Research

13 pages, 3599 KiB

Open AccessArticle

Neuropsychological Assessment of the Relationship of Working Memory with K-BIT Matrices and Vocabulary in Normal Development and ADHD Children and Adolescents

by Elena I. Rodriguez-Martínez, Raquel Muñoz-Pradas, Antonio Arjona, Brenda Y. Angulo-Ruiz, Vanesa Muñoz and Carlos M. Gómez

Brain Sci. 2023, 13(11), 1538; https://doi.org/10.3390/brainsci13111538 - 31 Oct 2023

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Abstract

Background: The present report tries to understand the possible relationship between working memory (WM) and intelligence measurements, using the direct scores of the Working Memory Test Battery for Children (WMTBC) and Kaufman’s Brief Intelligence Test (K-BIT), in normal development (ND) and diagnosed attention [...] Read more.

Background: The present report tries to understand the possible relationship between working memory (WM) and intelligence measurements, using the direct scores of the Working Memory Test Battery for Children (WMTBC) and Kaufman’s Brief Intelligence Test (K-BIT), in normal development (ND) and diagnosed attention deficit hyperactivity disorder (ADHD) children and adolescents. Results: Partial correlations, discounting the effect of age, showed a significant correlation in ND subjects between the central executive (CE) component of WM and the WM visuospatial sketchpad (VSS) component and the WM phonological loop (PL); also, significant correlations were obtained for the WM VSS with the K-BIT Matrices scores, the WM PL with the K-BIT Vocabulary, and the K-BIT Matrices scores with the K-BIT Vocabulary. For ADHD subjects, there were significant correlations between WM VSS and WM CE, and WM VSS and K-BIT Matrices. We tested the robustness of these correlations by selecting a small number of subjects through permutations; a robust correlation between WM CE and WM PL in ND, and between WM VSS and WM CE and WM VSS and K-BIT Matrices scores was obtained. These results were also supported by mediation analysis. Conclusions: There is a relationship during development between WM as measured with WMTBC and general intelligence as measured with K-BIT in ND and ADHD subjects. The dysexecutive character of ADHD has been shown, given that by controlling for intelligence, the differences in WM performance between ND and ADHD disappear, except for WM CE. The results suggest that in ADHD subjects, the WM VSS component presents a more pivotal role during cognitive processing compared to ND subjects. Full article

(This article belongs to the Special Issue Advances in ADHD)

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17 pages, 2258 KiB

Open AccessArticle

Working Memory-Related Neurofunctional Correlates Associated with the Frontal Lobe in Children with Familial vs. Non-Familial Attention Deficit/Hyperactivity Disorder

by Xiaobo Li, Chirag Motwani, Meng Cao, Elizabeth Martin and Jeffrey M. Halperin

Brain Sci. 2023, 13(10), 1469; https://doi.org/10.3390/brainsci13101469 - 18 Oct 2023

Cited by 1 | Viewed by 1260

Abstract

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence, heritability, and heterogeneity. Children with a positive family history of ADHD have a heightened risk of ADHD emergence, persistence, and executive function deficits, with the neural mechanisms having been under investigated. The [...] Read more.

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence, heritability, and heterogeneity. Children with a positive family history of ADHD have a heightened risk of ADHD emergence, persistence, and executive function deficits, with the neural mechanisms having been under investigated. The objective of this study was to investigate working memory-related functional brain activation patterns in children with ADHD (with vs. without positive family histories (ADHD-F vs. ADHD-NF)) and matched typically developing children (TDC). Voxel-based and region of interest analyses were conducted on two-back task-based fMRI data of 362 subjects, including 186, 96, and 80 children in groups of TDC, ADHD-NF, and ADHD-F, respectively. Relative to TDC, both ADHD groups had significantly reduced activation in the left inferior frontal gyrus (IFG). And the ADHD-F group demonstrated a significant positive association of left IFG activation with task reaction time, a negative association of the right IFG with ADHD symptomatology, and a negative association of the IFG activation laterality index with the inattention symptom score. These results suggest that working memory-related functional alterations in bilateral IFGs may play distinct roles in ADHD-F, with the functional underdevelopment of the left IFG significantly informing the onset of ADHD symptoms. Our findings have the potential to assist in tailored diagnoses and targeted interventions in children with ADHD-F. Full article

(This article belongs to the Special Issue Advances in ADHD)

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24 pages, 350 KiB

Open AccessArticle

Impact of COVID-19 on Physical Activity in Families Managing ADHD and the Cyclical Effect on Worsening Mental Health

by Erica Seal, Julie Vu, Alexis Winfield and Barbara Fenesi

Brain Sci. 2023, 13(6), 887; https://doi.org/10.3390/brainsci13060887 - 31 May 2023

Cited by 2 | Viewed by 2195

Abstract

Physical activity supports symptom management in children with ADHD and reduces the mental health burden associated with caregiving for children with ADHD. Survey-based research shows that COVID-19 reduced physical activity among diverse populations. This study used a qualitative approach situated within a socioecological [...] Read more.

Physical activity supports symptom management in children with ADHD and reduces the mental health burden associated with caregiving for children with ADHD. Survey-based research shows that COVID-19 reduced physical activity among diverse populations. This study used a qualitative approach situated within a socioecological framework to (1) understand how COVID-19 impacted physical activity of children with ADHD and their caregivers, to (2) identify barriers to their physical activity, and to (3) identify potential areas of support. Thirty-three participants were interviewed between October 2020 and January 2021. Content analysis revealed that physical activity declined for children and caregivers; significant barriers were social isolation and rising intrapersonal difficulties such as diminishing self-efficacy and energy levels and increased mental health difficulties. Worsening mental health further alienated caregivers and children from physical activity, undermining its protective effects on ADHD symptom management and mental wellbeing. Participants identified needing community support programs that offer virtual, live physical activity classes as well as psycho-emotional support groups. There is vital need to support physical activity opportunities during high-stress situations in families managing ADHD to buffer against diminishing mental wellbeing. This will promote further physical activity engagement and allow families to reap the cognitive, psychological, and emotional benefits. Full article

(This article belongs to the Special Issue Advances in ADHD)

17 pages, 545 KiB

Open AccessArticle

Exploring the Relationship between Cardiorespiratory Fitness and Executive Functioning in Adults with ADHD

by Michelle Ogrodnik, Sameena Karsan, Victoria Cirone and Jennifer J. Heisz

Brain Sci. 2023, 13(4), 673; https://doi.org/10.3390/brainsci13040673 - 17 Apr 2023

Cited by 1 | Viewed by 1937 | Correction

Abstract

Objective: Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD. Method: Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 [...] Read more.

Objective: Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD. Method: Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 ADHD; n = 36 Control). Participants completed the Six-Minute Walk Test to estimate CRF. Results: Mean performance measures of executive function did not differ by group. However, higher estimated CRF was associated with better Stroop task performance, and the association was strongest for individuals with ADHD. Conclusion: In adults with ADHD, higher estimated CRF was associated with better inhibitory control, but not with other measures of executive functioning. Full article

(This article belongs to the Special Issue Advances in ADHD)

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14 pages, 693 KiB

Open AccessFeature PaperArticle

Risk and Adversity Factors in Adult Patients with Comorbid Attention Deficit Hyperactivity Disorder (ADHD), Binge Eating Disorder (BED), and Borderline Personality Disorder (BPD): A Naturalistic Exploratory Study

by Derek Ryan and Joseph Sadek

Brain Sci. 2023, 13(4), 669; https://doi.org/10.3390/brainsci13040669 - 16 Apr 2023

Viewed by 2083

Abstract

This study was a retrospective pilot chart review of adult attention deficit hyperactivity disorder (ADHD) patients diagnosed with and without comorbid binge eating disorder (BED) and borderline personality disorder (BPD). ADHD research is critical because of its prevalence and persistence into adulthood. In [...] Read more.

This study was a retrospective pilot chart review of adult attention deficit hyperactivity disorder (ADHD) patients diagnosed with and without comorbid binge eating disorder (BED) and borderline personality disorder (BPD). ADHD research is critical because of its prevalence and persistence into adulthood. In the literature, ADHD, BED, and BPD are linked to an underlying impulsivity factor. This comparative study examined whether differences existed between patient groups concerning risk factors, comorbid disorders, and continuous performance test (CPT) cognitive scoring. The main goal was to find significant associations suggestive of correlations between specific factors and a principal diagnosis of ADHD with comorbid BED and BPD. Study participants were patients between 18 and 30 diagnosed by a psychiatrist in an outpatient clinic between June 2022 and December 2022. Both the control and comorbidity groups included 50 participants (N = 100). Patients were randomly chosen based on the chronological order of intake visit dates at the clinic and were selected as participants upon meeting the inclusion criteria. Data were collected through the Med Access EMR database, with quantitative data analyzed using SPSS and chi-squared p-value tests. The results showed significant associations between a principal diagnosis of ADHD with comorbid BPD and BED and (1) having four or more overall risk factors; (2) having five specific reported psychosocial risk factors: family issues, bullying, poverty, trouble with the law, and physical abuse; and (3) having on average more risk factors and comorbidities as compared to ADHD patients without comorbid BPD and BED. No association was found between low CPT scores and, thus, differential cognitive functionality between groups. This research will inform future study hypotheses to develop the clinical profile of ADHD patients with comorbid BED and BPD. Full article

(This article belongs to the Special Issue Advances in ADHD)

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14 pages, 4821 KiB

Open AccessArticle

Multisensory Enhancement of Cognitive Control over Working Memory Capture of Attention in Children with ADHD

by Biye Cai, Shizhong Cai, Hua He, Lu He, Yan Chen and Aijun Wang

Brain Sci. 2023, 13(1), 66; https://doi.org/10.3390/brainsci13010066 - 29 Dec 2022

Cited by 2 | Viewed by 2267

Abstract

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children. Although it has been well documented that children with ADHD are associated with impairment of executive functions including working memory (WM) and inhibitory control, there is not yet a consensus [...] Read more.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children. Although it has been well documented that children with ADHD are associated with impairment of executive functions including working memory (WM) and inhibitory control, there is not yet a consensus as to the relationship between ADHD and memory-driven attentional capture (i.e., representations in WM bias attention toward the WM-matched distractors). The present study herein examined whether children with ADHD have sufficient cognitive control to modulate memory-driven attentional capture. 73 school-age children (36 with ADHD and 37 matched typically developing (TD) children) were instructed to perform a visual search task while actively maintaining an item in WM. In such a paradigm, the modality and the validity of the memory sample were manipulated. The results showed that under the visual WM encoding condition, no memory-driven attentional capture was observed in TD children, but significant capture was found in children with ADHD. In addition, under the audiovisual WM encoding condition, memory-matched distractors did not capture the attention of both groups. The results indicate a deficit of cognitive control over memory-driven attentional capture in children with ADHD, which can be improved by multisensory WM encoding. These findings enrich the relationship between ADHD and cognitive control and provide new insight into the influence of cross-modal processing on attentional guidance. Full article

(This article belongs to the Special Issue Advances in ADHD)

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13 pages, 1032 KiB

Open AccessArticle

Distinct Thalamic and Frontal Neuroanatomical Substrates in Children with Familial vs. Non-Familial Attention-Deficit/Hyperactivity Disorder (ADHD)

by Rahman Baboli, Meng Cao, Jeffery M. Halperin and Xiaobo Li

Brain Sci. 2023, 13(1), 46; https://doi.org/10.3390/brainsci13010046 - 26 Dec 2022

Cited by 2 | Viewed by 2277

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent, inheritable, and heterogeneous neurodevelopmental disorder. Children with a family history of ADHD are at elevated risk of having ADHD and persisting its symptoms into adulthood. The objective of this study was to investigate the influence of [...] Read more.

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent, inheritable, and heterogeneous neurodevelopmental disorder. Children with a family history of ADHD are at elevated risk of having ADHD and persisting its symptoms into adulthood. The objective of this study was to investigate the influence of having or not having positive family risk factor in the neuroanatomy of the brain in children with ADHD. Cortical thickness-, surface area-, and volume-based measures were extracted and compared in a total of 606 participants, including 132, 165, and 309 in groups of familial ADHD (ADHD-F), non-familial ADHD (ADHD-NF), and typically developed children, respectively. Compared to controls, ADHD probands showed significantly reduced gray matter surface area in the left cuneus. Among the ADHD subgroups, ADHD-F showed significantly increased gray matter volume in the right thalamus and significantly thinner cortical thickness in the right pars orbitalis. Among ADHD-F, an increased volume of the right thalamus was significantly correlated with a reduced DSM-oriented t-score for ADHD problems. The findings of this study may suggest that a positive family history of ADHD is associated with the structural abnormalities in the thalamus and inferior frontal gyrus; these anatomical abnormalities may significantly contribute to the emergence of ADHD symptoms. Full article

(This article belongs to the Special Issue Advances in ADHD)

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13 pages, 1947 KiB

Open AccessArticle

Clinical Utility of Eye Tracking in Assessing Distractibility in Children with Neurological Disorders or ADHD: A Cross-Sectional Study

by Dirk J. J. Sweere, Johan J. M. Pel, Marlou J. G. Kooiker, Johannes P. van Dijk, Elizabeth J. J. M. van Gemert, Petra P. M. Hurks, Sylvia Klinkenberg, R. Jeroen Vermeulen and Jos G. M. Hendriksen

Brain Sci. 2022, 12(10), 1369; https://doi.org/10.3390/brainsci12101369 - 09 Oct 2022

Cited by 3 | Viewed by 2510

Abstract

This study aims to investigate distractibility quantified by recording and analyzing eye movements during task-irrelevant distraction in children with and without ADHD and in children with and without neurological disorders. Gaze behavior data and press latencies of 141 participants aged 6–17 that were [...] Read more.

This study aims to investigate distractibility quantified by recording and analyzing eye movements during task-irrelevant distraction in children with and without ADHD and in children with and without neurological disorders. Gaze behavior data and press latencies of 141 participants aged 6–17 that were collected during a computerized distraction paradigm with task-irrelevant stimuli (IDistrack) were analyzed. Children using attention-regulating medication were excluded from participation. Data were analyzed for subgroups that were formed based on the presence of neurological disorders and the presence of ADHD separately. Participants with ADHD and participants with neurological disorders spent less time fixating on the target stimuli compared to their peers without ADHD (p = 0.025) or their peers without neurological disorders (p < 0.001). Participants with and without ADHD had equal press latencies (p = 0.79). Participants with neurological disorders had a greater press latency compared to their typically developing peers (p < 0.001). Target fixation duration shows a significant association with parent-reported attention problems (r = −0.39, p < 0.001). We conclude that eye tracking during a distraction task reveals potentially valid clinical information that may contribute to the assessment of dysfunctional attentional processes. Further research on the validity and reliability of this paradigm is recommended. Full article

(This article belongs to the Special Issue Advances in ADHD)

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16 pages, 1194 KiB

Open AccessArticle

The Link between ADHD Symptoms and Antisocial Behavior: The Moderating Role of the Protective Factor Sense of Coherence

by Haym Dayan, Mona Khoury-Kassabri and Yehuda Pollak

Brain Sci. 2022, 12(10), 1336; https://doi.org/10.3390/brainsci12101336 - 03 Oct 2022

Cited by 3 | Viewed by 4293

Abstract

Numerous studies have established the link between ADHD and antisocial behavior, one of the most serious functional impairments caused by the disorder. However, research on protective factors that mitigate this link is still lacking. The Salutogenic Model of Health offers the “Sense of [...] Read more.

Numerous studies have established the link between ADHD and antisocial behavior, one of the most serious functional impairments caused by the disorder. However, research on protective factors that mitigate this link is still lacking. The Salutogenic Model of Health offers the “Sense of Coherence” (SOC), establishing that individuals who see their lives as logical, meaningful, and manageable are more resistant to various risk factors and diseases. The present study examines for the first time whether SOC is also a protective factor against different ADHD-related types of antisocial behaviors (severe/mild violent behavior, verbal violence, property crimes, public disorder, and drug abuse). A total of 3180 participants aged 15–50 completed online questionnaires assessing the level of ADHD symptoms, antisocial behaviors, and SOC. Structural equation modeling was applied to examine the research hypothesis. An interaction between ADHD symptoms and SOC was found in predicting each type of antisocial behavior (beta = −0.06–−0.17, p < 0.01). The link between ADHD symptoms and antisocial behavior was significantly weaker for high than low SOC participants, regardless of age group. The current study found that people with high SOC are protected against the effect of ADHD symptoms on one of the most serious functional impairments, antisocial behavior. These findings suggest that SOC is a protective factor from the adverse effects of ADHD symptoms, justifying further prospective and intervention studies. Full article

(This article belongs to the Special Issue Advances in ADHD)

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10 pages, 577 KiB

Open AccessEditor’s ChoiceArticle

Testing the Impact of Depressive and Anxiety Features on the Association between Attention-Deficit/Hyperactivity Disorder Symptoms and Academic Performance among University Students: A Mediation Analysis

by Ilaria Riboldi, Cristina Crocamo, Tommaso Callovini, Chiara Alessandra Capogrosso, Susanna Piacenti, Angela Calabrese, Susanna Lucini Paioni, Federico Moretti, Francesco Bartoli and Giuseppe Carrà

Brain Sci. 2022, 12(9), 1155; https://doi.org/10.3390/brainsci12091155 - 30 Aug 2022

Cited by 12 | Viewed by 2812

Abstract

Attention deficit/hyperactivity disorder (ADHD) is associated with poor academic performance also among university students. This relationship may be made more complex by comorbid conditions. The aim of this study was to evaluate the mediating role of anxiety and depressive symptoms in the relationship [...] Read more.

Attention deficit/hyperactivity disorder (ADHD) is associated with poor academic performance also among university students. This relationship may be made more complex by comorbid conditions. The aim of this study was to evaluate the mediating role of anxiety and depressive symptoms in the relationship between ADHD and academic performance. Data were drawn from the CAMPUS study (registration number: 0058642/21), an ongoing survey on university students’ mental health. Using a logit model, mediation analyses were carried out to test whether the relationship between ADHD symptoms (assessed by ASRS-5) and academic performance might be mediated by depressive (assessed by PHQ-9) and anxiety (assessed by GAD-7) symptoms. Our results showed that worse academic performance is associated with ADHD symptoms (p < 0.001). However, about 24% of the overall association between ADHD symptoms and academic performance was mediated by depressive symptoms (indirect effect: 0.065, 95%CI 0.022; 0.100), whereas the contribution of anxiety symptoms to the model was not significant. Along with the association between ADHD symptoms and poor academic performance, our findings highlight the key mediating role of depressive symptoms, which may be targeted with tailored support, ultimately improving both the academic performance and the well-being of university students with ADHD. Full article

(This article belongs to the Special Issue Advances in ADHD)

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15 pages, 331 KiB

Open AccessArticle

The Contributions of Cognitive Abilities to the Relationship between ADHD Symptoms and Academic Achievement

by Demi Tsantilas, Alzena Ilie, Jessica Waldon, Melissa McGonnell and Penny Corkum

Brain Sci. 2022, 12(8), 1075; https://doi.org/10.3390/brainsci12081075 - 13 Aug 2022

Viewed by 2114

Abstract

The main objective of this study was to examine whether increased levels of inattentive (INA) and hyperactive/impulsive (H/I) behaviours were associated with lower scores on standardized tests of achievement in basic reading, spelling, and math skills, after accounting for certain known background risk [...] Read more.

The main objective of this study was to examine whether increased levels of inattentive (INA) and hyperactive/impulsive (H/I) behaviours were associated with lower scores on standardized tests of achievement in basic reading, spelling, and math skills, after accounting for certain known background risk factors and cognitive processes. Clinical assessment data from a rigorously diagnosed, stimulant-medication-naïve sample of 354 elementary school-aged children experiencing academic difficulties and behavioural symptoms of inattention and/or hyperactivity/impulsivity were analyzed. Although higher scores of INA were significantly associated with lower scores in reading, spelling, and math, these associations did not persist when cognitive variables were added to the models. H/I was associated with math achievement, along with cognitive and background variables. Overall, cognitive variables accounted for the majority of the variance across basic reading, spelling, and math skills. Additionally, the only background demographic variables associated with academic achievement were age and sex for spelling and math. This finding highlights the importance of looking beyond observable INA and H/I behaviours to determine the underlying factors influencing academic achievement. Accurate identification of deficits in specific academic skills and the underlying factors influencing achievement in these skills are essential components in determining appropriate recommendations and targeted interventions. Full article

(This article belongs to the Special Issue Advances in ADHD)

23 pages, 1525 KiB

Open AccessArticle

by Rachael E. Lyon, Jala Rizeq, David B. Flora, Rhonda Martinussen, Brendan F. Andrade and Maggie E. Toplak

Brain Sci. 2022, 12(8), 1033; https://doi.org/10.3390/brainsci12081033 - 04 Aug 2022

Cited by 2 | Viewed by 1854

Abstract

Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old [...] Read more.

Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally. Growth curve analyses and correlations were conducted to better understand how these two types of measures relate to one another across development, as well as the impact of age-related variance. EF was assessed using the Stroop Task and Trail Making test and behavioral ratings of self-regulation were captured using the SWAN scale. EF task performance improved steeply until age 14–15, whereas the SWAN Scale showed small age-related decreases. EF task performance was moderately correlated with age among 8–13-year-olds and to a lesser extent among 14–20-year-olds. SWAN scores were not significantly related to age in either group. Correlations were similar in an ADHD “at-risk” subgroup. EF task performance and parent ratings of attention regulation have different developmental trajectories, which may partly explain why correlations are low to modest in these samples. In particular, age-related variance is an important methodological consideration with significant implications for the assessment of self-regulation in children and youth with ADHD. Full article

(This article belongs to the Special Issue Advances in ADHD)

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12 pages, 744 KiB

Open AccessFeature PaperArticle

Developmental Risk, Adversity Experiences and ADHD Clinical Profiles: A Naturalistic Exploratory Study

by Brooke Streeter and Joseph Sadek

Brain Sci. 2022, 12(7), 919; https://doi.org/10.3390/brainsci12070919 - 13 Jul 2022

Cited by 2 | Viewed by 2153

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that results from complex interactions of multiple genes and environmental risk and adversity factors. Some researchers have suggested a need for additional research into differing clinical presentations of ADHD for further classification. In this context, [...] Read more.

Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that results from complex interactions of multiple genes and environmental risk and adversity factors. Some researchers have suggested a need for additional research into differing clinical presentations of ADHD for further classification. In this context, this study aimed to investigate whether increases in risk and adversity factors increase the severity of ADHD and the number of comorbid psychiatric disorders. This is a naturalistic retrospective chart review exploratory study in 100 patients 16 years or older who have a confirmed diagnosis of ADHD. The quantitative data were analyzed using SPSS, using the Mann–Whitney test for parametric data and the Chi-square and Kruskal–Wallis p value tests for non-parametric and categorical data. Qualitative data were tabulated and described. The study found that (1) the average number of comorbidities increases with the severity of ADHD, (2) the average number of risk and adversity factors increases with the severity of ADHD, (3) the number of risk and adversity factors were positively associated with the number of comorbidities, and (4) Level of education was negatively associated with the number of risk and adversity factors and the number of comorbidities. The implications of these findings are discussed, and future research in this important area is suggested. Full article

(This article belongs to the Special Issue Advances in ADHD)

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13 pages, 1660 KiB

Open AccessArticle

Attention Deficit Hyperactivity Disorder Assessment Based on Patient Behavior Exhibited in a Car Video Game: A Pilot Study

by Aaron Sujar, Sofia Bayona, David Delgado-Gómez, Carolina Miguélez-Fernández, Juan Ardoy-Cuadros, Inmaculada Peñuelas-Calvo, Enrique Baca-García and Hilario Blasco-Fontecilla

Brain Sci. 2022, 12(7), 877; https://doi.org/10.3390/brainsci12070877 - 01 Jul 2022

Cited by 5 | Viewed by 2236

Abstract

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the [...] Read more.

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the experience of the medical professional. Attempts to obtain additional measures to support the medical diagnosis, such as reaction time when performing a task, can be found in the literature. We propose an information recording system that allows to study in detail the behavior shown by children already diagnosed with ADHD during a car driving video game. We continuously record the participants’ activity throughout the task and calculate the error committed. Studying the trajectory graphs, some children showed uniform patterns, others lost attention from one point onwards, and others alternated attention/inattention intervals. Results show a dependence between the age of the children and their performance. Moreover, by analyzing the positions by age over time using clustering, we show that it is possible to classify children according to their performance. Future studies will examine whether this detailed information about each child’s performance pattern can be used to fine-tune treatment. Full article

(This article belongs to the Special Issue Advances in ADHD)

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Review

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15 pages, 727 KiB

Open AccessReview

Understanding Problematic Social Media Use in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): A Narrative Review and Clinical Recommendations

by Tycho J. Dekkers and Jorien van Hoorn

Brain Sci. 2022, 12(12), 1625; https://doi.org/10.3390/brainsci12121625 - 26 Nov 2022

Cited by 5 | Viewed by 9283

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is consistently associated with a host of social problems, such as victimization and difficulties in maintaining close friendships. These problems are not limited to offline relations but also manifest in the online social world, as previous research shows that ADHD [...] Read more.

Attention-Deficit/Hyperactivity Disorder (ADHD) is consistently associated with a host of social problems, such as victimization and difficulties in maintaining close friendships. These problems are not limited to offline relations but also manifest in the online social world, as previous research shows that ADHD is associated with problematic use of social media. Given the ubiquitous nature of social media, the goal of the current review is to understand why adolescents with ADHD demonstrate more problematic social media use than their typically developing peers. To this end, we provide a narrative review on the evidence for the link between ADHD and social media use, and consequently present an integrative framework, which encompasses neurobiological mechanisms (i.e., imbalance theory of brain development and dual pathway model of ADHD) and social mechanisms, including influences from peers and parents. We conclude that empirical work shows most consistent evidence for the link between problematic social media use and ADHD (symptoms), while intensity of social media use is also associated with several other behaviors and outcomes. Finally, we hypothesize how existing interventions for ADHD may work on the identified mechanisms and provide at-hand clinical recommendations for therapists working with adolescents with ADHD who exhibit problematic social media use. Full article

(This article belongs to the Special Issue Advances in ADHD)

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14 pages, 1258 KiB

Open AccessReview

A Review of Canadian Diagnosed ADHD Prevalence and Incidence Estimates Published in the Past Decade

by Stacey D. Espinet, Gemma Graziosi, Maggie E. Toplak, Jacqueline Hesson and Priyanka Minhas

Brain Sci. 2022, 12(8), 1051; https://doi.org/10.3390/brainsci12081051 - 08 Aug 2022

Cited by 6 | Viewed by 5774

Abstract

(1) Background: ADHD is recognized as one of the most common neurodevelopmental disorders. The worldwide prevalence of ADHD is estimated at 5.3%; however, estimates vary as a function of a number of factors, including diagnostic methods, age, sex and geographical location. A review [...] Read more.

(1) Background: ADHD is recognized as one of the most common neurodevelopmental disorders. The worldwide prevalence of ADHD is estimated at 5.3%; however, estimates vary as a function of a number of factors, including diagnostic methods, age, sex and geographical location. A review of studies is needed to clarify the epidemiology of ADHD in Canada. (2) Methods: A search strategy was created in PubMed and adapted for MEDLINE and PsycINFO. Papers were included if they examined diagnosed ADHD prevalence and/or incidence rates in any region of Canada, age group and gender. A snowball technique was used to identify additional papers from reference lists, and experts in the field were consulted. (3) Results: Ten papers included in this review reported on prevalence, and one reported on incidence. One study provided an overall prevalence estimate across provinces for adults of 2.9%, and one study provided an overall estimate across five provinces for children and youth of 8.6%. Across age groups (1 to 24 years), incidence estimates ranged from 0.4% to 1.2%, depending on province. Estimates varied by age, gender, province, region and time. (4) Conclusions: The overall Canadian ADHD prevalence estimate is similar to worldwide estimates for adults. Most studies reported on prevalence rather than incidence. Differences in estimates across provinces may reflect the varying number of practitioners available to diagnose and prescribe medication for ADHD across provinces. To achieve a more comprehensive understanding of the epidemiology of ADHD in Canada, a study is needed that includes all provinces and territories, and that considers estimates in relation to age, gender, ethnicity, geographical region, socioeconomic status and access to mental healthcare coverage. Incidence rates need further examination to be determined. Full article

(This article belongs to the Special Issue Advances in ADHD)

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14 pages, 249 KiB

Open AccessReview

Tolerance to Stimulant Medication for Attention Deficit Hyperactivity Disorder: Literature Review and Case Report

by Kenneth Handelman and Fernando Sumiya

Brain Sci. 2022, 12(8), 959; https://doi.org/10.3390/brainsci12080959 - 22 Jul 2022

Cited by 8 | Viewed by 6106

Abstract

Recommended treatment for attention deficit hyperactivity disorder (ADHD) includes stimulant medication. While these medicines are effective for most ADHD patients, benefits may wear off, suggesting tolerance. This paper reviews the published literature on tolerance to stimulant medication treatment for ADHD. As there are [...] Read more.

Recommended treatment for attention deficit hyperactivity disorder (ADHD) includes stimulant medication. While these medicines are effective for most ADHD patients, benefits may wear off, suggesting tolerance. This paper reviews the published literature on tolerance to stimulant medication treatment for ADHD. As there are relatively few studies published, pivotal studies and ADHD treatment guidelines were also reviewed. Research demonstrates physiological changes related to continued stimulant usage in neurons and certain brain regions, suggesting a mechanism for tolerance development. One clinical study showed that 24.7% of patients developed tolerance to stimulants in the time of days to weeks; another showed 2.7% developed tolerance over 10 years. Long term follow-up studies demonstrate that medication response may lessen over longer durations of treatment in a high percentage of patients. Strategies to manage tolerance include switching stimulant medicines, drug holidays, or clinical reassessment. Three cases illustrate challenges with treating patients who develop tolerance to stimulant medication. The paucity of research and lack of guidance to clinicians may contribute to significant under recognition of tolerance to stimulant medication. Further research is required to define clinical tolerance for stimulants in ADHD and to provide guidance on identifying and managing tolerance in clinical practice. Full article

(This article belongs to the Special Issue Advances in ADHD)

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25 pages, 951 KiB

Open AccessSystematic Review

Social Robots and Brain–Computer Interface Video Games for Dealing with Attention Deficit Hyperactivity Disorder: A Systematic Review

by José-Antonio Cervantes, Sonia López, Salvador Cervantes, Aribei Hernández and Heiler Duarte

Brain Sci. 2023, 13(8), 1172; https://doi.org/10.3390/brainsci13081172 - 07 Aug 2023

Cited by 2 | Viewed by 2646

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity that affects a large number of young people in the world. The current treatments for children living with ADHD combine different approaches, such as pharmacological, behavioral, cognitive, and [...] Read more.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity that affects a large number of young people in the world. The current treatments for children living with ADHD combine different approaches, such as pharmacological, behavioral, cognitive, and psychological treatment. However, the computer science research community has been working on developing non-pharmacological treatments based on novel technologies for dealing with ADHD. For instance, social robots are physically embodied agents with some autonomy and social interaction capabilities. Nowadays, these social robots are used in therapy sessions as a mediator between therapists and children living with ADHD. Another novel technology for dealing with ADHD is serious video games based on a brain–computer interface (BCI). These BCI video games can offer cognitive and neurofeedback training to children living with ADHD. This paper presents a systematic review of the current state of the art of these two technologies. As a result of this review, we identified the maturation level of systems based on these technologies and how they have been evaluated. Additionally, we have highlighted ethical and technological challenges that must be faced to improve these recently introduced technologies in healthcare. Full article

(This article belongs to the Special Issue Advances in ADHD)

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29 pages, 3929 KiB

Open AccessSystematic Review

Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP

by Valerie Tourjman, Gill Louis-Nascan, Ghalib Ahmed, Anaïs DuBow, Hubert Côté, Nadia Daly, George Daoud, Stacey Espinet, Joan Flood, Emilie Gagnier-Marandola, Martin Gignac, Gemma Graziosi, Zeeshan Mansuri and Joseph Sadek

Brain Sci. 2022, 12(8), 1023; https://doi.org/10.3390/brainsci12081023 - 01 Aug 2022

Cited by 10 | Viewed by 6813

Abstract

Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA [...] Read more.

Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind–Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms. Full article

(This article belongs to the Special Issue Advances in ADHD)

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10 pages, 282 KiB

Open AccessPerspective

A Paradigm for Targeting Functional Impairment as an Outcome in Attention-Deficit/Hyperactivity Disorder

by Margaret Danielle Weiss

Brain Sci. 2022, 12(8), 1014; https://doi.org/10.3390/brainsci12081014 - 31 Jul 2022

Cited by 3 | Viewed by 1883

Abstract

Although functional impairment is required for a diagnosis in the DSM 5, the time frame and definition of functional impairment is ambiguous. We present a conceptual review clarifying the difference between functional impairment as a stable trait representing strength or disability in various [...] Read more.

Although functional impairment is required for a diagnosis in the DSM 5, the time frame and definition of functional impairment is ambiguous. We present a conceptual review clarifying the difference between functional impairment as a stable trait representing strength or disability in various domains, and functional impairment as secondary to emotional or behavior problems, which is a state sensitive to change with treatment intervention. Functional impairment as a measure of treatment outcome includes both change from baseline and status at the endpoint of treatment. When using a validated measure of function, functional improvement can be defined as the percentage of patients who achieve the Minimal Important Clinical Difference (MCID) and functional remission as the percentage of patients who normalize at treatment endpoint. True treatment remission should be defined as both symptomatic and functional remission. Full article

(This article belongs to the Special Issue Advances in ADHD)

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5 pages, 204 KiB

Open AccessOpinion

Malingering and Stimulant Medications Abuse, Misuse and Diversion

by Joseph Sadek

Brain Sci. 2022, 12(8), 1004; https://doi.org/10.3390/brainsci12081004 - 28 Jul 2022

Cited by 3 | Viewed by 1808

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that interferes with multiple aspects of daily functioning. Malingering or feigning of symptoms can be a major challenge during ADHD assessment. Stimulant medication abuse, misuse and diversion may constitute another challenge during management. A [...] Read more.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that interferes with multiple aspects of daily functioning. Malingering or feigning of symptoms can be a major challenge during ADHD assessment. Stimulant medication abuse, misuse and diversion may constitute another challenge during management. A literature search of the past 15 years on the topic continued to suggest that there are several reasons for malingering and faking ADHD symptoms. Some of the reasons include the intent to obtain prescriptions for stimulant medications for performance enhancement, to gain access to additional school services and accommodations, to use recreationally and to sell as a street drug. In some countries, patients may receive additional tax or student loan benefits. Several researchers suggested that self-report rating measures are easily simulated by patients without ADHD. They concluded that no questionnaire has proved sufficiently robust against false positives. Some clinical factors that may suggest malingering during the ADHD assessment are highlighted and some available tests to detect malingering are discussed. Full article

(This article belongs to the Special Issue Advances in ADHD)

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