Article

Preliminary Findings for the Effectiveness of Whole Green Coffee Powder (WGCP) Versus Placebo in a Double-blind Withdrawal Design Study with Young Adults on Three Tasks of Executive Function

Authors:
  • Independent Researcher
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

OBJECTIVE: This study compared relative effects of whole green coffee powder (WGCP) on cognitive functioning in neurotypical adults under three treatment conditions: placebo (A), low-dose 889.9 mg WGCP (B1), and moderate-dose 1334.4 mg WGCP (B2). METHOD: Fourteen adults aged 18–25 years, acted as their own controls in three treatment conditions within a seven-session withdrawal design. Participants completed the Cambridge Neuropsychological Test Automated Battery for attention-deficit/hyperactivity disorder (ADHD) at each ses-sion. The Side Effects Behavior Monitoring Scale (SEBMS), used to assess stimulant effects in individuals with ADHD, was a secondary outcome measure to assess adverse events associated with caffeine intake delivered by capsule. Self-report of qualitative effects was collected. RESULTS: Results indicated that moderate doses of WGCP significantly improved sustained attention (vs placebo and low dose) and working memory (vs low dose only) but had no effect on response inhibition. Low doses of WGCP showed decreased sustained attention. Fifty percent of subjects reported positive subjective improvement in well-being. No side effects were reported. CONCLUSION: Commercially available WGCP (ie, sold as GoBean®) in moderate doses improved executive functioning for sustained attention and working memory but had no effect on response inhibition. Implications for individuals with attention difficulties are discussed.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
Since its first publication, the Clinical Global Impression Scale (CGI) has become one of the most widely used assessment instruments in psychiatry. Although some conflicting data has been presented, studies investigating the CGI's validity have only rarely been conducted so far. It is unclear whether the improvement index CGI-I or a difference score of the severity index CGI-S (dif) is more valid in depicting clinical change. The current study examined the validity of these two measures and investigated whether therapists' CGI ratings correspond to the view the patients themselves have on their condition. Thirty-one inpatients of a German psychotherapeutic hospital suffering from a major depressive disorder (age M = 45.3, SD = 17.2; 58.1% women) participated. Patients filled in the Beck Depression Inventory (BDI). CGI-S and CGI-I were rated from three perspectives: the treating therapist (THER), the team of therapists involved in the patient's treatment (TEAM), and the patient (PAT). BDI and CGI-S were filled in at admission and discharge, CGI-I at discharge only. Data was analysed using effect sizes, Spearman's ρ and intra-class correlations (ICC). Effect sizes between CGI-I and CGI-S (dif) ratings were large for all three perspectives with substantially higher change scores on CGI-I than on CGI-S (dif). BDI (dif) correlated moderately with PAT ratings, but did not correlate significantly with TEAM or THER ratings. Congruence between CGI-ratings from the three perspectives was low for CGI-S (dif) (ICC = .37; Confidence Interval [CI] .15 to .59; F(30,60) = 2.77, p < .001; mean ρ = 0.36) and moderate for CGI-I (ICC = .65 (CI .47 to .80; F(30,60) = 6.61, p < .001; mean ρ = 0.59). Results do not suggest a definite recommendation for whether CGI-I or CGI-S (dif) should be used since no strong evidence for the validity of neither of them could be found. As congruence between CGI ratings from patients' and staff's perspective was not convincing it cannot be assumed that CGI THER or TEAM ratings fully represent the view of the patient on the severity of his impairment. Thus, we advocate for the incorporation of multiple self- and clinician-reported scales into the design of clinical trials in addition to CGI in order to gain further insight into CGI's relation to the patients' perspective.
Article
Full-text available
Attentional control has been conceptualized as executive functioning by neuropsychologists and as working memory capacity by experimental psychologists. We examined the relationship between these constructs using a factor analytic approach in an adult life span sample. Several tests of working memory capacity and executive function were administered to more than 200 subjects between 18 and 90 years of age, along with tests of processing speed and episodic memory. The correlation between working memory capacity and executive functioning constructs was very strong (r = .97), but correlations between these constructs and processing speed were considerably weaker (rs ≈ .79). Controlling for working memory capacity and executive function eliminated age effects on episodic memory, and working memory capacity and executive function accounted for variance in episodic memory beyond that accounted for by processing speed. We conclude that tests of working memory capacity and executive function share a common underlying executive attention component that is strongly predictive of higher level cognition.
Article
Full-text available
The effects of caffeine on cognition were reviewed based on the large body of literature available on the topic. Caffeine does not usually affect performance in learning and memory tasks, although caffeine may occasionally have facilitatory or inhibitory effects on memory and learning. Caffeine facilitates learning in tasks in which information is presented passively; in tasks in which material is learned intentionally, caffeine has no effect. Caffeine facilitates performance in tasks involving working memory to a limited extent, but hinders performance in tasks that heavily depend on working memory, and caffeine appears to rather improve memory performance under suboptimal alertness conditions. Most studies, however, found improvements in reaction time. The ingestion of caffeine does not seem to affect long-term memory. At low doses, caffeine improves hedonic tone and reduces anxiety, while at high doses, there is an increase in tense arousal, including anxiety, nervousness, jitteriness. The larger improvement of performance in fatigued subjects confirms that caffeine is a mild stimulant. Caffeine has also been reported to prevent cognitive decline in healthy subjects but the results of the studies are heterogeneous, some finding no age-related effect while others reported effects only in one sex and mainly in the oldest population. In conclusion, it appears that caffeine cannot be considered a ;pure' cognitive enhancer. Its indirect action on arousal, mood and concentration contributes in large part to its cognitive enhancing properties.
Article
Full-text available
Objective: This study assesses the misuse and diversion of prescribed attention-deficit/hyperactivity disorder (ADHD) medications. Method: One hundred fifteen students, attending two universities, with prescriptions for ADHD medications completed a Web survey in spring 2007. Results: Eighty-nine of 115 students (69%) used their ADHD medications as prescribed, whereas 36 (31%) had misused during college by taking larger or more frequent doses than prescribed or by using someone else’s medication. Nine students (8%) reported intranasal use during the previous 6 months, and 30 (26%) had diverted medications to peers. Misuse was associated with impulsivity and with other substance use. Enhancing the ability to study outside of class was students’ primary motive for misuse, but nonacademic reasons were also reported. Students who misused ADHD medications generally felt that doing so was helpful. Conclusions: Although most students use their ADHD medication as prescribed, misuse and diversion is not uncommon. Because enhancing academic performance was the primary motive for misuse, the results raise questions about whether undergraduates with ADHD perceive their treatment as adequate and the extent to which physicians and students communicate about issues related to medication adjustments. (J. of Att. Dis. 2009; 13(2) 144-153)
Article
Full-text available
Although the subjective effects of caffeine abstinence, acute and chronic administration, and tolerance are well described, the corresponding neurophysiological effects are not. Caffeine withdrawal, acute caffeine effects, caffeine tolerance, and net beneficial effects of chronic caffeine administration were investigated using cerebral blood flow velocity, quantitative electroencephalography (EEG), and subjective effects. Sixteen regular caffeine users participated in this double-blind, within-subject study during which they received acute caffeine and placebo challenges (1) while maintained on 400 mg caffeine daily for > or =14 days and (2) while maintained on placebo for > or =14 days. Blood flow velocity was determined for the middle (MCA) and anterior (ACA) cerebral arteries using pulsed transcranial Doppler sonography. EEG was recorded from 16 scalp sites. Subjective effects were assessed with questionnaires. Acute caffeine abstinence (evaluated 24 h after placebo substitution) increased mean, systolic, and diastolic velocity in the MCA and ACA and decreased pulsatility index in the MCA. Acute caffeine abstinence increased EEG theta and decreased beta 2 power. Acute caffeine abstinence also increased measures of Tired, Fatigue, Sluggish, and Weary and decreased ratings of Energetic, Friendly, Lively, and Vigor. Acute caffeine effects were demonstrated across a wide range of measures, including cerebral blood flow, EEG, and subjective effects. Tolerance and "complete" tolerance were observed on subjective but not physiological measures. Chronic caffeine effects were demonstrated only on the measure of EEG beta 2 power. Acute caffeine abstinence and administration produced changes in cerebral blood flow velocity, EEG, and subjective effects. Tolerance to subjective but not physiological measures was demonstrated. There was almost no evidence for net effects of chronic caffeine administration on these measures. Overall, these findings provide the most rigorous demonstration to date of physiological effects of caffeine withdrawal.
Article
Full-text available
Attention plays an essential role in the construction of the mental models necessary to make sense of ongoing events. In this article, we consider the implications of temporary inattention during reading for the construction and updating of the situation model during text comprehension. We examined how self-reported mind wandering during reading relates to the online construction of the situation model of the narrative, which in this case involved the pseudonym used by a villain in a detective novella. In successful readers, mind wandering without awareness, referred to as zoning out, was less frequent when the text revealed a clue about the villain's identity. Additional analyses indicated that mind wandering interfered with the construction of the situation model independent of the participants' ability to retrieve factual information. The analysis of the temporal consequences of zoning out indicated that lapses had the greatest influence when they occurred early in the narrative. These results confirm the intuition that zoning out during reading is an indication that the construction of the situation model has gone awry, and underscore the fact that our ability to understand ongoing events depends on the ability to pay attention when it matters.
Article
Full-text available
In a residential research ward the reinforcing and subjective effects of caffeine were studied under double-blind conditions in volunteer subjects with histories of heavy coffee drinking. In Experiment 1, 6 subjects had 13 opportunities each day to self-administer either a caffeine (100 mg) or a placebo capsule for periods of 14 to 61 days. All subjects developed a clear preference for caffeine, with intake of caffeine becoming relatively stable after preference had been attained. Preference for caffeine was demonstrated whether or not preference testing was preceded by a period of 10 to 37 days of caffeine abstinence, suggesting that a recent history of heavy caffeine intake (tolerance/dependence) was not a necessary condition for caffeine to function as a reinforcer. In Experiment 2, 6 subjects had 10 opportunities each day to self-administer a cup of coffee or (on different days) a capsule, dependent upon completing a work requirement that progressively increased and then decreased over days. Each day, one of four conditions was studied: caffeinated coffee (100 mg/cup), decaffeinated coffee, caffeine capsules (100 mg/capsule), or placebo capsules. Caffeinated coffee maintained the most self-administration, significantly higher than decaffeinated coffee and placebo capsules but not different from caffeine capsules. Both decaffeinated coffee and caffeine capsules were significantly higher than placebo capsules but not different from each other. In both experiments, subject ratings of "linking" of coffee or capsules covaried with the self-administration measures. These experiments provide the clearest demonstrations to date of the reinforcing effects of caffeine in capsules and in coffee.
Article
Full-text available
Despite being the most widely consumed psychoactive substance in the world, there is considerable confusion regarding the effects of caffeine. This study examined objective indices of performance, and self-reported mood, headache, and sleep in 36 healthy male and female habitual caffeine consumers exposed to a pattern of moderate intake. A double-blind placebo-controlled cross-over design with counterbalancing was employed in which all subjects participated in four experimental conditions involving the ingestion of placebo or caffeine 3 times daily for 6 days followed by a 7th (challenge) day of placebo or caffeine ingestion. No evidence was found that caffeine improved performance, either in the context of acute or habitual use. On the contrary, performance was found to be significantly impaired when caffeine was withdrawn abruptly following habitual use. Participants reported feeling more alert and less tired following acute ingestion of caffeine, but feeling less alert in conjunction with chronic exposure to the drug. In addition, caffeine withdrawal was associated with reported increases in frequency and severity of headache, and with reports of sleeping longer and more soundly.
Article
Full-text available
The literature suggests that the following effects on behavior of adult humans may occur when individuals consume moderate amounts of caffeine. (1) Caffeine increases alertness and reduces fatigue. This may be especially important in low arousal situations (e.g. working at night). (2) Caffeine improves performance on vigilance tasks and simple tasks that require sustained response. Again, these effects are often clearest when alertness is reduced, although there is evidence that benefits may still occur when the person is unimpaired. (3) Effects on more complex tasks are difficult to assess and probably involve interactions between the caffeine and other variables which increase alertness (e.g. personality and time of day). (4) In contrast to the effects of caffeine consumption, withdrawal of caffeine has few effects on performance. There is often an increase in negative mood following withdrawal of caffeine, but such effects may largely reflect the expectancies of the volunteers and the failure to conduct "blind" studies. (5) Regular caffeine usage appears to be beneficial, with higher users having better mental functioning. (6) Most people are very good at controlling their caffeine consumption to maximise the above positive effects. For example, the pattern of consumption over the day shows that caffeine is often consumed to increase alertness. Indeed, many people do not consume much caffeine later in the day since it is important not to be alert when one goes to sleep. In contrast to effects found from normal caffeine intake, there are reports that have demonstrated negative effects when very large amounts are given or sensitive groups (e.g. patients with anxiety disorders) were studied. In this context caffeine has been shown to increase anxiety and impair sleep. There is also some evidence that fine motor control may be impaired as a function of the increase in anxiety. Overall, the global picture that emerges depends on whether one focuses on effects that are likely to be present when caffeine is consumed in moderation by the majority of the population or on the effects found in extreme conditions. The evidence clearly shows that levels of caffeine consumed by most people have largely positive effects on behavior. Excessive consumption can lead to problems, especially in sensitive individuals.
Article
As prescriptions for stimulant medication to treat ADHD have increased, so have concerns about the nonmedical use and diversion of stimulant medication, especially among college students. There is also growing concern about young adults feigning ADHD in order to receive a prescription for stimulant medication. This paper summarizes recent research on the nonmedical use and diversion of stimulant medication with a focus on the prevalence of these behaviors, motivations for nonmedical use, factors associated with nonmedical use, and the consequences of such use. Research on the medical misuse of prescribed medication and malingering to obtain a diagnosis of ADHD is also discussed.
Article
Objective The Clinical Global Impression Scale (CGI) is established as a core metric in psychiatric research. This study aims to test the validity of CGI as a clinical outcome measure suitable for routine use in a private inpatient setting. Methods The CGI was added to a standard battery of routine outcome measures in a private psychiatric hospital. Data were collected on consecutive admissions over a period of 24 months, which included clinical diagnosis, demographics, service utilization and four routine measures (CGI, HoNOS, MHQ‐14 and DASS‐21) at both admission and discharge. Descriptive and comparative data analyses were performed. Results Of 786 admissions in total, there were 624 and 614 CGI‐S ratings completed at the point of admission and discharge, respectively, and 610 completed CGI‐I ratings. The admission and discharge CGI‐S scores were correlated ( r = 0.40), and the indirect improvement measures obtained from their differences were highly correlated with the direct CGI‐I scores ( r = 0.71). The CGI results reflected similar trends seen in the other three outcome measures. Conclusions The CGI is a valid clinical outcome measure suitable for routine use in an inpatient setting. It offers a number of advantages, including its established utility in psychiatric research, sensitivity to change, quick and simple administration, utility across diagnostic groupings, and reliability in the hands of skilled clinicians.
Article
Recent behavioral and neuroscientific evidence speaks to the question of whether the human focus of attention is limited to a single item or can accommodate several items. This issue is fundamental to an understanding of the nature of human cognition and brain function. Here I review evidence from visual working memory tasks and suggest that it supports the concept of a focus of attention that can include several items at once as a core vehicle of working memory, regardless of the stimulus modality. One brain area in particular, the left intraparietal sulcus (IPS), seems critically important in the network underlying the focus of attention as a working memory storage mechanism. This view is reconciled with evidence previously taken to indicate that the focus of attention only includes a single item at a time, which is reinterpreted here.
Article
The main aim of this study was to examine the age-dependent persistence of attention-deficit hyperactivity disorder (ADHD) in boys transitioning from adolescence into early adulthood attending to different definitions of persistence. We conducted a 10-year follow-up study (mean follow-up time=11 years) of 110 boys with ADHD and 105 non-ADHD controls. Both groups were 6-17 years of age at ascertainment. ADHD was considered persistent at follow-up if subjects met full or subthreshold (more than half of the symptoms required for a full diagnosis) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV) diagnostic criteria, failed to attain functional remission (Global Assessment of Functioning, GAF score < or =60) or were receiving treatment for ADHD. While 65% of children with ADHD no longer met full DSM-IV criteria for ADHD at the 10-year follow-up, 78% of subjects met at least one of our definitions of persistence. Persistence as described above was associated with more psychiatric co-morbidity, more familiality with mood disorders and higher levels of educational and interpersonal impairments than controls. This 10-year longitudinal follow-up study shows that the majority of ADHD boys experience persistent symptoms and functional impairments into early adulthood. Persistence of ADHD is associated with greater psychiatric comorbidity, familiality and functional impairments.
Article
The effects of caffeine on mood and memory tasks were investigated in a double-blind study of 95 healthy young adults who were randomly assigned to three doses: 0, 200, and 400 mg of oral administration of caffeine. Subjects completed a battery of tasks once predrug and several times postdrug. Caffeine, in general, showed nonsignificant effects on cognitive, learning, and memory performance. The exception is that 200 mg caffeine facilitated performance on the relatively more difficult cancellation (addition and multiplication) tasks than the digit cancellation task. In addition caffeine decreased boredom and relaxation, and increased other ratings of subjective moods--anxiousness, tenseness, and nervousness. The reduction in boredom or fatigue is associated with the repetitive nature of the task and the period of time during which the tasks were repeated. In general, high-to-moderate users of caffeine recalled more words than low users, particularly at the beginning of the lists. Results are discussed in terms of the effects of caffeine on task difficulty and sensitivity and the relative potency of caffeine doses on behavior. User effect is suggested as an important consideration of memory assessment.
Article
The CANTAB battery was developed for the assessment of cognitive deficits in humans with neurodegenerative diseases or brain damage. It consists of a series of interrelated computerized tests of memory, attention, and executive function, administered via a touch sensitive screen. It allows a decomposition of complex tasks commonly used in clinical assessment into their cognitive components and enables the extrapolation of findings from the animal literature. Tests include versions of the Wisconsin Card-Sorting Test and the Tower and London and also the Delayed Matching-to-Sample test, widely used in monkeys for visual recognition memory. The tests are constructed in such a way that they may be given to animals (monkeys) with minimal change. The nonverbal nature of the CANTAB tests makes them largely language independent and culture free. CANTAB has been standardized on a large, predominantly elderly, population and validated in neurosurgical patients as well as in patients with basal ganglia disorders, Alzheimer's disease, depression, and schizophrenia. In addition, CANTAB has been used to evaluate: a) the therapeutic effects of dopaminergic and cholinergic medication in neurodegenerative disease; b) cognition in 5-11-year-old normal, learning-disabled, and autistic children; c) deficits in patients with HIV infection; and d) early, asymptomatic Huntington's disease. The latter illustrate its usefulness in early identification of progressive disorders. It is suggested that the battery should have particular utility across a wide range of age and intelligence in longitudinal assessment after exposure to toxicants, and allow meaningful comparison with experimental studies of toxic effects in other species.
Article
Neuropsychological test batteries are repeatedly administered to evaluate changes over time or the effects of clinical interventions. Relationships between scores on different tests within batteries are also examined to test models for associations between functional deficits. These comparisons may be misleading unless Test/Re-test reliability for individual tests is satisfactory. Interpretations of repeated measurements also depend on the extent to which improvement with practice varies between tasks and between more and less able individuals. Test/Re-test correlations and practice effects for two neuropsychological test batteries (CANTAB, ISPOCD) and from laboratory tasks commonly used in cognitive assessments of older people were obtained from large groups of healthy elderly. Tests in neuropsychological batteries varied markedly in test/re-test reliability which, in some cases, fell below levels considered methodologically acceptable. Putative measures of 'frontal' or 'executive' function, in which performance may be markedly improved by abrupt discovery of an appropriate strategy, were especially likely to show low reliability. Most tests showed significant practice effects, and on some these are substantial enough to compromise comparisons on repeated testing. On a minority of tests practice effects were counter-intuitive, in that less able showed significantly more gains than more able individuals.
Article
There is little evidence concerning the effects of caffeine in doses typical of one cup of tea. The present study investigated the effect of 60 mg caffeine, consumed in either tea or hot water, on performance on a subset of the CANTAB test battery. Eight males participated in a practice session and four test sessions. In each test session, the participant consumed a different hot beverage and then, over approximately 90 min, completed nine tests from the CANTAB battery. The four beverages were created by crossing beverage identity (tea or hot water) and caffeine dose (0 or 60 mg). Significant speeding of reaction time by caffeine consumption was found in pattern recognition, delayed match to sample, and match to sample visual search. The effect on reaction time of 60 mg caffeine can be detected, and may be evident within minutes of consumption. Objective reports of immediate beneficial effects of consumption, most research has postponed measurement to coincide with peak plasma caffeine levels (Blanchard and Sawers 1983). The intention of the present study was to investigate the effects of consuming a single cup of tea on a variety of cognitive tests. Testing began immediately after consumption and lasted approximately 80 min.
Article
Caffeine is present in many widely consumed drinks and some foods. In the fairly extensive literature on the psychostimulant effects of caffeine, there are few dose-response studies and even fewer studies of the effects of doses of caffeine lower than 50 mg (the range of the amounts of caffeine contained in, for example, a typical serving of tea or cola). This study measured the effects of 0, 12.5, 25, 50 and 100 mg caffeine on cognitive performance, mood and thirst in adults with low and moderate to high habitual caffeine intakes. This was a double-blind, within-subjects study. Following overnight caffeine abstinence, participants (n=23) completed a test battery once before and three times after placebo or caffeine administration. The test battery consisted of two performance tests, a long duration simple reaction time task and a rapid visual information processing task, and a mood questionnaire (including also an item on thirst). Effects on performance and mood confirmed a psychostimulant action of caffeine. All doses of caffeine significantly affected cognitive performance, and the dose-response relationships for these effects were rather flat. The effects on performance were more marked in individuals with a higher level of habitual caffeine intake, whereas caffeine increased thirst only in low caffeine consumers. After overnight caffeine abstinence, caffeine can significantly affect cognitive performance, mood and thirst at doses within and even lower than the range of amounts of caffeine contained in a single serving of popular caffeine-containing drinks. Regular caffeine consumers appear to show substantial tolerance to the thirst-increasing but not to the performance and mood effects of caffeine.
Article
The present study evaluated the association between habitual caffeine intake via coffee and tea and cognitive performance. This was done as part of a larger research programme into the determinants of cognitive ageing (the Maastricht Aging Study: MAAS). Possible withdrawal effects that may have explained in part the positive association between performance and intake in an earlier study were controlled for. In addition, all cognitive tests in this study were administered under strict laboratory conditions. A group of 1875 healthy adults, stratified for age (range 24 - 81 years), sex, and general ability, were screened for habitual intake of coffee and tea and took part in extensive cognitive testing. Multiple regression analysis with control for age, sex, socio-demographic variables, and substance use showed that habitual caffeine consumption was significantly related to better long-term memory performance and faster locomotor speed. No relationships were found between habitual caffeine consumption and short-term memory, information processing, planning, and attention as measured with the Stroop Test. Moreover, no difference in sensitivity to caffeine intake between different age groups was found, suggesting that caffeine intake did not counteract age-related cognitive decline. Several recommendations are made to improve the design of future studies in this field. Copyright 2000 John Wiley & Sons, Ltd.
Article
This study examined the persistence of attention deficit hyperactivity disorder (ADHD) into adulthood. We analyzed data from published follow-up studies of ADHD. To be included in the analysis, these additional studies had to meet the following criteria: the study included a control group and it was clear from the methods if the diagnosis of ADHD included subjects who did not meet full criteria but showed residual and impairing signs of the disorder. We used a meta-analysis regression model to separately assess the syndromatic and symptomatic persistence of ADHD. When we define only those meeting full criteria for ADHD as having 'persistent ADHD', the rate of persistence is low, approximately 15% at age 25 years. But when we include cases consistent with DSM-IV's definition of ADHD in partial remission, the rate of persistence is much higher, approximately 65%. Our results show that estimates of ADHD's persistence rely heavily on how one defines persistence. Yet, regardless of definition, our analyses show that evidence for ADHD lessens with age. More work is needed to determine if this reflects true remission of ADHD symptoms or is due to the developmental insensitivity of diagnostic criteria for the disorder.
Article
The objective of this study was to evaluate functional impairments in a nonreferred sample of adults identifying themselves as having been diagnosed with attention-deficit/hyperactivity disorder (ADHD) by a clinician in their community. We completed a survey in April and May 2003 of a community sample of 500 adults who reported having received a diagnosis of ADHD in the community and 501 gender- and age-matched comparisons from a national sample representative of the U.S. population. Adults with self-reports of diagnosed ADHD in the community were significantly less likely to have graduated high school (83% vs. 93% of controls; p < or = .001) or obtain a college degree (19% vs. 26%; p < .01), were less likely to be currently employed (52% vs. 72%; p < or = .001), and had significantly more mean job changes over 10 years (5.4 vs. 3.4 jobs; p < or = .001). They also were significantly more likely to have been arrested (37% vs. 18% of controls; p < or = .001) or divorced (28% vs. 15%; p < or = .001) and were significantly less satisfied (p < or = .001) with their family, social, and professional lives. Adults who reported having received a diagnosis of ADHD in the community had significant impairment in multiple domains of functioning compared with age- and gender-matched controls without this diagnosis, highly consistent with findings derived from carefully diagnosed referred samples.
Article
The Clinical Global Impression Scale (CGI) is established as a core metric in psychiatric research. This study aims to test the validity of CGI as a clinical outcome measure suitable for routine use in a private inpatient setting. The CGI was added to a standard battery of routine outcome measures in a private psychiatric hospital. Data were collected on consecutive admissions over a period of 24 months, which included clinical diagnosis, demographics, service utilization and four routine measures (CGI, HoNOS, MHQ-14 and DASS-21) at both admission and discharge. Descriptive and comparative data analyses were performed. Of 786 admissions in total, there were 624 and 614 CGI-S ratings completed at the point of admission and discharge, respectively, and 610 completed CGI-I ratings. The admission and discharge CGI-S scores were correlated (r = 0.40), and the indirect improvement measures obtained from their differences were highly correlated with the direct CGI-I scores (r = 0.71). The CGI results reflected similar trends seen in the other three outcome measures. The CGI is a valid clinical outcome measure suitable for routine use in an inpatient setting. It offers a number of advantages, including its established utility in psychiatric research, sensitivity to change, quick and simple administration, utility across diagnostic groupings, and reliability in the hands of skilled clinicians.
Unpublished rating scale, Cleveland Clinic, Center for Pediatric Behavioral Health
  • M Manos
Manos M. Side Effects/Behavior Monitoring Scale. Unpublished rating scale, Cleveland Clinic, Center for Pediatric Behavioral Health. Cleveland Clinic, Cleveland, OH, 2003.
What Causes ADHD? Understanding What Goes Wrong and Why
  • T Niggj
Nigg JT. What Causes ADHD? Understanding What Goes Wrong and Why. New York, NY: Guilford Press; 2006:113-115.
The Methylxanthime Beverages and Foods, Chemical Consumption and Health Effects
  • R M Gilbert
Gilbert RM. Caffeine consumption. In: Spiller GA, ed. The Methylxanthime Beverages and Foods, Chemical Consumption and Health Effects. New York: Liss; 1984:185-214.