Preclinical models, receptor localization, and genetic linkage data support the role of D4 receptors in the etiology of ADHD. This proof-of-concept study was designed to evaluate MK-0929, a selective D4 receptor antagonist as treatment for adult ADHD.
A randomized, double-blind, placebo-controlled, crossover study was conducted in adults with primary ADHD. The primary end point was changed from baseline in total score on the Adult ADHD Investigator Symptom Rating Scale following a 4-week treatment regimen. Additional measures included Clinical Global Impression-Severity Scale, Hospital Anxiety and Depression Scale, and Brown Attention Deficit Disorder Scale and D4 genotype analysis.
No statistically significant treatment differences were found between MK-0929 and placebo in any of the primary or secondary assessments.
Results from this study suggest that blockade of the D4 receptor alone is not efficacious in the treatment of adult ADHD.
To prospectively investigate prediction of ADHD to anxiety disorders (ANXs) in a national sample of Taiwan.
From the Taiwan National Health Insurance Dataset (1997-2007), we collected 2,385 cases of new diagnoses of ADHD from 1999 to 2003 and 9,540 sex-, age- and index dates of the first diagnosis of ADHD-matched cohort controls without ADHD. The outcome is age of the first diagnosis of ANXs until December 31, 2007.
More cases of ADHD (17.7%) developed ANXs than did matched controls (1.9%) with a younger age onset (12.7 years vs. 17.9 years) and a shorter "survival time" (1.4 years vs. 5.0 years). Cox models revealed a significant prediction of ADHD to ANXs controlling for other psychiatric comorbidities [Hazard ratio (HR) = 15.83]. The magnitude of such association was greater in males and decreased with older age of first ADHD diagnosis.
The findings imply that early detection and treatment for ADHD may offset later development of ANXs.
The authors investigated whether childhood specific learning difficulties (SLDs) predict later school performance in adolescents with ADHD symptoms (ADHDs) and how SLDs associate with educational aspirations.
In the Northern Finland Birth Cohort 1986 (n = 9,432), data about children were collected using questionnaires for parents and teachers at ages 7 and 8 and for parents and adolescents at ages 15/16. Information on school performance was obtained from a national register.
The occurrence of SLDs at 8 years was 19.9% (n = 1,198), ADHDs at 15/16 years was 8.0% (n = 530), and comorbid ADHDs and SLDs was 3.0% (n = 179). Having ADHDs but not SLDs or having both was associated with a significantly lower mean value in school grades for theoretical subjects. Adolescents with comorbid ADHDs and SLDs repeated a grade more often, and their educational aspirations were less ambitious than those in other groups.
ADHDs and SLDs have a negative influence on academic achievements.
To examine the value of the Conners 10-item scale to predict academic outcomes at age 16 years in schoolchildren aged 7 and 10 years.
A cohort study of N = 544 children in a municipality of Stockholm County was conducted. Using the parent and teacher version of the Conners 10-item scale, 7- and 10-year-olds were screened for ADHD symptoms and followed-up for school outcome at age 16 years.
The best predictors for school outcome at age 16 years were the Conners items, "child failing to finish tasks" and "being inattentive, easily distracted," with a high specificity (90%-97%) but low sensitivity (18%-39%).
This study indicates a considerable association between certain symptoms of inattentiveness in young schoolchildren and academic underachievement at age 16 years. Screening for one to two symptoms of inattention in schoolchildren identifies 30% to 40% of participants at risk for later poor school attainment.
To explore the relationship between the symptoms of ADHD, the extent to which college students seek to maximize their decisions, and the degree to which students feel regret for their decisions.
Undergraduate students (N = 275) completed four questionnaires measuring ADHD symptomology, internal restlessness, maximization tendencies, and regret. It was hypothesized that (a) participants who reported more behaviors associated with ADHD and internal restlessness would report more maximizing tendencies, (b) participants reporting greater ADHD symptoms and internal restlessness symptoms would be more likely to report feelings of regret, (c) men would report more symptoms of ADHD and internal restlessness than women, and (d) men would be more likely to report maximization tendencies than women.
Findings supported the hypotheses and interaction were found.
Findings provided new information concerning relationships between ADHD symptomology, internal restlessness, maximization tendencies, and regret.
Objective: The present article reports on the discovery and translation of a chapter in a 1775 medical textbook by the German physician, Melchior Adam Weikard, which describes attention disorders. This article is believed to be the earliest reference to the syndrome that today is known as attention deficit hyperactivity disorder, or ADHD. Method: The authors briefly discuss previous efforts to identify the earliest description of ADHD thought to be the lectures of George Still in 1902 and subsequently, the medical textbook by the physician, Alexander Crichton, in 1798. Background is provided on Weikard followed by the English translation of his short chapter on attention deficits and the rationale for why it should be viewed as relevant to the history of ADHD. Results and Conclusions: The authors argue that Weikard's description in 1775 now deserves to be credited with providing the first description of attention disorders in the medical literature known to date.
Objective: Attention capacities are critical for adaptive functioning and development. Reliable assessment measures are needed for the study of attention capacities in early childhood. In the current study, we investigated the factor structure of the Utrecht Tasks of Attention in Toddlers Using Eye-tracking (UTATE) test battery that assesses attention capacities in 18-month-old toddlers with eye-tracking techniques. Method: The factor structure of 13 measures of attention capacities, based on four eye-tracking tasks, was investigated in a sample of 95 healthy toddlers (18 months of age) using confirmatory factor analysis. Results: Results showed that a three-factor model best fitted the data. The latent constructs reflected an orienting, alerting, and executive attention system. Conclusion: This study showed support for a three-factor model of attention capacities in 18-month-old toddlers. Further study is needed to investigate whether the model can also be used with children at risk of attention problems. (J. of Att. Dis. 2013; XX(X) 1-XX).
Evaluate nonmedical use (NMU) of ADHD prescription stimulants (Ritalin(®), Adderall(®), Adderall(®) XR, Concerta(®), and Vyvanse(®)) in a U.S. adult general population sample.
In all, 10,000 adults (aged 18-49) from an online, opt-in panel, proximity matched to U.S. Census demographics, were surveyed to assess NMU prevalence, routes of administration (ROA), reasons for NMU, and diversion source.
Lifetime NMU of any prescription drug was 35.1%, pain medications (24.6%), sedatives/tranquilizers (15.6%), sleep medications (9.9%), and prescription stimulants (8.1%). Within the prescription stimulants, rates of NMU (per 100,000 prescriptions dispensed) were 1.62 for Ritalin and 1.61 for Adderall followed by Adderall XR (0.62), Concerta (0.19), and Vyvanse (0.13). Respondents used stimulants mostly for wakefulness and performance enhancement, obtained the drugs from family/friends, and used oral ROA.
NMU of ADHD prescription stimulants were low compared with other prescription medications. While prevalence of NMU was higher for immediate-release than extended-release ADHD medications, absolute rates for prescription stimulants were low.
Objective: To examine the relative contribution of hyperactivity, conduct, and emotional problems in predicting criminal offending. Method: In all, 173 boys aged 6 to 8 years (assessed for hyperactivity, conduct, and emotional problems) were followed up 19 years later by examining criminal offense histories. Results: Significant main effects for total and violent convictions were found, the strongest being for violent criminal offenses. Conduct problems predicted general offending (irrespective of the type of conviction), whereas emotional problems were the single best predictor of violent convictions. Hyperactivity was not a significant predictor in the models. Conclusion: The findings provide insight into the developmental mechanisms that mediate criminal behavior by showing that childhood emotional problems independently contribute to the risk of violent offending in later life.
Objective: We examined the risk of hospital-treated injuries related to the symptoms/diagnosis of ADHD. Method: The study population (N = 6,111) was composed from the Northern Finland Birth Cohort 1986. At the age of 8, symptoms of hyperactivity and at the age of 15, symptoms of ADHD were assessed by the parents while the clinical diagnoses of ADHD were set in adolescence. Information on injuries was obtained from national register. Results: The risk for hospital-treated injuries during ages 0 to 7 was 1.7-fold increased among those with symptoms of hyperactivity assessed at age 8. Also, injuries during ages 7 to 15 years were more common among those with symptoms of ADHD at age 15 with respect to any injury, fractures, and intracranial injuries, and among those with the diagnosis of ADHD with respect to any injury. Conclusion: The present study shows an association between hospital-treated injuries and symptoms of ADHD in a large epidemiological sample of 0- to 15-year-old children. (J. of Att. Dis. 2013; XX(X) 1-XX).
Since the positive effects of stimulants on disruptive behavior were described (Bradley & Bowen, 1941), further pediatric studyhas been limited almost exclusively to samples of hyperkinetic school-age children. Because these agents normally were viewed as arousing in their effects on the central nervous system, but were calming in their therapeutic effects on these children, stimulant effects on Attention Deficit Disorder (ADD) were interpreted as being 'paradoxical.' Investigation of effects in normal children and adolescents and in those with disorders unrelated to Attention-Deficit/Hyperactivity Disorder (ADHD), as well as in young adult samples, however, indicate that stimulants appear to have similar behavioral effects in normal and in hyperactive children. This brief report is an update (as of August 2002) on studies of stimulants in ADHD and normal children, with particular focus on MPH.
Methylphenidate is prescribed for children and adolescents to treat ADHD. As in many Western countries, the increase in methylphenidate consumption is a public concern in Switzerland. The article discusses the authors' assessment of prescription prevalence in 2002 and 2005 for school-aged children in the canton of Vaud.
Pharmacy prescription information is available from the regional public health authority. Descriptive analyses are conducted on an anonymized database of the years 2002 and 2005. Data for each year are compared to assess trends in methylphenidate prescription prevalence.
The findings show an increase from 0.74% to 1.02% in the number of prescriptions for 5- to 14-year-old children, particularly in prescriptions for girls. Data also show important geographical differences in prescription.
The prevalence of methylphenidate prescription is lower in Switzerland than other Western countries, particularly the United States. However, some aspects of prevalence are similar, including the increase per year, demographics, and geographic characteristics.
To investigate the change of ADHD medication prescriptions in Turkey between 2009 and 2013.
Consumption data of ADHD medications, immediate release (IR) methylphenidate (MPH; Ritalin), OROS MPH (Concerta), and atomoxetine (Strattera) were obtained from IMS Health database for the November 2008 to October 2013 period. Defined daily dose (DDD) of each drug was calculated according to WHO definitions and time-series analysis was conducted.
There was a significant seasonal effect for prescription of all drugs. Annual use of ADHD medications increased 2.18 times for all ADHD medications combined. DDDs per 1,000 population per day for all ADHD medications were 0.28 in 2009, 0.41 in 2010, 0.52 in 2011, and 0.59 in 2012. OROS MPH represented almost 75% of all ADHD medication utilization.
As reported from several other countries, ADHD medication use increased in Turkey. Results suggested that over- and underdiagnosis might be seen at the same time.
Applied child psychologists and behavioral consultants often use systematic behavioral observations to inform the psychological assessment and intervention development process for children referred for attention and hyperactivity problems. This article provides a review of the 2010 version of the eCOVE classroom observation software in terms of its utility in tracking the progress of children with attention and hyperactive behaviors and its use in evaluating teacher behaviors that may impede or promote children's attention and positive behavior. The eCOVE shows promise as an efficient tool for psychologists and behavioral consultants who want to evaluate the effects of interventions for children with symptoms of ADHD, ODD, mood disorders and learning disorders; however, some research-based improvements for future models are suggested. The reviewers also share their firsthand experience in using eCOVE to evaluate teacher and student behavior exhibited on a television show about teaching urban high school students and during a movie about an eccentric new kindergarten teacher. Rich examples are provided of using strategic behavioral observations to reveal how to improve the classroom environment so as to facilitate attention, motivation and positive behavior among youth. Broader implications for enhancing the use of systematic behavioral observations in the assessment of children and adolescents with attention disorders and related behavioral problems are discussed. Key issues are examined such as the use of behavioral observations during psychological consultation to prevent the previously found gender bias in referrals for ADHD. Using behavioral observations to enhance differential diagnosis is also discussed.
To examine written expression and the executive function skills (working memory, verbal fluency, and planning and organization) involved in written expression in college-aged students with ADHD.
Two groups of undergraduate students, aged 19 to 28 years, (ADHD, n = 31; control, n = 27) are evaluated on selected measures of executive function and a measure of written expression.
No statistically significant differences are found between groups on measures of executive function and written expression. A standard multiple regression model is significant for predicting writing mechanics, with a measure of behavioral inhibition making a statistically significant contribution.
Findings from the study provide important information about the link between specific executive function abilities and written expression, particularly for fundamentals in writing in college students.
The purpose of this study was to examine the impact of stimulant treatment on risk for alcohol and illicit drug use in adolescents with ADHD.
Analysis of data derived from a prospective open-label treatment study of adolescent ADHD ( n = 115, 76% male), and a historical, naturalistic sample of ADHD ( n = 44, 68% male) and non-ADHD youth ( n = 52, 73% male) of similar age and sex. Treatment consisted of extended-release methylphenidate in the clinical trial or naturalistic stimulant treatment. Self-report of alcohol and drug use was derived from a modified version of the Drug Use Screening Inventory.
Rates of alcohol and drug use in the past year were significantly lower in the clinical trial compared with untreated and treated naturalistic ADHD comparators, and similar to rates in non-ADHD comparators.
Well-monitored stimulant treatment may reduce the risk for alcohol and substance use in adolescent ADHD.
It has been proposed that ADHD is an executive control disorder. Little is known however about the maturation of executive control in ADHD.
A cross-sectional study of ADHD patients compared to normal controls tested on a computerized neurocognitive test battery.
175 patients with ADHD, age 10 to 29, compared to 175 age-matched normal controls.
In every age group, ADHD patients were impaired in measures of psychomotor speed, reaction time, cognitive flexibility, and attention. Participants in both groups improved with age. In tests of executive control, normals improved their performance with shorter reaction times. ADHD patients improved their performance but by adopting a less efficient strategy: Their reaction times increased with age.
These data support executive control as a "core deficit" in ADHD. In the Stroop and the shifting attention tests, ADHD patients proved to be inefficient in allocating their attentional resources.
To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12).
Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. DSM-IV adult ADHD behaviors were systematically rated, and impairment resulting from symptoms was scored on a 5-point Likert-type scale.
Correlations between degree of impairment and number of behaviors were high (r's = .83 to .85, p < .001). The impairment criterion had no effect on classifying any participants as having, or not having, adult ADHD. All participants who reported experiencing 5 or more inattention or hyperactive-impulsive behaviors as "often" or "very often" in adulthood were significantly impaired by their symptoms.
Contrary to results reported in children, there was a strong relationship between number of ADHD symptoms and degree of impairment. However, for several reasons (discussed in the article), it should not be concluded that the impairment criterion is superfluous.
To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients.
Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status.
Of the patients, 24% reported being in work, compared to 79% in a population-based control group (N = 359). Combined subtype of ADHD, substance abuse, and a reported history of depression or anxiety were correlated with being out of work. Current and past medical treatment of ADHD was correlated with being in work. Logistic regression analyses showed that stimulant therapy during childhood was the strongest predictor for being in work as adults (odds ratio = 3.2, p = .014).
Early recognition and treatment of ADHD is a strong predictor of being in work as an adult, independently of comorbidity, substance abuse, and current treatment.
Increasing numbers of adults are seeking treatment for ADHD. Pharmacotherapy is well established as the first line treatment for adult ADHD, although medications alone may be insufficient treatment for the myriad problems experienced by these patients. Few studies have examined the clinical outcomes of a combination of pharmacotherapy and psychotherapy for this clinical population. The purpose of the present study is to examine the potential effectiveness of the combination of pharmacotherapy and cognitive-behavior therapy modified to treat adult patients diagnosed with ADHD.
Forty-three adults who underwent a structured diagnostic assessment for ADHD complete 6 months of combined treatment. Treatment outcome is assessed by comparing pre- and posttreatment measures of ADHD symptoms, comorbid symptoms, and ratings of overall functioning.
Results indicate that combined treatment is associated with significant improvements on all clinical measures. Limitations of the study design and directions for future research are discussed.
The aim was to compare different scales capturing ADHD symptoms for older individuals' self-reports about childhood and current ADHD symptomatology. An additional aim was relating these results to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD criteria.
The 25-item Wender Utah Rating Scale (WURS) administered in a population-based sample of 1,599 individuals aged 65 to 80. Two subsamples each with 30 individuals were randomly drawn based on their Wender Utah Rating Scale (WURS) scores, and studied using the Wender Riktad ADHD Symtom Skala (WRASS), interview assessed Barkley Scales, and DSM-IV ADHD criteria.
Higher WURS and WRASS scores were related to higher Barkley Childhood and Current Symptoms Scales Scores. Also, reporting more symptoms on these scales was related to meeting DSM-IV criteria for childhood and current ADHD.
The results support significant persistence of ADHD symptoms when using different scales designed for the capture of childhood and current ADHD symptomatology. Further studies of ADHD in a lifespan perspective are encouraged.
To provide a better estimate of the prevalence of ADHD in adulthood, the authors complete a telephone survey of 966 randomly selected adults. They compute two diagnoses from the survey data. Participants meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for both childhood and adulthood are defined as narrow ADHD. Broad ADHD adds to that definition those meeting subthreshold criteria. Cronbach's alpha is .90 for the 18 DSM-IV symptoms in childhood and .88 when rated for current symptoms in adulthood. No one item unduly influences the reliability of the total score. The authors find similar results in separate analyses of hyperactive-impulsive and inattentive symptoms. They estimate prevalences of 2.9% for Narrow ADHD and 16.4% for Broad ADHD. Having ADHD is associated with lower levels of education and employment status. These findings suggest that adult ADHD is a common disorder associated with impaired functioning.
The authors investigate self-reported coping with interpersonal stressors among boys with and without ADHD in two studies and provide initial evidence for effects of different subgroups of ADHD on coping in Study 2.
In Study 1, 20 Austrian adolescents with ADHD were compared to 20 healthy controls. In Study 2, 44 German children and adolescents with ADHD (35 without and 9 with conduct disorders) were compared to 44 healthy controls matched by age and grade level, respectively.
Increased maladaptive coping was found in both studies. Study 2 revealed heightened maladaptive coping among both subgroups of ADHD, but the subgroup of ADHD with conduct disorders was more affected compared to healthy controls than the subgroup with ADHD alone.
Results suggest an impaired interpersonal coping style in ADHD and point to the potential benefit of stress management and social skills training for boys with ADHD. (
The Academic and Behavioral Competencies (ABC) Program, a schoolwide program to reduce classroom disruption and encourage rule following, academic task completion, and homework completion, is described. The program was initially developed and implemented in an elementary school with a high-risk population. Data from teachers, parents, and children indicate high levels of satisfaction with the program. In addition, unobtrusive measures of program impact, reported as reductions in referrals to the principal's office, suspensions, and increases in homework completion rates relative to the year prior to implementation of the program, suggest a preliminary positive impact of the program. A replication is reported for another school district, with teacher evaluations of satisfaction and effectiveness reported, supporting the flexibility and adaptability of the program. Although the present article does not constitute a systematic evaluation of the ABC Program, it presents preliminary data on the process of implementation and stakeholder satisfaction.
Children with ADHD have been widely reported to overestimate their abilities in social and academic domains, but a similar overestimation of physical abilities has not been examined. Twenty-four elementary school-age boys with ADHD and fifteen boys without ADHD were compared on their ability to accurately estimate their ability to complete four lab-based physical tasks, varying on three levels of difficulty: (a) within their ability, (b) 8% beyond their ability, and (c) 13% beyond their ability. Children with ADHD were significantly more likely than controls to overestimate their physical ability at difficult levels of the task. Implications of these results for preventing risky behaviors in children with ADHD are discussed.
The purpose of this study is to explore whether ADHD is associated with high creative ability. Sixty-seven children, ages 10 to 12 (33 ADHD and 34 controls) completed the Torrance Tests of Creative Thinking (TTCT), Maier's Two-String Problem, and the Block Design and Vocabulary subsets of the Wechsler Intelligence Scale for Children (WISC-III). The results show that there is no significant difference between the ADHD group's and control group's performance on either the TTCT, Maier's Two-String Problem, or WISC-III, suggesting that children diagnosed with ADHD are no more creative than children without the diagnosis.
There is a significant negative relation between externalizing behavior and emergent literacy skills among preschool children.
The purpose of this study was to examine the impact of gender on the predictive relation of externalizing behavior and emergent literacy in a group of 178 preschool children (mean age = 48.50 months, SD = 3.66; 48% boys).
Externalizing behaviors predicted emergent literacy over time. Distinct patterns of predictive associations dependent on gender were found. Girls with higher levels of externalizing behaviors experienced less change in their vocabulary skills compared with the vocabulary change shown by girls with lower levels of these problem behaviors.
The results suggest that early identification programs that include externalizing behavior problems and their relation with emergent literacy development should account for potential gender differences. A theoretical framework in which girls with behavior problems receive less opportunity for vocabulary acquisition is presented.
The present study aimed to investigate the effect of working memory, vocabulary, and grammar on narrative comprehension in children with ADHD.
Participants were 25 schoolchildren with ADHD and 25 typically developing (TD) children matched for chronological age and performance IQ. Children were assessed with the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), a verbal IQ test, and a story recall task.
It was shown that children with ADHD recall less information from the stories than did TD children, while they are less sensitive to the importance of the information they recall. Moreover, it was found that children with ADHD experience problems in answering factual questions. Further analysis revealed that deficiencies in narrative comprehension may be accounted for by problems in working memory.
The discussion focuses on the role of working memory in narrative comprehension and the implications of these findings for intervention approaches.
Investigated the relationship between selective and sustained attention and social behavior in children with different degrees of attentional disturbance.
Participants were 101 6- to 12-year-old children, including 18 who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), 61 who were clinically referred for attentional difficulties but did not meet criteria for ADHD, and 22 typically developing children. Two groups of children completed either a sustained attention task or a selective attention task. Task performance was compared with teacher reported social behavior.
In support of the investigator's hypothesis poor performance on the sustained attention task correlated with social behavior problems. However, contrary to expectation, poor performance on the selective attention task was not correlated with teacher reported social problems. Results are discussed with specific emphasis on the need to identify underlying cognitive contributions to social dysfunction.
The findings support a growing body of research highlighting the negative relationship between inattention and social functioning.
To evaluate the time estimation abilities of college students with ADHD on a novel, complex task that approximated academically oriented activities.
Totally 20 college students with ADHD were compared to a sample of 20 non-ADHD students. Both groups completed a task, and scores were obtained for time to complete the task, errors made, prospective time estimate, confidence in estimate, and retrospective time estimate. In addition, scores were calculated for the difference between prospective estimate and actual time as well as the difference between retrospective estimate and actual time.
Controlling for cognitive ability, the ADHD participants were significantly different from the non-ADHD participants on all dependent measures except confidence and errors.
College students with ADHD showed retrospective time estimation difficulties that may be related to academic functioning in the college setting.
ADHD is a lifelong condition, but it remains understudied in older adults. We examined the effects of ADHD-related inattention and hyperactivity symptoms on cognitive abilities in middle-age adults.
ADHD symptoms and cognitive abilities were accessed in a population-based sample (N = 2,091). Multiple regression analyses evaluated the effect of dimensional and categorical measures of ADHD on performance in cognitive tests.
ADHD symptoms are negatively associated with measures of reaction time, processing speed, task-switching, mental flexibility, and an aggregate measure of cognition. Inattention and hyperactive symptoms have reciprocal effects on performance in some cognitive tasks. Significant subclinical effects are present.
Our demonstration that cognitive effects of ADHD symptoms are present in the middle-age population provides the impetus to investigate whether these effects contribute to cognitive decline in late age and whether identification and treatment of ADHD symptoms in middle age might be effective in reducing late-age cognitive decline.
The comorbidity of ADHD and reading difficulties (ADHD + RD) is believed to be a disability distinct from ADHD alone, with unique challenges faced by individuals suffering from one disability versus the other. We aimed to examine the differential effect of 8 weeks of cognitive training on reading abilities and on executive functions, through use of the Wisconsin task, in children with ADHD and in children with ADHD + RD. Greater impairments in reading and executive functions, especially in speed of processing, were found in the comorbid group at baseline. The comorbid group showed greater improvements in most measures after training as well. We propose that the cognitive training used in the present study affected not only the immediate abilities of executive functioning but also the secondary ability of reading, especially in the comorbid group, by improving in particular, speed of processing. We suggest that a differential approach should be taken when treating children with ADHD + RD versus treating ADHD children. (J. of Att. Dis. 2013; XX(X) 1-XX).
ADHD is a common, heritable disorder of childhood. Sex chromosome abnormalities are relatively rare conditions that are sometimes associated with behavioral disorders.
The authors present a male child with ADHD and a major de-novo Y chromosome abnormality consisting of deletion of the long arm and duplication of the short arm. It is possible that the Y chromosomal abnormality is causing the ADHD syndrome in this boy.
Considering this case and considering that (a) ADHD is more common in boys than in girls, (b) the transmission of some genes associated with ADHD may occur preferentially from fathers rather than from mothers, and (c) ADHD is more common in children with XYY syndrome and Turner's syndrome than in other children, the authors propose that the sex chromosomes may contain risk genes for ADHD.
The authors examine how many Aboriginal children attending two reservation-based elementary schools in Northern Alberta, Canada, would demonstrate symptoms associated with ADHD using standardized parent and teacher questionnaires.
Seventy-five Aboriginal children in Grades 1 through 4 are tested. Seventeen of the 75 (22.7%) Aboriginal children demonstrated a match on parent and teacher forms, with T-scores greater than 1.5 standard deviations from the mean on the Conners' ADHD Index, Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) Hyperactive/Impulsive Index, DSM-IV Inattentive Index, and/or DSM-IV Total Combined T-score.
The number of Aboriginal children found to have symptoms associated with ADHD is significantly higher than expected based on prevalence rates in the general population.
These findings suggest either a high prevalence of ADHD in Aboriginal children or unique learning and behavioral patterns in Aboriginal children that may erroneously lead to a diagnosis of ADHD if screening questionnaires are used.
Patients with ADHD display a decreased contingent negative variation in Go/NoGo tasks. It is unclear whether the attenuation is due to deficits of executive function or to disorder of motor planning. The readiness potential (RP) recorded during self-initiated movements could cast light on this question.
RP was recorded in 25 stably medicated adult ADHD patients and 21 healthy controls matched for age, education, and verbal IQ. Participants also completed neuropsychological tests of executive function.
Compared with healthy controls, ADHD patients showed significantly diminished RP peaks and also decreased negativity in preparation of the movement at frontal locations. There were no significant group differences with regard to tests of executive function.
In adults with ADHD, deficits of motor organization are also manifest in situations not involving external stimulus processing. The attenuated RP occurred in the absence of executive dysfunction. Results are consistent with partial independence between motor and executive dysfunction in ADHD.
Some studies conducted on ADHD have found a statistically significant relationship between those diagnosed with the disorder and a higher susceptibility to abuse alcohol. However, other studies have found no such correlation, or have found this to be true of only a nonstatistically significant subset of the population of individuals with ADHD. This research found an answer to what may be causing these discrepancies in findings. Various studies on ADHD have discovered both biological and cognitive differences in some individuals with ADHD that may be responsible for this predisposition toward alcohol abuse found in a subset of the ADHD population. It is proposed that those individuals diagnosed with ADHD who also have a mutation in the dopamine receptor D4 (DRD4) and who possess a deficiency in functionality of the prefrontal area of the brain designed for planning and reasoning may be more likely to develop alcohol abuse. (J. of Att. Dis. 2011; XX(X) 1-XX).
ADHD is a common comorbid condition with substance use disorder. This study seeks to examine the discrepancy in the prevalence rate between those previously diagnosed with ADHD and those diagnosed while in treatment. It is hypothesized that clients with ADHD would have earlier unsuccessful terminations from treatment than non-ADHD clients and that the ADHD Self-Report Scale (ASRS Version 1.1) would be a reliable predictor.
Participants (N = 87) are admitted to a publicly funded 28-day residential treatment program. All participants are screened with the ASRS and participate in a clinical assessment evaluation.
A significant difference is found between the clinical record rate of 3.44% and the 43.68% rate found during treatment. The ASRS significantly predicts ADHD. Conclusions: The use of the ASRS is recommended and should be incorporated into standard intake assessment protocols. Careful diagnostic interviews are urged to determine if clients in residential treatment have ADHD.
This article reviews pharmacological, animal, and human evidence regarding the abuse liability of methylphenidate (MPH). Findings are not always consistent, but evidence converges to suggest that although intravenous methylphenidate has some abuse potential, there is very little potential for oral MPH abuse. Furthermore, the available data suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) who are treated with MPH are at lower risk for substance use disorder later in life. More longitudinal, prospective studies are needed to assess the long term effects of MPH treatment in ADHD.
To examine nonmedical use (NMU) of prescription ADHD stimulants among adults evaluated for substance abuse treatment.
147,816 assessments from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) system (10/01/2009 through 03/31/2012) examined NMU prevalence, routes of administration (ROA), and diversion sources.
Past 30-day NMU for prescription stimulants (1.29%) was significantly lower than that of prescription opioids (19.79%) or sedatives (10.62%). For stimulant products, NMU for Adderall was 0.62, followed by Adderall XR (0.42), Ritalin (0.16), Vyvanse (0.12), and Concerta (0.08); product differences likely have limited clinical relevance given the low estimates (<1%). Higher NMU per prescriptions was for Adderall (4.92), Ritalin (4.68), and Adderall XR (3.18) compared with newer formulations (Vyvanse 1.26, Concerta 0.89). Diversion source was mainly family/friends with no differences between products; swallowing whole was the most frequent ROA.
Prescription stimulant NMU was low compared with other prescription medications among individuals assessed for substance abuse problems, with little difference among specific products.