Journal of Attention Disorders最新文献

{"title":"Comprehensive Treatment and Monthly 2 Year Follow-Up in Children With ADHD: Randomized Controlled Prospective Study.","authors":"Lily Hechtman, Natalie Grizenko, Ridha Joober, Jens Kreitewolf, Mariam Ter-Stepanian, Marie-Ève Fortier, Kayla Eisenberg, Joy Etcovitch, William J Harvey","doi":"10.1177/10870547261478344","DOIUrl":"10.1177/10870547261478344","url":null,"abstract":"<p><p>ObjectivesTo evaluate the efficacy of regular monthly follow up in maintaining treatment gains versus follow up as needed in the community for children ages 6 to 12 years with ADHD.MethodsOne hundred and eighty six children, age 6 to 13 with DSM-IV diagnosed Attention Deficit Hyperactivity Disorder (ADHD) (combined presentation) received 3 months of comprehensive treatment which included long-acting stimulant medication titrated to optimal dose (via parent and teacher reports) and weekly parent training groups and child social skills and academic training. After the 3 months of treatment, children were randomized to either monthly follow up by the research team (treatment group) or follow up as usual in the community (control group). Comprehensive evaluations occurred at 3 months at the end of the comprehensive treatment, and at 6, 12, 18, and 24 month follow-up.ResultsChildren in both groups improved significantly in all domains after the 3 months of intensive comprehensive treatment. Treatment gains were maintained during the 2 year follow up period in both groups. However, the Hyperactive/Impulsive rating in Conners scale by parent report and some teacher reports were worse in the community group during the follow-up period.ConclusionThe importance of the initial intensive comprehensive 3 month treatment cannot be underestimated as these treatments resulted in significant improvements which were maintained for 2 years in both groups. Factors such as social economic status and available community treatment which may have influenced these results are discussed.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1438-1451"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of a Child and Parent Mindfulness-Based Training Versus Medication for Childhood ADHD.","authors":"Rachel T van der Meulen, Francisca J A van Steensel, Esther I de Bruin, Wiebe Korf, Susan M Bögels","doi":"10.1177/10870547261469623","DOIUrl":"10.1177/10870547261469623","url":null,"abstract":"<p><strong>Objective: </strong>ADHD imposes substantial societal costs. This randomized controlled trial examined the cost-effectiveness of family mindfulness training (\"MYmind\") versus medication in childhood ADHD.</p><p><strong>Method: </strong>An economic evaluation with a 10-month time horizon was conducted from a societal perspective. Children (<i>N</i> = 88, <i>M</i> = 11.27 years, 70% boys) with ADHD were randomized to MYmind (8 weekly 1.5-hr group mindfulness sessions for children and parallel for their parents, plus a 2-months follow-up) or medication (4-months immediate-release methylphenidate). During the following 6 months, families had free treatment choice, allowing crossover. Costs were assessed using retrospective cost-questionnaires. Primary outcome measures were children's inattention and quality-adjusted life years (QALYs). Secondary analyses included: hyperactivity/impulsivity, internalizing and externalizing problems as outcome measures, taking a healthcare (payers) perspective, shorter time horizons (2 and 4 months), a different inattention questionnaire, per protocol analyses, and exclusion of crossover participants.</p><p><strong>Results: </strong>At 10 months, primary cost-effectiveness analyses indicated that MYmind was inferior to medication for inattention but had higher QALY gains at higher costs. Specifically, MYmind had a 27% probability of being cost-effective for inattention and a 30% probability for QALYs. Secondary analyses showed similar results with even lower chances for mindfulness being cost-effective in the shorter-term horizons. Notably, in the subgroup excluding crossover participants, MYmind was dominant over medication, with an 81% chance to be cost-effective for both outcomes.</p><p><strong>Conclusions: </strong>MYmind was less cost-effective than medication in the short and medium term. Long-term cost-effectiveness of MYmind remained low for the total group, but was high among participants who did not crossover to the alternative treatment.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1452-1468"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Randomized Trial of the Parental Friendship Coaching+ Program for Parents With Elevated ADHD and/or Depressive Symptoms.","authors":"Sophie Smit, Sébastien Normand, Amori Yee Mikami","doi":"10.1177/10870547261474912","DOIUrl":"10.1177/10870547261474912","url":null,"abstract":"<p><strong>Introduction: </strong>Many parents of children with attention-deficit/hyperactivity disorder (ADHD) experience mental health challenges that may hinder engagement in behavioral parent training. This pilot randomized trial evaluated the feasibility and acceptability, and explored preliminary parent-related outcomes, of <i>Parental Friendship Coaching+</i> (PFC+). PFC+ is an engagement-enhanced adaptation of Parental Friendship Coaching (PFC) for parents with elevated ADHD and/or depressive symptoms raising children with ADHD and peer difficulties. PFC trains parents to support their child's friendships through social coaching.</p><p><strong>Method: </strong>Thirty-three Canadian parents (<i>M</i>_age = 38.9 years; 97% mothers) were randomized to 6 weeks of PFC+ (<i>n</i> = 18) or waitlist control (<i>n</i> = 15). Afterward, control parents received PFC+, while PFC+ parents entered naturalistic follow-up. PFC+ included participation-enhancing adaptations (e.g., one-time workshop, flexible coaching, online delivery) and connection-promoting adaptations (e.g., extended intake, treatment menu, peer-pairing).</p><p><strong>Results: </strong>On primary outcomes of treatment engagement, session completion was 97%, homework adherence averaged 81%, and alliance ratings were strong. Exploratory parent-related outcomes included parenting stress, parenting competence, and parenting behavior pre- to post-program. Compared to controls, PFC+ parents reported greater parenting competence and friendship facilitation, and reduced criticism, with medium but nonsignificant effects. In contrast, children reported declines in parents' positive involvement and friendship facilitation, and co-parents reported mixed, nonsignificant effects. Parenting stress declined in both PFC+ and control groups.</p><p><strong>Discussion: </strong>Findings support further evaluation of PFC+ as a potentially scalable, engagement-focused adaptation of behavioral parent training for families facing parent mental health barriers.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1423-1437"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Usual-Care Multimodal Cognitive Behavioral Therapy for Adolescents With Attention-Deficit/Hyperactivity Disorder Rated by Parents and Patients.","authors":"Daniel Walter, Eva Katharina Matthias, Elena von Wirth, Lydia Dachs, Anja Goertz-Dorten, Christiane Rademacher, Stephanie Schuermann, Katrin Woitecki, Tanja Wolff Metternich-Kaizman, Manfred Doepfner","doi":"10.1177/10870547261453645","DOIUrl":"10.1177/10870547261453645","url":null,"abstract":"<p><strong>Objective: </strong>Highly controlled, randomized controlled trials (RCTs) have provided evidence of the efficacy of multimodal cognitive behavioral therapy (CBT) including pharmacotherapy in adolescents with attention-deficit/hyperactivity disorder (ADHD). However, the effectiveness under routine care conditions has not been sufficiently evaluated. The present study investigates this transfer of evidence from randomized controlled trials to routine clinical practice investigating a large clinically referred sample of adolescents with ADHD receiving a CBT treatment under routine care conditions.</p><p><strong>Methods: </strong>In a sample of <i>N</i> = 420 adolescents with ADHD, we analyzed changes in parent- and self-rated emotional and behavioral symptoms during routine treatment at a university outpatient clinic using paired <i>t</i>-tests, effect sizes, and comparisons to a historical waitlist control group. The treatment included multimodal CBT for all patients and pharmacotherapy for about a quarter of patients. Results were compared to a historical waitlist control group.</p><p><strong>Results: </strong>In the total sample, small to medium pre-post effect sizes emerged for parent-rated (<i>d</i> = 0.47-0.68) and self-rated (<i>d</i> = 0.37-0.47) emotional and behavioral symptoms. For adolescents who rated in the clinical range at the start of treatment, large effect sizes were found for ADHD symptoms (<i>d</i> = 0.80-1.28), and the comparison with the control group revealed moderate to large effect sizes in favor of the treated sample (<i>d</i> = 0.52-0.93). On the whole, symptom change did not differ between patients with versus without additional pharmacotherapy.</p><p><strong>Conclusions: </strong>The findings suggest that routine outpatient treatment based on CBT principles may be effective for adolescents with ADHD, thus supporting the results of previous RCTs.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1408-1422"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADHD-Like Traits Reshape the Balance Between Inhibitory Control and Predictive Processes.","authors":"Karolina Horváth, Bianka Brezóczki, Adrienn Holczer, Teodóra Vékony, Dezső Németh","doi":"10.1177/10870547261432424","DOIUrl":"10.1177/10870547261432424","url":null,"abstract":"<p><strong>Objective: </strong>Adaptive behavior relies on a dynamic balance between flexible, goal-directed control, and efficient, automatic processes. This equilibrium is often disrupted in ADHD, a condition understood to exist along a continuum of traits in the general population. While ADHD is consistently linked to response inhibition deficits, its relationship with statistical learning (a mechanism for habit learning) and, crucially, the interaction between these functions, remains underexplored.</p><p><strong>Methods: </strong>Here, using a novel paradigm in a non-clinical sample of university students (<i>n</i> = 226), we investigated how ADHD-like traits modulate the interplay between response inhibition and statistical learning.</p><p><strong>Results: </strong>We found that higher ADHD-like traits were associated with poorer response inhibition, confirming previous research. Importantly, we uncovered an antagonistic relationship between inhibition and statistical learning, where weaker inhibitory control typically led to enhanced learning of environmental regularities. However, this learning advantage progressively diminished across the ADHD trait continuum, becoming markedly reduced in individuals with high symptom prevalence.</p><p><strong>Conclusion: </strong>These findings provide novel evidence that ADHD-like traits influence not only isolated neurocognitive processes but also their dynamic interaction, highlighting a spectrum-based mechanism that may underlie the transition from adaptive variability to maladaptive behavioral patterns. This work advocates for a dimensional approach to ADHD, emphasizing early detection and targeted interventions for individuals with varying levels of symptomatic expression, broadening support beyond traditional diagnostic boundaries.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1371-1386"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and Emotional Responding During Instrumental Learning in Children With ADHD: Reinforcement Schedule Effects.","authors":"An-Katrien Hulsbosch, Tom Beckers, Emi Furukawa, Marina Danckaerts, Dagmar Van Liefferinge, Gail Tripp, Saskia Van der Oord","doi":"10.1177/10870547261430072","DOIUrl":"10.1177/10870547261430072","url":null,"abstract":"<p><strong>Objective: </strong>Theoretical accounts of ADHD predict impaired learning under partial reinforcement and altered behavioral persistence under extinction. One of these theories (Amsel, 1992) postulates increased negative emotional responding (i.e., frustration) underlies these impairments, but to date emotional responding during instrumental learning has received limited attention. The current experimental study investigated behavioral and emotional responding during an instrumental learning task under different reinforcement schedules.</p><p><strong>Methods: </strong>Eighty-four children with ADHD and 83 neurotypical children completed a simple instrumental learning task under a continuous (100%), partial (33%) or stretching ratio (i.e., schedule thinning; 100%-33%) reinforcement schedule, followed by a four-minute extinction phase. Negative and positive emotional expressions of the children were assessed during task completion.</p><p><strong>Results: </strong>No group differences were found in either speed of acquisition or behavioral persistence under extinction with the reinforcement schedules applied in the current study. Across groups, partial reinforcement and stretching the ratios resulted in more behavioral persistence compared to continuous reinforcement, supporting the presence of a PREE effect. Children with ADHD showed more negative emotional expressions during both acquisition and extinction, irrespective of reinforcement condition. No diagnostic group or condition differences were found in the number of positive emotional expressions.</p><p><strong>Conclusion: </strong>Findings may have implications for instrumental learning based psychosocial treatments for children with ADHD, as their efficacy can be impacted by increased emotional responding.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1355-1370"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Controlled Trial of a Peer-Delivered High School Preparatory Intervention for ADHD.","authors":"Margaret H Sibley, Shauntal Van Dreel, Stefany J Coxe, Mercedes Ortiz, Benjamin Aaronson, Alexa Matlack, Taylor Rainwater, Brooke E Kircher, Joshua Langberg, Aaron Lyon, Autumn Yi, Carlos E Yeguez","doi":"10.1177/10870547261440604","DOIUrl":"10.1177/10870547261440604","url":null,"abstract":"<p><strong>Objective: </strong>The high school transition is a period of academic and socioemotional vulnerability for adolescents with ADHD. Standard high school interventions for ADHD typically demonstrate access and engagement challenges. Peer-delivered interventions may overcome staff time and resource shortages while increasing adolescent engagement. A previously tested peer-delivered model (STRIPES;16 weekly psychosocial sessions with a peer) showed promising effects but suboptimal engagement.</p><p><strong>Method: </strong>This development trial evaluates enhancements to STRIPES (STRIPES+) adding a 1-week peer-led school orientation and six parent training sessions. Ninth grade students meeting current ADHD symptom and impairment criteria (<i>N</i> = 72) were randomized to STRIPES+ versus school services as usual (SSU). Engagement metrics were evaluated and group × time 1-year outcome trajectories were compared using Linear Mixed Models.</p><p><strong>Results: </strong>Student and peer, but not parent, attendance was strong. STRIPES+ was feasible and acceptabled to students and peers. Compared to SSU, STRIPES+ demonstrated significant gains for school materials organization (<i>b</i> = 0.01, <i>SE</i> = 0.01, <i>p</i> = .040, <i>d</i> = 0.51), use of a daily planner (<i>b</i> = 0.64, <i>SE</i> = 0.31, <i>p</i> = .042, <i>d</i> = 0.38), self-reported sense of academic autonomy (<i>b</i> = 0.02, <i>SE</i> = 0.01, <i>p</i> = .018, <i>d</i> = .61), and reductions in parent academic assistance across three indices (<i>b</i> = -0.02, <i>SE</i> = 0.01, <i>p</i> = .014, <i>d</i> = 0.50; <i>b</i> = -0.01, <i>SE</i> = 0.04, <i>p</i> = .023, <i>d</i> = 0.50; <i>b</i> = -0.01, <i>SE</i> = 0.00, <i>p</i> = .021, <i>d</i> = 0.34). There was no acute impact on primary academic or ADHD symptom outcomes.</p><p><strong>Conclusions: </strong>Use of peer interventionists may be an effective engagement strategy for adolescents with ADHD. STRIPES+ engaged target mechanisms but students demonstrated similar 1-year school outcomes to SSU. A developmentally advantageous transfer of academic responsibility from parents to adolescents was noted in STRIPES+ relative to SSU. The long-term impact of STRIPES+ on promoting increasing academic autonomy through high school should be evaluated.</p><p><strong>Clinicaltrials: </strong>gov ID:NCT04571320.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1387-1407"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended-Release Guanfacine Hydrochloride is Safe and Effective as Mono- and Adjunctive Therapy in Children and Adolescents with ADHD: A Naturalistic, Multi-Center, Patient-Reported Outcome Measures-Based Study.","authors":"Meryem Ozlem Kutuk, Ali Evren Tufan, Fethiye Kilicaslan, Neslihan Tastepe, Yasemin Imrek, Oznur Adiguzel Akman, Sevay Alsen Guney, Huseyin Burak Baykara, Fadime Bayraktar, Aynur Akay Pekcanlar, Gulenay Korkmaz, Seda Ozcan, Nazlı Burcu Ozbaran, Gülen Guler Aksu, Fevziye Toros, Aylin Deniz Uzun Cakir, Burak Cakir, Merve Koksal, Hansa Betul Oz, Aziz Kara, Yekta Ozkan, Cagla Celikkol Sadic, Hacer Gizem Gercek, Berna Polat Tuysuz, Ayse Nur Kilic Guder, Caner Mutlu, Safak Eray Camli, Serkan Turan, Bedia Sultan Onal, Gulsum Yitik Tonkaz, Cansu Cobanoglu Osmanli, Berkan Sahin, Hatice Unver, Ugur Tekeoglu, Yuksel Sumeyra Naralan, Bürge Kabukcu Basay, Omer Basay, Ahmet Buber, Muhammed Furkan Tanir, Ahmet Sefa Gumussoy, Irem Damla Cimen, Ozlem Yildiz Gundogdu, Esen Yildirim Demirdogen, Abdullah Bozkurt, Mehmet Akif Akinci, Burcin Seyda Buran, Gonca Ozyurt, Veysel Ozdag, Nilfer Sahin, Duygu Karagoz, Bahadir Turan, Esra Hosoglu, Ifakat Sule Korkmaz, Yagmur Gunduz Cilci, Erman Esnafoglu, Esra Nazli Ikiz, Fatma Subasi Turgut, Masum Ozturk, Hakan Kayis, Fatma Benk Durmus, Semiha Comertoglu Arslan, Hatice Altun, Hakan Ogutlu, Sibelnur Avcil, Berrin Bilgic, Mustafa Dincer, Neslisah Gur Kurcaloglu, Leyla Bozatli, Hasan Cem Aykutlu, Gunay Budagova, Cilem Bilginer, Mehmet Akif Cansiz, Hasan Kandemir, Cem Gokcen, Neslihan Inal, Eyup Sabri Ercan","doi":"10.1177/10870547261492120","DOIUrl":"https://doi.org/10.1177/10870547261492120","url":null,"abstract":"<p><strong>Aims: </strong>Attention-deficit hyperactivity disorder (ADHD) is characterized by impairing and age-inappropriate inattention, hyperactivity, and impulsivity. Extended-release guanfacine hydrochloride (GXR) is a selective α2A-adrenergic agonist approved as mono- and adjunctive therapy to psychostimulant medications for ADHD. This multicenter retrospective study aimed to assess patients with ADHD initiating treatment with GXR as mono- and adjunctive therapy in a non-Western, real-world clinical setting.</p><p><strong>Methods: </strong>The study was designed as a naturalistic, Patient-Reported Outcome Measures (PROMs)-based, clinic-based, multi-center study; thirty-two child and adolescent psychiatry clinics from 26 cities located in seven geographical regions of Türkiye were included. Clinicians evaluated ADHD symptom severity at baseline and at the end of the 6th month with Clinical Global Impressions (CGI)-Severity, Improvement, and Adverse Effect scales while parents evaluated symptoms with the DSM-IV-Based Screening Scale for Disruptive Behavior Disorders. Adverse effects after GXR treatment were determined from patient records. Dose equivalents for stimulants, antidepressants, antipsychotics, and mood stabilizers used concurrently with GXR were calculated. Univariate and bivariate analyses along with linear mixed models were used to model change. Logistic regression was used to evaluate predictors of treatment response in sensitivity analysis.</p><p><strong>Results: </strong>Five hundred and sixty-seven patients (<i>n</i> = 437, 77.1% male) with a mean age of 11.2 (<i>SD</i> = 2.8) years were enrolled. Comorbid diagnoses were common (82.4%) along with combination therapy (85.0%). GXR at a median dose of 2.0 to 3.0 mg/day was associated with improvement and the rate of adverse effects was low. GXR showed differential symptom-domain effects, with greater improvement in hyperactive-impulsive (HI) compared to inattentive (IA) symptoms. Children with comorbid autism spectrum disorder (ASD; <i>n</i> = 175, 30.0% of the sample) showed notable clinical improvement. Response was modified by baseline symptom severity.</p><p><strong>Conclusion: </strong>GXR may be a viable treatment option for children and adolescents with ADHD and various comorbidities among Turkish youth in real-world clinical populations, with baseline symptom severity as a potential modifier of response. The differential response favoring HI symptoms and notable effectiveness in comorbid ASD represent clinically important findings of this naturalistic, PROM-based study.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261492120"},"PeriodicalIF":3.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Stimulant Medications on Symptom and Treatment Outcomes in Adults With Comorbid Attention-Deficit/Hyperactivity and Substance Use Disorder: A Systematic Review and Meta-Analysis.","authors":"Madeline B Benz, Katherine Rieke, Yuliia Sereda, Htun Ja Mai, James L Rudolph, Rachel E Dew, Jennifer M Primack, John E McGeary, Taylor Rickard, Thomas A Trikalinos, Eric Jutkowitz","doi":"10.1177/10870547261493758","DOIUrl":"https://doi.org/10.1177/10870547261493758","url":null,"abstract":"<p><p>ObjectiveSymptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) are increasingly recognized among adults and frequently co-occur with substance use disorders (SUD). Changing guidelines and complexity of treatment merit a review of approaches for managing this diagnostic overlap among adults.MethodsWe conducted a systematic review for randomized controlled trials (RCT) and nonrandomized comparative studies (NRCS) focused on the benefits and harms of non-stimulant/nonpharmacological ADHD treatment compared to psychostimulant medications for those with comorbid ADHD and SUD by searching: Medline (via PubMed), Embase, and PsycINFO from inception to December 14, 2023, the Cochrane library from inception to January 30, 2024, and ClinicalTrials.gov from inception to February 23, 2024. After screening, evidence from eligible studies was qualitatively and quantitatively synthesized by a multidisciplinary team of researchers and clinicians.ResultsOf 6,419 unique records screened, six RCTs and one NRCS were eligible for review, analyzing a total of <i>N</i> = 662 people. There was no evidence of differences in ADHD treatment adherence, substance use, SUD symptom change, or substance abstinence in people with co-occurring ADHD and SUD who were not prescribed stimulant medications compared to people prescribed stimulants (low confidence for all). No significant difference was observed in the proportion of individuals with improved scores on the Clinical Global Improvement scale based on a pooled analysis of three studies (pooled <i>OR</i> = 1.27 [0.32, 5.09]). Although trending in a clinically positive direction, studies provide insufficient evidence (no conclusion) for ADHD symptom change, SUD treatment adherence, medication misuse/diversion, and measures of depression and anxiety. There was no evidence of a difference in various measures of adverse events (strength of evidence not assessed).ConclusionsSignificant limitations in the evidence base prevent the ability to draw substantial conclusions, and additional inquiry is recommended in future research. Available data, while limited, may indicate increased maintenance in SUD treatment for long-acting stimulants, and there is insufficient data to support the efficacy of non-stimulants for ADHD treatment in SUD patients. Though literature is minimal, a cautious interpretation suggests that current evidence does not support concerns that stimulant medications can precipitate substance-related problems in adults with co-occurring SUD and ADHD.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261493758"},"PeriodicalIF":3.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between ADHD Symptoms and Psychiatric Symptoms in Children: Effects of Functional Impairment and Temperament.","authors":"James D Lynch, Sambridhi Subedi, Matthew Zimon, Virginia Peisch, Anne B Arnett","doi":"10.1177/10870547261438181","DOIUrl":"10.1177/10870547261438181","url":null,"abstract":"<p><strong>Objective: </strong>ADHD is a highly prevalent neurodevelopmental disorder that is associated with elevated rates of co-occurring psychiatric symptoms. The present study evaluated the role of functional impairment in mediating the association between ADHD symptoms and psychiatric symptoms, as well as the moderating role of temperament traits.</p><p><strong>Method: </strong>Participants included two cohorts: an early childhood longitudinal sample (ages 2-4 years; <i>n</i> = 93) and a middle childhood cross-sectional sample (ages 7-11 years; <i>n</i> = 92). Both cohorts were oversampled for ADHD diagnosis or concerns. ADHD symptom severity, psychiatric symptoms, functional impairment, and temperament were assessed by caregiver report. Linear mediation and moderated mediation models were conducted, with ADHD symptom severity as the independent variable, functional impairment as the mediator, and psychiatric symptoms as the dependent variable; additionally, baseline psychiatric symptoms were covaried in the longitudinal early childhood analysis.</p><p><strong>Results: </strong>Across both samples, we found significant mediation effects for depression and aggression. In the middle childhood sample, functional impairment also fully mediated the association between ADHD and anxiety symptom severity. In the moderated mediation models, negative affect enhanced indirect effects on depression in early childhood and aggression in middle childhood. There were no protective effects of surgency.</p><p><strong>Conclusions: </strong>Intervention specifically targeting functional impairment in this population has key clinical implications as it may help reduce the elevated risk of psychiatric comorbidity in the ADHD population, particularly in children with elevated levels of negative emotionality who are seemingly at highest risk.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"1290-1304"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}