2 Diabetes.ResultsmyCompass users logged in an average of 6 times and completed an average of .29 modules. Healthy Lifestyles users logged in an average of 4 times and completed an average of 1.37 modules. At baseline, mean scores on several outcome measures, including the primary outcome of work and social functioning, were near to the normal range, despite an extensive recruitment process. Approximately 61.6% (473/780) of participants completed the postintervention assessment. Intention-to-treat analyses revealed improvement in functioning, depression, anxiety, diabetes distress, and healthy eating over time in both groups. Except for blood glucose monitoring and medication adherence, there were no specific between-group effects. Follow-up analyses suggested the outcomes did not depend on age, morbidity, or treatment engagement.ConclusionsImprovement in social and occupational functioning and the secondary outcomes was generally no greater for myCompass users than for users of the control program at 3 months postintervention. These findings should be interpreted in light of near-normal mean baseline scores on several variables, the self-selected study sample, and sample attrition. Further attention to factors influencing uptake and engagement with mental health treatments by people with T2DM, and the impact of illness comorbidity on patient conceptualization and experience of mental health symptoms, is essential to reduce the burden of T2DM.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12615000931572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368109&isReview=true (Archived by WebCite at http://www.webcitation.org/7850eg8pi)

Occupational issues of adults with ADHD

BackgroundADHD is a common neurodevelopmental disorder that persists into adulthood. Its symptoms cause impairments in a number of social domains, one of which is employment. We wish to produce a consensus statement on how ADHD affects employment.MethodsThis consensus development conference statement was developed as a result of a joint international meeting held in July 2010. The consensus committee was international in scope (United Kingdom, mainland Europe, United Arab Emirates) and consisted of individuals from a broad range of backgrounds (Psychiatry, Occupational Medicine, Health Economists, Disability Advisors). The objectives of the conference were to discuss some of the occupational impairments adults with ADHD may face and how to address these problems from an inclusive perspective. Furthermore the conference looked at influencing policy and decision making at a political level to address impaired occupational functioning in adults with ADHD and fears around employing people with disabilities in general.ResultsThe consensus was that there were clear weaknesses in the current arrangements in the UK and internationally to address occupational difficulties. More so, Occupational Health was not wholly integrated and used as a means of making positive changes to the workplace, but rather as a superfluous last resort that employers tried to avoid. Furthermore the lack of cross professional collaboration on occupational functioning in adults with ADHD was a significant problem.ConclusionsFuture research needs to concentrate on further investigating occupational functioning in adults with ADHD and pilot exploratory initiatives and tools, leading to a better and more informed understanding of possible barriers to employment and potential schemes to put in place to address these problems.

Occupational Functioning in Adults with ADHD

Occupational Functioning in Adults with ADHDKevin R. Murphy and Russell A. BarkleyKevin R. MurphyDr. Murphy is on the Editorial Board of The ADHD Report and is Director of the Adult ADHD Center of Central Massachusetts, Northborough, MA.Search for more papers by this author and Russell A. BarkleyDr. Barkley is the Editor of The ADHD Report and is a Research Professor of Psychiatry, State University of New York Upstate Medical Center, Syracuse, NY, and a Clinical Professor of Psychiatry, Medical University of South Carolina, Charleston, SC.Search for more papers by this authorPublished Online:March 2007https://doi.org/10.1521/adhd.2007.15.1.6PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutReferencesBarkley R. A., , Fischer M., , Smallish L., , & Fletcher K.. (2006). Young adult follow–up of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 192–202. Crossref, Google ScholarBarkley, R. A., Murphy, K. R., & Fischer, M. (2007, in press). ADHD in Adults: Original Research, Integration, and Clinical Implications. New York: Guilford. Google ScholarDe Quiros, G. B., & Kinsbourne, M. (2001). Adult ADHD: Analysis of self–ratings on a behavior questionnaire. In J. Wasserstein, L. Wolf, & F. Lefever (Eds.), Adult attention deficit disorder: Brain mechanisms and life outcomes. Annals of the New York Academy of Sciences, 931, 140–147. Google ScholarGordon, M., & Keiser, S. (Eds.). (1998). Accommodations in higher education under the Americans with Disabilities Act (ADA): A No–Nonsense Guide for Clinicians, Educators, Administrators, and Lawyers. New York: Guilford. Google ScholarHallowell, E. M., & Ratey, J. J. (1994). Driven to Distraction. New York: Pantheon. Google ScholarMannuzza S., , Gittelman–Klein R., , Bessler A., , Malloy P., , & LaPadula M.. (1993). Adult outcome of hyperactive boys: Educational achievement, occupational rank, and psychiatric status. Archives of General Psychiatry, 50, 565–576. Crossref, Google ScholarMannuzza S., , Klein R., , Bessler A., , Malloy P., , & LaPadula M.. (1998). Adult psychiatric status of hyperactive boys grown up. American Journal of Psychiatry, 155, 493–498. Crossref, Google ScholarMurphy K., , & Barkley R. A.. (1996). Attention deficit hyperactivity disorder in adults: Comorbidity and adaptive impairments. Comprehensive Psychiatry, 37, 393–401. Crossref, Google ScholarPatterson D. A., , & Lee M–S.. (1995). Field trial of the Global Assessment of Functioning Scale – Modified. American Journal of Psychiatry, 152, 1386–1388. Crossref, Google ScholarTorgersen T., , Gjervan B., , & Rasmussen K.. (2006). ADHD in adults: A study of clinical characteristics, impairment, and comorbidity. Nordic Journal of Psychiatry, 60, 38–43. Crossref, Google ScholarTriolo, S. J. (1999). Attention deficit hyperactivity disorder in adulthood: A practitioner's handbook. New York: Brunner/Mazel. Google ScholarWeiss, G., & Hechtman, L. (1993). Hyperactive Children Grown Up (2nd ed.). New York: Guilford. Google ScholarWender, P. (1995). Attention–Deficit Hyperactivity Disorder in Adults. New York: Oxford University Press. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Cited byCited by1. The Association of Oral Stimulant Medication Adherence with Work Productivity among Adults with ADHDOnline publication date: 17 June 2021. Go to citation Crossref Google Scholar2. Attention Deficit Hyperactivity Disorder (ADHD) and Earnings in Later-Life Self-EmploymentOnline publication date: 20 November 2019. Go to citation Crossref Google Scholar3. Post hoc Responder and Remission Analyses from Two Studies of SHP465 Mixed Amphetamine Salts Extended-Release Among Adults with Attention-Deficit/Hyperactivity DisorderOnline publication date: Go to citation Crossref Google Scholar4. Addressing Attention-Deficit/Hyperactivity Disorder in the WorkplaceOnline publication date: 13 March 2015. Go to citation Crossref Google Scholar5. Letter to the EditorOnline publication date: 19 June 2009. Go to citation Crossref Google ScholarMike Scapillato6. The Disruptive Parent in the ADHD Support GroupOnline publication date: 19 June 2009. Go to citation Crossref 7. Attention-Deficit/Hyperactivity Disorder and Correctional Health CareOnline publication date: Go to citation Crossref Google Scholar8. Attention-Deficit/Hyperactivity Disorder and the Juvenile Justice SystemOnline publication date: Go to citation Crossref Google Scholar Volume 15Issue 1Feb 2007 Information© The Guilford PressPDF download