Attention deficit and hyperactivity disorders最新文献

{"title":"What stops practitioners discussing medication breaks in children and adolescents with ADHD? Identifying barriers through theory-driven qualitative research.","authors":"Kinda Ibrahim, Parastou Donyai","doi":"10.1007/s12402-018-0258-9","DOIUrl":"10.1007/s12402-018-0258-9","url":null,"abstract":"<p><p>National and international guidelines on the treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents call for annual reviews to assess continuing need for medication by considering brief periods without medication, referred to as 'Drug holidays'. However, drug holidays are reactively initiated by families, or recommended by practitioners if growth has been suppressed by medication rather than proactively to check the need. There is little evidence of planned, practitioner-initiated drug holidays from methylphenidate. The aim of this study was to identify what stops practitioners from routinely discussing planned drug holidays from methylphenidate with children, adolescents, and their parents. Practitioners involved in shared-care prescribing for children and adolescents with ADHD in one UK County were included. Interviews with 8 general practitioners (GPs) and 8 Child and Adolescent Mental Health Service (CAMHS) practitioners were conducted. Transcripts were analysed qualitatively against the components of the Capability-Opportunity-Motivation-Behaviour (COM-B) model. Possible interventions for increasing prescribers' engagement with planned drug holidays were considered in response. Multiple barriers to practitioner engagement in planned drug holidays from methylphenidate were identified. Capability, in terms of knowledge and skills, was not a barrier identified for CAMHS practitioners but was for GPs. Opportunity was a main barrier for both groups, who reported lack of time and the absence of educational material about drug holidays. Motivation was more complex to define, with CAMHS practitioners questioning the need for drug holidays and GPs being more accepting due to worries about long-term medication side effects as well as cost savings. 'Education' and 'enablement' interventions were identified as key activities targeting all three components, which could feasibly increase uptake of practitioner-initiated planned drug holidays from methylphenidate. The application of the COM-B system identified a number of key barriers to practitioner engagement with drug holidays in children and adolescents with ADHD. Accordingly, a number of interventions could be developed to facilitate change. For example, educating and training GPs about ADHD management and drug holidays, and developing a decision aid to help families make informed decisions about whether or not to implement drug holidays could be used.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 4","pages":"273-283"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36292441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent and child neurocognitive functioning predict response to behavioral parent training for youth with ADHD.","authors":"Whitney D Fosco,&nbsp;Dustin E Sarver,&nbsp;Michael J Kofler,&nbsp;Paula A Aduen","doi":"10.1007/s12402-018-0259-8","DOIUrl":"10.1007/s12402-018-0259-8","url":null,"abstract":"<p><p>Parental cognitive functioning is thought to play a key role in parenting behavior and may inform response to behavioral intervention. This open-label pilot study examined the extent to which parent and child cognition impacted response to behavioral parent training for children with ADHD. Fifty-four participants (27 parent-child dyads; M_ages = 10.6 and 45.2 for children and parents, respectively) completed tasks assessing visuospatial and phonological working memory, inhibitory control, and choice-reaction speed at pre-treatment. Drift diffusion modeling decomposed choice-reaction time data into indicators of processing speed (drift rate) and response caution (boundary separation). Parents completed a 10-week manualized behavioral parent training program. Primary outcomes were pre- and post-treatment child ADHD and conduct problem severity, and parent-reported relational frustration and parenting confidence. Bayesian multiple regressions assessed parent and child cognitive processes as predictors of post-treatment outcomes, controlling for pre-treatment behavior. Better child visuospatial and phonological WM and higher parental response caution were associated with greater reductions in inattention. For conduct problems, better parental self-regulation (stronger inhibitory control and greater response caution) predicted fewer post-treatment conduct problems. Higher parental response caution also predicted lower post-treatment relational frustration and higher parental confidence. Bayesian evidence supported no relation between parent and child cognitive functions and treatment-related changes in hyperactivity. This pilot study demonstrates that cognitive processes central to etiologic theories of ADHD and models of parenting behavior can be successfully integrated into treatment outcome research to inform which families are most likely to benefit from behavioral interventions. This study demonstrates the feasibility of bridging the translational research gap between basic and applied clinical science and facilitates research on the role of cognition in psychosocial interventions.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 4","pages":"285-295"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0259-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperactivity in mice lacking one allele of the glutamic acid decarboxylase 67 gene.","authors":"Karen Müller Smith","doi":"10.1007/s12402-018-0254-0","DOIUrl":"https://doi.org/10.1007/s12402-018-0254-0","url":null,"abstract":"<p><p>GABAergic interneuron loss, maturational delay or imbalance of glutamatergic to GABAergic signaling has been implicated in several neuropsychiatric disorders including Tourette syndrome and attention-deficit/hyperactivity disorder (ADHD). In schizophrenia, decreases in parvalbumin (PV), somatostatin (Sst) and glutamic acid decarboxylase (GAD) RNA have been observed and seem to indicate a failure in maturation in PV and Sst neurons. In Tourette syndrome, which has a high level of comorbid ADHD, reduced numbers of parvalbumin expressing neurons have been observed in the basal ganglia of affected patients. In addition, polymorphisms in the GAD1 gene that codes for GAD67 protein have been associated with ADHD. We have examined whether mice with a disrupted Gad67 allele, the Gad67 GFP knock-in mice (Gad67-GFP^+/-), display abnormal locomotor behavior or altered anxiety behavior on the elevated plus maze. We found that Gad67-GFP^+/- mice displayed a mild hyperactivity compared to control littermates.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 4","pages":"267-271"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0254-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35929550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance-based measures and behavioral ratings of executive function in diagnosing attention-deficit/hyperactivity disorder in children.","authors":"Alexander Tan,&nbsp;Lauren Delgaty,&nbsp;Kayla Steward,&nbsp;Melissa Bunner","doi":"10.1007/s12402-018-0256-y","DOIUrl":"https://doi.org/10.1007/s12402-018-0256-y","url":null,"abstract":"<p><p>Deficits in real-world executive functioning (EF) are a frequent characteristic of attention-deficit/hyperactivity disorder (ADHD). However, the predictive value of using performance-based and behavioral rating measures of EF when diagnosing ADHD remains unclear. The current study investigates the use of performance-based EF measures and a parent-report questionnaire with established ecological validity and clinical utility when diagnosing ADHD. Participants included 21 healthy controls, 21 ADHD-primary inattentive, and 21 ADHD-combined type subjects aged 6-15 years. A brief neuropsychological battery was administered to each subject including common EF assessment measures. Significant differences were not found between groups on most performance-based EF measures, whereas significant differences (p < 0.05) were found on most parent-report behavioral rating scales. Furthermore, performance-based measures did not predict group membership above chance levels. Results further support differences in predictive value of EF performance-based measures compared to parent-report questionnaires when diagnosing ADHD. Further research must investigate the relationship between performance-based and behavioral rating measures when assessing EF in ADHD.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 4","pages":"309-316"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0256-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36015974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intolerance of uncertainty in children with attention-deficit/hyperactivity disorder.","authors":"Colette Gramszlo,&nbsp;Nicholas D Fogleman,&nbsp;Paul J Rosen,&nbsp;Janet Woodruff-Borden","doi":"10.1007/s12402-017-0244-7","DOIUrl":"https://doi.org/10.1007/s12402-017-0244-7","url":null,"abstract":"<p><p>Intolerance of uncertainty (IU) has often been studied in the context of internalizing disorders, but no studies to our knowledge have explored the relation between IU and externalizing disorders. Given the proposed link between IU and emotion regulation, the current study sought to examine levels of IU in an externalizing clinical population with known emotion regulation difficulties-attention-deficit/hyperactivity disorder (ADHD). IU levels in this population were compared to a clinical population known to experience elevated levels of IU. Participants in present study were ninety-three children (36 anxiety disorder, 28 ADHD, 29 unaffected children) ages 7-13, who completed the Intolerance of Uncertainty Scale-Short Version (IUS). Responses on the IUS were converted to total IU, prospective IU, and inhibitory IU. A linear mixed model analysis of covariance was conducted while controlling for age, sex, and ADHD medications. A significant interaction was observed between diagnostic status and IU scale. Planned contrasts indicated that children with anxiety disorders and ADHD reported significantly higher levels of IU relative to unaffected children, and children with ADHD reported comparable levels of inhibitory IU relative to children with anxiety disorders. The current results contribute to a growing literature on the link between IU and psychopathology. IU appears to be a transdiagnostic construct present among children with internalizing and externalizing disorders, and may be broadly associated with emotion regulation deficits rather than specific disorder symptoms.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"189-197"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-017-0244-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35541581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory study of barriers to successful office contacts for attention deficit hyperactivity disorder.","authors":"Jayde T Hooven,&nbsp;Benjamin N Fogel,&nbsp;James G Waxmonsky,&nbsp;Deepa L Sekhar","doi":"10.1007/s12402-017-0246-5","DOIUrl":"https://doi.org/10.1007/s12402-017-0246-5","url":null,"abstract":"<p><p>The American Academy of Pediatrics published attention deficit hyperactivity disorder (ADHD) guidelines, but significant variability exists in care. This exploratory study aimed to understand barriers to compliance with primary care office contacts for ADHD medication management. The study was conducted at a single academic medical center via retrospective chart review between 6/1/15 and 5/31/16 in combination with telephone interviews. Participants included 306 children 6-12 years old with an ADHD-related ICD-9/ICD-10 diagnosis. Factors affecting compliance were assessed via multivariable linear regression using the outcome of unsuccessful office contacts based on the percentage of missed, canceled, or rescheduled appointments. ADHD patients averaged 28.3% (SD 23.8%) unsuccessful office contacts. Unsuccessful contacts significantly increased by 15% for Hispanic ethnicity, 8% for public insurance, 8% for inattentive subtype, and 3% for every 10 miles additional distance from the office. Telephone interviews were attempted for those missing ≥ 3 appointments, which represented 18.3% (56/306) of the sample. Interviews were successfully completed with 37.5% (21/56). Of these, 52.3% (11/21) of parents preferred in-person visits. Structural barriers were not a concern, but 52.3% (11/21) reported high caregiver strain and fatigue. The results indicate that cultural barriers to understanding of ADHD and its management must be reconsidered. Use of Internet-based platforms may be a novel approach to address issues of distance, financial difficulty, and parental stress.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"237-243"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-017-0246-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35235784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of cognitive-behavioral therapy for older adults with ADHD: a randomized controlled trial.","authors":"Mary V Solanto,&nbsp;Craig B Surman,&nbsp;Jose Ma J Alvir","doi":"10.1007/s12402-018-0253-1","DOIUrl":"https://doi.org/10.1007/s12402-018-0253-1","url":null,"abstract":"<p><p>Older adults with ADHD exhibit significant functional impairment, yet there is little research to guide clinicians in evidence-based care of these adults. This study examined response to treatment in older adults who participated in a previous study of the efficacy of cognitive-behavioral treatment (CBT) in adult ADHD. It was hypothesized that older adults would respond less well to CBT than younger adults, given the cognitive demands of the treatment. As described in the original publication, 88 adults who met DSM-IV criteria for ADHD were randomized to receive either a manualized 12-week CBT group intervention targeting executive dysfunction or a parallel Support group. In the current study, outcomes for 26 adults, aged 50 or older, were compared with those of 55 younger adults with respect to inattentive symptoms assessed on a structured interview by a blind clinician, as well as on ratings by self and/or collateral on measures of attention, executive dysfunction, and comorbidity. Contrary to the hypothesis, older and younger adults were equally responsive to CBT on measures of attention. The older adults also responded as well to Support as to CBT on several outcome measures. The results provide preliminary evidence that CBT is an effective intervention for older adults with ADHD. The unexpected response to support highlights a possible age-specificity of effective therapeutic intervention that requires further investigation.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"223-235"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0253-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35872080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-deficit/hyperactivity disorder, joint hypermobility-related disorders and pain: expanding body-mind connections to the developmental age.","authors":"Carolina Baeza-Velasco,&nbsp;Lorenzo Sinibaldi,&nbsp;Marco Castori","doi":"10.1007/s12402-018-0252-2","DOIUrl":"https://doi.org/10.1007/s12402-018-0252-2","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) and generalized joint hypermobility (JH) are two separated conditions, assessed, and managed by different specialists without overlapping interests. Recently, some researchers highlighted an unexpected association between these two clinical entities. This happens in a scenario of increasing awareness on the protean detrimental effects that congenital anomalies of the connective tissue may have on human health and development. To review pertinent literature to identify possible connections between ADHD and GJH, special emphasis was put on musculoskeletal pain and syndromic presentations of GJH, particularly the hypermobile Ehlers-Danlos syndrome. A comprehensive search of scientific databases and references lists was conducted, encompassing publications based on qualitative and quantitative research. Impaired coordination and proprioception, fatigue, chronic pain, and dysautonomia are identified as potential bridges between ADHD and JH. Based on these findings, a map of the pathophysiological and psychopathological pathways connecting both conditions is proposed. Although ADHD and JH are traditionally separated human attributes, their association may testify for the dyadic nature of mind-body connections during critical periods of post-natal development. Such a mixed picture has potentially important consequences in terms of disability and deserves more clinical and research attention.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"163-175"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0252-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35832028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom covariance accounts for behavioral approach associations across impulse control disorders.","authors":"Brianne A Brooker,&nbsp;Dragana Ostojic,&nbsp;Carlin J Miller","doi":"10.1007/s12402-017-0245-6","DOIUrl":"https://doi.org/10.1007/s12402-017-0245-6","url":null,"abstract":"<p><p>Behavioral approach system (BAS) dysfunction has been identified as a correlate of and a potential mechanism for attention-deficit/hyperactivity disorder (ADHD) and comorbid disorders. This study examined the role of symptom covariation in the relations among BAS dysfunction, ADHD symptoms, and comorbid impulsive personality disorder features. Undergraduates (N = 207) completed measures of BAS functioning, ADHD symptoms, and borderline and antisocial personality disorder symptoms, and associated features (i.e., relational aggression). Hierarchical regression suggested that age, impulsive ADHD symptoms, and relational aggression were associated with BAS functioning. Adding other ADHD symptom dimensions (inattention, hyperactivity) and antisocial and borderline scores to the model did not increase variance accounted for beyond that accounted for by ADHD impulsivity scores. Results highlight a role of symptom covariance in the previously demonstrated relation between BAS, impulsive presentations of ADHD, and comorbid impulsive personality pathology. Implications for etiological models of ADHD and its co-occurrence with other disorders are discussed.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"199-208"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-017-0245-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD.","authors":"Nicholas D Fogleman,&nbsp;Kirsten D Leaberry,&nbsp;Paul J Rosen,&nbsp;Danielle M Walerius,&nbsp;Kelly E Slaughter","doi":"10.1007/s12402-018-0248-y","DOIUrl":"https://doi.org/10.1007/s12402-018-0248-y","url":null,"abstract":"<p><p>The current study explored the concurrent and longitudinal association between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD. Eighty children (42 ADHD, 38 non-ADHD) ages 8-12 participated in the present study conducted over a 6-month period. During the baseline session, parents completed a structured diagnostic interview and the Vanderbilt ADHD Parent Rating Scale to determine whether their child met criteria for ADHD, and the Child Behavior Checklist (CBCL) to assess their child's internalizing and externalizing behaviors; children completed the Perception of Peer Support Scale (PPSS) to assess experiences of peer victimization. At the 6-month follow-up session, parents completed the CBCL and children completed the PPSS. Concurrently, internalizing behaviors were associated with peer victimization among children with and without ADHD; ADHD moderated this relation, such that internalizing behaviors were more strongly related to peer victimization among children with ADHD. Longitudinally, internalizing behaviors at baseline predicted peer victimization at 6-month follow-up; however, further analyses demonstrated there was a covarying change in internalizing behaviors and peer victimization. These findings suggest internalizing behaviors are related to peer victimization concurrently, and over time, and are associated with increased risk for peer victimization in the presence of ADHD. Additionally, internalizing behaviors and peer victimization appear to share a dynamic relationship; that is, decreases in internalizing behaviors predict similar decreases in peer victimization. No significant relations were observed between externalizing behaviors and peer victimization. Implications and limitations are discussed.</p>","PeriodicalId":88387,"journal":{"name":"Attention deficit and hyperactivity disorders","volume":"10 3","pages":"209-222"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12402-018-0248-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35734821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}