National estimates and factors associated with medication treatment for childhood attention-deficit/hyperactivity disorder
ABSTRACT In this study we identified child and family-level characteristics that were associated with medication treatment for attention-deficit/hyperactivity disorder using nationally representative survey data.
National Survey of Children's Health data from 79264 youth 4 to 17 years of age were used. Data were weighted to adjust for the complex survey design of the National Survey of Children's Health. Gender-specific logistic regression models were generated to identify child and family-level characteristics that were collectively associated with current medication status among youth with a reported diagnosis of attention-deficit/hyperactivity disorder.
Nationally, 7.8% of youth aged 4 to 17 years had a reported attention-deficit/hyperactivity disorder diagnosis, and 4.3% had both a disorder diagnosis and were currently taking medication for the disorder. Current medication treatment among youth with attention-deficit/hyperactivity disorder was associated with white race, younger age, English spoken in the home, health care coverage, a health care contact within the last year, and reported psychological difficulties. Gender-specific logistic regression models revealed that, together, younger age, higher income, health care coverage, having psychological difficulties, and a health care contact in the past year were associated with medication use among boys with attention-deficit/hyperactivity disorder. Among girls with the disorder, younger age, psychological difficulties, fair-to-poor paternal mental health status, and a health care contact within the last year were collectively associated with current medication use. CONCLUSIONS. Regardless of gender, younger age, the presence of psychological difficulties, and a recent health care contact were significantly associated with medication treatment for attention-deficit/hyperactivity disorder. However, additional health care access and income variables among boys and paternal mental health status among girls represented gender-specific factors that were also associated with medication treatment for the disorder. Future studies should characterize how and when the burden associated with attention-deficit/hyperactivity disorder leads to treatment, support, or services for this prevalent and impairing neurobehavioral disorder.
- SourceAvailable from: Annette L Kirchgessner[Show abstract] [Hide abstract]
ABSTRACT: Prescription stimulants are often used to treat attention deficit hyperactivity disorder (ADHD). Drugs like methylphenidate (Ritalin, Concerta), dextroamphetamine (Dexedrine), and dextroamphetamine-amphetamine (Adderall) help people with ADHD feel more focused. However, misuse of stimulants by ADHD and nonaffected individuals has dramatically increased over recent years based on students' misconceptions or simple lack of knowledge of associated risks. In this review, we discuss recent advances in the use and increasing misuse of prescription stimulants among high school and college students and athletes. Given the widespread belief that stimulants enhance performance, there are in fact only a few studies reporting the cognitive enhancing effects of stimulants in ADHD and nonaffected individuals. Student athletes should be apprised of the very serious consequences that can emerge when stimulants are used to improve sports performance. Moreover, misuse of stimulants is associated with dangers including psychosis, myocardial infarction, cardiomyopathy, and even sudden death. As ADHD medications are prescribed for long-term treatment, there is a need for long-term safety studies and education on the health risks associated with misuse is imperative.09/2012; 2(5):661-77. DOI:10.1002/brb3.78
- Journal of child and adolescent psychopharmacology 06/2011; 21(3):295-7. DOI:10.1089/cap.2010.0101 · 3.07 Impact Factor
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ABSTRACT: This review proposes a new taxonomy of automatic and controlled attention. The taxonomy distinguishes among the role of the attendee (puppet and robot, critic and actor), the attention process (stimulus orienting vs. response control), and the attention operation (activation vs. inhibition vs. adjustment), and identifies cognitive phenotypes by which attention is overtly expressed. We apply the taxonomy to four childhood attention disorders: attention deficit hyperactivity disorder, spina bifida meningomyelocele, traumatic brain injury, and acute lymphoblastic leukemia. Variations in attention are related to specific brain regions that support normal attention processes when intact, and produce disordered attention when impaired. The taxonomy explains group differences in behavioral inattention, hyperactivity, and impulsiveness, as well as medication response. We also discuss issues relevant to theories of the cognitive and neural architecture of attention: functional dissociations within and between automatic and controlled attention; the relative importance of type of brain damage and developmental timing to attention profile; cognitive-energetic models of attention and white matter damage; temporal processing deficits, attention deficits and cerebellar damage; and the issue of cognitive phenotypes as candidate endophenotypes.Journal of the International Neuropsychological Society 10/2008; 14(5):673-90. DOI:10.1017/S1355617708080983 · 3.01 Impact Factor