Self-reported Attention Deficit Hyperactivity Disorder Research Articles

Assessing Attention-Deficit/Hyperactivity Disorder in Post-9/11 Veterans: Prevalence, Measurement Correspondence, and Comorbidity With Posttraumatic Stress Disorder.

Attention-deficit/hyperactivity disorder (ADHD) is common among Veterans but overlapping symptoms with other prevalent psychiatric disorders (e.g., posttraumatic stress disorder [PTSD]) complicate diagnosis. This study aims to (1) assess the prevalence of ADHD, (2) evaluate the correspondence between ADHD self-report measures, and (3) examine the association between ADHD and PTSD in a sample of combat-deployed post-9/11 Veterans. A total of 332 combat-deployed post-9/11 Veterans from VA Boston Healthcare System completed the Clinician-Administered PTSD Rating Scale, 2 ADHD self-report questionnaires (Wender Utah Rating Scale-25 and the Adult ADHD Self-Report Scale v1.1), and report of the presence/absence of a historical ADHD diagnosis. Attention-deficit/hyperactivity disorder status via Wender Utah Rating Scale ([WURS-25] criterion standard) was compared to historical ADHD diagnosis and the ASRSv.1.1 screener. Log-binomial regression models assessed the relationship between ADHD and PTSD. This study was reviewed and approved by the VA Boston Institutional Review Board. In all, 12.7% of the sample met criteria for ADHD per the WURS-25. The WURS-25 demonstrated poor sensitivity with historical ADHD diagnosis (27.7%) but adequate specificity (90.3%). Poor sensitivity (60.7%) and specificity (60.8%) were observed between the WURS-25 and the ASRS-v.1.1. The prevalence of ADHD was 2.5 times as high for Veterans with a history of PTSD (Prevalence Ratio [PR] = 2.53, 95% CI: 1.11, 7.28) and over twice as high for those with current PTSD (PR = 2.19, 95% CI: 1.17, 4.38). Attention-deficit/hyperactivity disorder is prevalent in this sample of Veterans and is associated with an increased risk of current and lifetime PTSD. The low correspondence across self-report ADHD measures illustrates the complexity of assessing ADHD in this highly comorbid population. When evaluating ADHD in Veterans, clinicians should carefully consider alternative and contributory symptom etiologies, such as PTSD, to ensure accurate diagnosis and treatment.

Associations between ADHD symptoms, executive function and frontal EEG in college students

Introduction This study aims to assess whether electroencephalogram (EEG) spectral power change scores (e.g. task spectral power subtracted from resting state spectral power) across three different frequency bands, alpha (8–12 Hz), theta (4–7 Hz), and beta (13–30 Hz), predicts self-reported attention-deficit hyperactivity disorder (ADHD) symptoms using the Adult ADHD Self-Report Scale (ASRS) over and above self-reported executive function (EF) abilities using the Behavior Rating Inventory of Executive Function (BRIEF-A) Global Executive Composite (GEC) T-scores for adults. Methods Data were collected at a rural, mid-sized southeastern university (N = 52) and participants received course credit for participation. Participants self-reported ADHD symptoms and EF abilities before completing eyes open resting state and the attention network test (ANT), a common flanker task that measures ability to orient attention, stay alert, and resolve conflict (i.e. distractor arrows) while recording EEG spectral power at electrodes F3 and F4. Bivariate correlations determine associations between EEG measures and self-reported ADHD symptoms and EF abilities. Linear regressions were used to assess whether EEG change scores were predictive of ADHD symptoms over and above EF abilities. Results High correlation coefficients were found only when comparing the ASRS and BRIEF-A GEC T-scores (r = .822, p <.001). Regression analyses produced significant results indicating EEG spectral change scores were predictive of ADHD symptoms, over and above GEC T-Scores, for the alpha band but not the theta and beta bands. Additionally, we found an inverse relationship when comparing change scores in the alpha band across the right (F4) and left (F3) hemispheres supporting the theory of frontal asymmetry for individuals with increased ADHD symptoms. Conclusion This study is the first to assess the predictive ability of EEG spectral power change scores in predicting ADHD symptoms, which are not solely explained by deficits in executive control. Past research has indicated significant differences when comparing task and resting state spectral power indicating change scores might have some utility in measuring cognitive load, specifically in the alpha band, which has been associated with inhibition, working memory, and anticipation of stimuli. Further research should be conducted to assess the utility change scores might have in providing an objective measure related to a clinical population with ADHD.

Examining ADHD and Cognitive Disengagement Syndrome Symptoms in Relation to Food Insecurity in Early Adolescents.

Approximately 13.8million U.S. households face food insecurity, which severely affects child development, with more than half of these households including children. Research links food insecurity to cognitive deficits and mental health challenges, highlighting the need for thorough understanding and intervention. Although existing studies have explored the association between food insecurity and internalizing symptomatology, less research has examined food insecurity in relation to attention-deficit/hyperactivity disorder (ADHD) symptoms. Further, no studies have explored the connection between food insecurity and cognitive disengagement syndrome (CDS) symptoms, closely related to ADHD symptoms. Despite extant research linking CDS to environmental factors, empirical attention to its potential association with food insecurity is notably lacking. Additionally, adolescents, almost twice as likely as younger children to experience household food insecurity, are likely more aware and respond differently to challenges during this developmental period. Accordingly, this study investigated the unique associations of parent-, teacher-, and youth self-reported ADHD dimensions and CDS symptoms in relation to parent-reported food insecurity in early adolescents (N = 136, ages 10-12). Controlling for age, sex, race, and medication use, no informant's ratings of ADHD symptom dimensions were uniquely related to food insecurity. In contrast, higher parent-, teacher-, and youth self-reported CDS symptoms were uniquely associated with greater food insecurity. This finding was robust to additional control of family income for teacher- and youth self-reported CDS symptoms. These findings highlight the complex link between food insecurity and mental health, suggest a connection with CDS symptoms, and stress the need to address food insecurity as a public health priority, especially in early adolescence.

Black Mothers of Children With and Without ADHD: Relationships Among Maternal Psychopathology, Parenting Stress, and Parenting Cognitions.

Parents of children with attention-deficit/hyperactivity disorder (ADHD) endorse increased parenting stress and lower levels of parenting efficacy and satisfaction as compared to parents of children without ADHD. Additionally, maternal ADHD and depression differentiate children with and without ADHD, with children with ADHD being more likely to have a mother with psychopathology. With a focus on an understudied population, we investigated the extent to which maternal self-reported ADHD and depression were associated with self-reported parenting stress and parenting cognitions in 70 Black mothers of children with (maternal Mage = 35.52, SD = 6.49) and without ADHD (maternal Mage = 35.39, SD = 6.53) recruited from a metropolitan area in the southeastern United States. Analyses indicated that Black mothers of children with ADHD reported higher levels of parenting stress, lower levels of parenting efficacy, and lower levels of parenting satisfaction. However, there were no significant differences between groups on measures of maternal ADHD or depression. Maternal depression significantly accounted for variability in both parenting satisfaction and parenting stress beyond child ADHD and maternal education. With maternal depression in the models, the association between maternal ADHD and parenting stress and parenting satisfaction lost significance. Given the racial disparities in the treatment of ADHD, future research should focus on investigating the linkages between maternal depression, parenting stress, parenting satisfaction, and parenting behaviors in Black mothers in order to delineate whether there are cultural adaptations that may improve treatment utilization rates for child ADHD within this population.

The Association between Hyperactivity and Suicidal Behavior and Attempts among Children Referred from Emergency Departments.

The global prevalence of suicidal behaviors in children is rising, with attention-deficit hyperactivity disorder (ADHD) proposed as a contributing factor. This study examines the association between ADHD facets (hyperactivity and inattention) and suicidal behavior and attempts in children. Additionally, it seeks to compare self-reported ADHD symptoms and suicide-related incidents with parental reports. A cohort of 71 children referred from emergency departments due to suicidal thoughts and behaviors completed self- and parental report questionnaires. The results revealed that elevated hyperactivity scores, surpassing the ADHD diagnosis threshold, were significantly associated with increased rates of suicidal behavior. Hyperactivity demonstrated a stronger association with lifetime suicide attempts compared to inattention. Moreover, children's self-reported ADHD symptoms exhibited a stronger correlation with suicide attempts than parental reports. This study highlights the critical role of hyperactivity in understanding suicidal behaviors among children with ADHD. It underscores the importance of considering hyperactivity-related symptoms in assessment and treatment approaches for suicidal behavior in this population.

Detecting Noncredible Responding in College Student ADHD Assessment: A Comparison of Several Brief Symptom Validity Tests

AbstractA diagnosis of attention-deficit/hyperactivity disorder (ADHD) offers tangible and psychological benefits to college students. These incentives lead some students to exaggerate symptoms on self-report rating scales. Although validity tests can detect noncredible responding, they are seldom used by clinicians who conduct adult ADHD evaluations. Many validity tests require considerable time, are expensive to administer, or are not accessible to many clinicians. We conducted a between-subjects simulation study examining the ability of several brief symptom validity tests to differentiate college students with self-reported ADHD (n = 229) and students without ADHD randomly assigned to honest control (n = 260) or simulator (n = 239) conditions. All participants completed the Conners’ Adult ADHD Rating Scales (CAARS) with several embedded validity indicators (i.e., CAARS Inconsistency Index, CAARS Infrequency Index [CII], Dissociative Experiences Scale, Exaggeration Index [EI]), and the Subtle ADHD Malingering Screener. Results showed that students without ADHD could easily simulate this condition. Simulators earned significantly higher scores than participants in the ADHD and control conditions on all the validity tests that we examined, except the CAARS Inconsistency Index. Elevated scores on the CAARS hyperactive-impulsive scale, the CII, or the EI yielded the best classification statistics with specificity to controls ranging from 98.5 to 100%, sensitivity to simulators ranging from 35.6 to 42.7%, and low positive cases among participants in the ADHD condition. Associations between these validity scales were moderate. Requiring elevated scores on multiple validity scales yielded perfect specificity to controls, sensitivities to simulators between 27.2 and 31.8%, and few positive cases among participants in the ADHD condition (0 to 3.1%). These tests may offer clinicians a time- and cost-effective way to evaluate the validity of students’ self-reports, especially when integrated with objective information from other sources.

Influence of maternal attention-deficit hyperactive disorder on child dental neglect - An analytical cross-sectional study.

Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario. The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children. The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done. The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children. Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.

Exploring autism spectrum disorder (ASD) and attention deficit disorder (ADD/ADHD) in children exposed to polybrominated biphenyl.

Although the causes of attention-deficit/hyperactivity disorder (ADHD) and autism have not been identified, exposure to endocrine-disrupting chemicals, such as polybrominated biphenyl (PBB), during fetal development and early life has been suspected to impact neurological development. This study aims to investigate the association between prenatal and early life exposure to PBB and the development of ADHD and autism later in life. Data from the Michigan PBB Registry, a cohort of Michigan residents who had been exposed to PBB in a mass contamination event in 1973, was leveraged for this nested case-control analysis among two distinct samples: (1) Those who self-reported ADHD or autism diagnosis, and (2) mothers who reported their child's ADHD or autism diagnosis. PBB exposure was measured in participants of the PBB Registry, and the mother's PBB level was used in mother-reported analyses. Cases were matched with controls by sex and year of birth. Conditional logistic regression models were used to estimate the association between PBB level and case status. PBB levels were higher among those who were exposed in early life compared with those exposed in utero (geometric mean: 0.300 ng/ml vs. 0.016 ng/ml). Among women in this cohort, a higher than expected proportion of self-reported ADHD diagnosis (11.11%), compared with population estimates. PBB was not associated with ADHD or autism in either self-reported or mother-reported analyses. This study adds to the sparse literature about prenatal and early life exposure to PBB-153 and ADHD and autism. Future studies should examine potential effect modification by sex.

A novel self-rating instrument designed for long-term, app-based monitoring of ADHD symptoms: A mixed-methods development and validation study.

Regular outcome monitoring is essential for effective attention deficit hyperactivity disorder (ADHD) treatment, yet routine care often limits long-term contacts to annual visits. Smartphone apps can complement current practice by offering low-threshold, long-term sustainable monitoring capabilities. However, special considerations apply for such measurement which should be anchored in stakeholder preferences. This mixed-methods study engaged 13 experienced clinicians from Region Stockholm in iterative qualitative interviews to inform development of an instrument for app-based ADHD monitoring: the mHealth scale for Continuous ADHD Symptom Self-monitoring (mCASS). A subsequent survey, including the mCASS and addressing app-based monitoring preferences, was administered to 397 individuals with self-reported ADHD. Psychometric properties of the mCASS were explored through exploratory factor analysis and examinations of internal consistency. Concurrent validity was calculated between the mCASS and the Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1). Additional quantitative analyses included summary statistics and repeated-measures ANOVAs. Clinicians identified properties influencing willingness to use and adherence including content validity, clinical relevance, respondent burden, tone, wording and preferences for in-app results presentation. The final 12-item mCASS version demonstrated four factors covering everyday tasks, productivity, rest and recovery and interactions with others, explaining 47.4% of variance. Preliminary psychometric assessment indicated satisfactory concurrent validity (r = .595) and internal consistency (α = .826). The mCASS, informed by clinician and patient experiences, appears to be valid for app-based assessment of ADHD symptoms. Furthermore, insights are presented regarding important considerations when developing mobile health (mHealth) instruments for ADHD individuals. These can be of value for future, similar endeavours.

Are We Measuring ADHD or Anxiety? Examining the Factor Structure and Discriminant Validity of the Adult ADHD Self-Report Scale in an Adult Anxiety Disorder Population.

Adults with clinical anxiety have significant symptom overlap and above average rates of attention-deficit/hyperactivity disorder (ADHD). Despite this, ADHD remains a vastly under-detected disorder among this population, indicating the need for a screener with well-understood symptom dimensions and good discriminant validity. The current study compared competing models of ADHD as well as discriminant properties of self-reported ADHD symptoms as measured by the Adult ADHD Self-Report Scale (ASRS-v1.1) in 618 adults with clinical anxiety. A three-factor correlated model of Inattention, Impulsivity, and Hyperactivity, with the movement of one item, talks excessively, to a factor of Impulsivity from Hyperactivity fit better than the one-factor, two-factor, and traditional three-factor models of ADHD. Discriminant properties of the screener were fair to good against measures of clinical anxiety and distress; however, some items within the Hyperactivity factor (e.g., difficulty relaxing; feeling driven by a motor) loaded more strongly onto factors of clinical anxiety than ADHD when measures were pooled together. These results suggest that clinicians making differential diagnoses between adult ADHD and anxiety or related disorders should look for evidence of ADHD beyond the overlapping symptoms, particularly for those within the Hyperactivity factor.

Natural vs. Surgical Postmenopause and Psychological Symptoms Confound the Effect of Menopause on Executive Functioning Domains of Cognitive Experience.

The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause. A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CES-D). We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2). In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2). The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.Reprinted from Maturitas 2023; 170:64-73, with permission from Elsevier. Copyright © 2023.

Altered brain functional connectivity in patients with resistance to thyroid hormone ß.

To investigate changes in brain network organization and possible neurobehavioral similarities to attention-deficit hyperactivity disorder (ADHD), we measured changes in brain resting-state functional connectivity (rs-fMRI) and cognitive domains in patients with resistance to thyroid hormone β (RTHβ) and compared them with those in healthy control subjects. In this prospective case-control study, twenty-one participants with genetically confirmed RTHβ were matched with 21 healthy controls. The Adult ADHD Self-Report Scale (ASRS-v1.1) and ADHD Rating Scale-IV were used to assess self-reported symptoms of ADHD. A voxel-wise and atlas-based approach was used to identify changes in the brain networks. The RTHβ group reported behavioral symptoms similar to those of ADHD. We found evidence of weaker network integration of the lingual and fusiform gyri in the RTHβ group, which was mainly driven by weaker connectivity to the bilateral insula and supplementary motor cortex. Functional connectivity between regions of the default mode network (angular gyrus/middle temporal gyrus) and regions of the cognitive control network (bilateral middle frontal gyrus) was increased in RTHβ patients compared to healthy controls. Increased connectivity between regions of the default mode network and the dorsolateral prefrontal cortex is frequently reported in ADHD and is interpreted to be associated with deficits in attention. Our finding of weaker connectivity of the lingual gyrus to the bilateral insula (salience network) in RTHβ patients has also been reported previously in ADHD and may reflect decreased habituation to visual stimuli and increased distractibility. Overall, our observations support the notion of neuropsychological similarities between RTHβ and ADHD.

Understanding ADHD stigma: The predictive roles of beliefs about the causes of ADHD and self-reported ADHD symptoms

The present cross-sectional study explored the link between beliefs about the causes of attention deficit hyperactivity disorder (ADHD), self-reported ADHD symptoms, and the perceived related stigma. The sample was convenient and comprised 231 adults aged 18 to 64 years (M = 27.50, SD = 9.77, XX (88.3%) females) without an ADHD diagnosis. Participants completed self-reported scales measuring ADHD symptoms, stigma, and an adapted Literacy Scale measuring the beliefs about the causes of ADHD (i.e., beliefs that ADHD is caused by adversity, by biomedical factors, fate, or the environment). The results suggested that self-reported ADHD symptoms and beliefs that the causes of ADHD are biomedical were positively linked to ADHD-related perceived stigma. The multiple hierarchical regression analysis exploring the predictive power of age, self-reported ADHD symptoms, and beliefs about its causes on the perceived ADHD stigma suggested that these variables explained 11.7% of the variance in ADHD-related stigma. The strongest predictor of ADHD stigma was self-reported ADHD symptoms, followed by beliefs that ADHD is caused by biomedical factors.

Risky driving behavior among individuals with Autism, ADHD, and typically developing persons

IntroductionMany individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) often experience difficulty with driving, including difficulty with obtaining a driver’s license as well as driving safely and efficiently. Such difficulties negatively impact their ability to function independently and participate in daily activities that require driving. ASD and ADHD commonly occur co-morbidly and share many overlapping clinical features. Few studies have directly compared the nature of difficulties in driving safety outcomes between ASD and ADHD. The overarching goal of the current study was to characterize and compare self-reported driving behavior among young autistic drivers, ADHD drivers, and typically developing (TD) drivers. MethodFifty-four participants (14 ASD, 20 ADHD, 20 TD); ages 16–30) completed the Autism Spectrum Quotient and ADHD Adult Rating scale as a method of screening of symptoms. All three groups then completed the Driving Behavior Questionnaire (DBQ), which measured self-reported driving violations, driving errors, and overall risky driving behavior. The three groups of ASD, ADHD, and TD individuals were then compared regarding symptomology and driving behavior differences. ResultsOne-way ANOVAs indicated group differences in DBQ total scores and DBQ errors. Drivers with ADHD reported significantly greater overall risky driving behaviors and driving errors compared to ASD and TD drivers. There were no significant differences between ASD and TD drivers in reported risky driving behaviors and errors. Linear regressions indicated that among all drivers, self-reported ADHD symptoms were significantly associated with higher levels of self-reported overall risky driving and driving errors, regardless of diagnostic group. DiscussionRisky driving and driving errors may be more closely related to symptoms that are characteristic of ADHD. This has implications for individuals with ADHD and autistic individuals who often show or report higher rates of ADHD symptoms. Future studies should compare driving skills of ASD and ADHD drivers using objective measures of driving performance, such as driving simulators or on-road tests.

Do attention-deficit/hyperactivity symptoms influence treatment outcome in gambling disorder?

Background and aimsNumerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD. Therefore, we aimed to explore differences between patients with GD with and without self-reported ADHD symptoms regarding psychopathology, personality, sociodemographic and treatment outcome measures. MethodThis longitudinal study included 170 patients with GD receiving cognitive behavioral therapy. Multiple self-reported instruments were used to assess clinical variables and sociodemographic measures prior to treatment. ResultsA clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were observed between the two groups. However, patients with self-reported ADHD symptoms experienced more severe relapses (i.e., gambled more money) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention. ConclusionIndividuals with GD and self-reported symptoms of ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.

Sociodemographic, mental health, and physical health factors associated with participation within re-contactable mental health cohorts: an investigation of the GLAD Study

BackgroundThe Genetic Links to Anxiety and Depression (GLAD) Study is a large cohort of individuals with lifetime anxiety and/or depression, designed to facilitate re-contact of participants for mental health research. At the start of the pandemic, participants from three cohorts, including the GLAD Study, were invited to join the COVID-19 Psychiatry and Neurological Genetics (COPING) study to monitor mental and neurological health. However, previous research suggests that participation in longitudinal studies follows a systematic, rather than random, process, which can ultimately bias results. Therefore, this study assessed participation biases following the re-contact of GLAD Study participants.MethodsIn April 2020, all current GLAD Study participants (N = 36,770) were invited to the COPING study. Using logistic regression, we investigated whether sociodemographic, mental, and physical health characteristics were associated with participation in the COPING baseline survey (aim one). Subsequently, we used a zero-inflated negative binomial regression to examine whether these factors were also related to participation in the COPING follow-up surveys (aim two).ResultsFor aim one, older age, female gender identity, non-binary or self-defined gender identities, having one or more physical health disorders, and providing a saliva kit for the GLAD Study were associated with an increased odds of completing the COPING baseline survey. In contrast, lower educational attainment, Asian or Asian British ethnic identity, Black or Black British ethnic identity, higher alcohol consumption at the GLAD sign-up survey, and current or ex-smoking were associated with a reduced odds. For aim two, older age, female gender, and saliva kit provision were associated with greater COPING follow-up survey completion. Lower educational attainment, higher alcohol consumption at the GLAD Study sign-up, ex-smoking, and self-reported attention deficit hyperactivity disorder had negative relationships.ConclusionsParticipation biases surrounding sociodemographic and physical health characteristics were particularly evident when re-contacting the GLAD Study volunteers. Factors associated with participation may vary depending on study design. Researchers should examine the barriers and mechanisms underlying participation bias in order to combat these issues and address recruitment biases in future studies.

Factor structure of the patient health questionnaire-4 in adults with attention-deficit/hyperactivity disorder.

Persons with attention-deficit/hyperactivity disorder (ADHD) frequently experience symptoms of anxiety and depression. In this population, there is a need for validated brief self-report screening questionnaires to assess the severity of comorbid mental health problems. The Patient Health Questionnaire 4 (PHQ-4) is a self-report questionnaire that may contribute to this purpose as it can screen for both disorders efficiently. However, this will be the first study examining the factor structure of the PHQ-4 in samples of adults with ADHD, and also evaluating the validity of the Norwegian version of the PHQ-4. The aim of the current cross-sectional study was to examine the factor structure and validity of the Norwegian version of the PHQ-4 in a sample of adults who reported having been diagnosed with ADHD. Of 496 invited, a total of 326 participants (66%) completed the PHQ-4, The World Health Organization Five Well-Being Index, the Oslo Social Support Scale and the 4-item Perceived Stress Scale electronically in a web-portal between the 9th and 30th of June 2020. Confirmatory factor analysis of the PHQ-4 supported a two-factor structure [RMSEA = 0.038 (90% CI 0.000-0.159), CFI = 1.00, TLI = 0.999, SRMR = 0.004], consisting of a depression factor and an anxiety factor. Standardized factor loadings were 0.79 to 0.97. The PHQ-4 was negatively correlated with well-being and social support and positively correlated with perceived level of stress. This study indicates promising psychometric properties of the PHQ-4 as a measure of anxiety and depressive symptoms in adults with self-reported ADHD who are fluent in Norwegian. The questionnaire's brevity makes it a valuable resource in research and clinical settings. However, more studies are needed to test the instrument in a clinical sample.

A-37 Performance of Adolescents with Attention Deficit/Hyperactivity Disorder on Sway Medical Mobile Balance and Cognitive Tests

Abstract Purpose Prior research has revealed differences on some cognitive and balance tests between adolescents with and without attention deficit/hyperactivity disorder (ADHD). We examined if preseason baseline performance on the Sway Medical Mobile Balance and Cognitive Tests differs by self-reported ADHD diagnosis in in adolescents ages 14-18. Methods Test data from 26,460 adolescents (48.7% girls) between 14- and 18-years-old (mean=15.90 years, standard deviation=1.45), who underwent baseline testing in the summer of 2022 and denied having sustained a concussion in the past 6 months, were examined. Mann-Whitney U tests were used to compare balance and cognitive test scores between adolescents with and without a self-reported ADHD diagnosis within boys and girls, and significance was set at p&amp;lt;.01. Results For both boys and girls, adolescents with ADHD obtained worse scores (i.e., slower performance) on the Reaction Time, Impulse Control, and Inspection Time tests (p&amp;lt;.001) and lower scores (i.e., worse performance) on Memory tests (p&amp;lt;.001) and on balance testing (p&amp;lt;.001). Effect sizes for these differences ranged from tiny to small (Hedge’s g=.05-.24). Conclusions Adolescents aged 14-18 with a self-reported ADHD diagnosis performed slightly worse on the Sway Medical Mobile Balance and Cognitive Tests, with minimal to small effect sizes. For boys and girls, the largest differences (though small in magnitude) were noted on balance testing and the Memory and Inspection Time tests.

The Relationship Between Pediatric Attention-Deficit/Hyperactivity Disorder Symptoms and Asthma Management

PurposeChildren with comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and asthma are at an increased risk for adverse health outcomes and reduced quality of life. The objective of these analyses was to examine if self-reported ADHD symptoms in children with asthma are associated with asthma control, asthma controller medication adherence, quick relief medication use, pulmonary function, and acute healthcare utilization. MethodsWe analyzed data from a larger study testing a behavioral intervention for Black and Latinx children with asthma aged 10–17 years and their caregivers. Participants completed the Conners-3AI self-report assessment for ADHD symptoms. Asthma medication usage data were collected for 3 weeks following baseline via electronic devices fitted to participants' asthma medications. Other outcome measures included the Asthma Control Test, self-reported healthcare utilization, and pulmonary function measured by spirometry testing. ResultsThe study sample consisted of 302 pediatric participants with an average age of 12.8 years. Increased ADHD symptoms were directly associated with reduced adherence to controller medications, but no evidence of mediation was observed. Direct effects of ADHD symptoms on quick-relief medication use, health care utilization, asthma control, or pulmonary function were not observed. However, the effect of ADHD symptoms on emergency room visits was mediated by controller medication adherence. DiscussionADHD symptoms were associated with significantly reduced asthma controller medication adherence and indirectly with emergency room visits. There are significant potential clinical implications to these findings, including the need for the development of interventions for pediatric asthma patients with ADHD.

Features of attention deficit/hyperactivity disorder and antisocial behaviour in a general population-based sample of adults.

Attention deficit/hyperactivity disorder (ADHD) is known to be a risk factor for antisocial and delinquent behaviour, but there is still a lack of information on how features of ADHD relate to offending behaviour among adults not already defined by their offending. Our aim was to add to knowledge about relationships between ADHD and antisocial behaviour among adults in the general population by answering the following questions: (A) Does the level of self-reported ADHD features relate to criminal and non-criminal antisocial behaviour? (B) To what extent are self-ratings of ADHD features independent of socio-demographic features previously identified as predictors of antisocial behaviour? A sample of adults was originally recruited to study public response to the COVID-19 outbreak through an online panel to be representative of the Israeli population. Among other scales, the 2025 participants completed an ADHD self-report scale, an antisocial behaviour self-report scale and a socio-demographic questionnaire probing for age, gender, urbanity, place of birth, socioeconomic status (education and income), family status (being in a relationship and having children) and religiosity. Higher mean totals for the inattention and hyperactivity ADHD scale scores were associated with higher mean antisocial behaviour scores. These relationships were only slightly affected by socio-demographic variables, including sex, age, education and income. Our findings suggest that not only may features of ADHD, even below a diagnostic threshold, constitute a risk factor for antisocial behaviour, but also that the self-rated levels of these problems covary. These findings are important for informing the early detection of risk of antisocial behaviour in the general population and its prevention.