Search

Objective: Behavioral economic theory suggests that alcohol risk is related to elevated alcohol reinforcing efficacy (demand) combined with diminished availability of reinforcing substance-free activities, but little research has examined these reward-related processes at the daily level in association with comorbid conditions that might influence behavioral patterns and reward. Young people with attention-deficit/hyperactivity disorder (ADHD) report high levels of risky drinking, and this risk may be due in part to elevated demand for alcohol and diminished engagement in enjoyable and valued substance-free activities. Method: College student drinkers (N = 101; 48.5% female; 68.3% White; 18–22 years old) with (n = 51) and without (n = 50) ADHD completed 14 consecutive daily diaries (diary entry n = 1,414). We conducted a series of multilevel path models to examine (a) the associations among ADHD and average daily alcohol demand, substance-free enjoyment, and response contingent positive reinforcement (RCPR) for goal-directed behaviors; (b) the associations among concurrent daily alcohol demand, substance-free reinforcement, and RCPR for goal-directed behaviors and daily alcohol use and alcohol-related negative consequences; and (c) the moderating effect of ADHD on these within-day associations. Results: ADHD was significantly associated with more daily alcohol-related negative consequences and less daily substance-free enjoyment and RCPR. Regardless of ADHD status, there were significant associations among behavioral economic risk factors and alcohol use and negative consequences, though effects differed within and between persons. There were no moderating effects of ADHD on within-person associations. Conclusions: Results expose areas of impairment specific to drinkers with ADHD and advance theory on ADHD and hazardous drinking. Public Health Significance Statement: This study indicates that college student drinkers with attention-deficit/hyperactivity disorder (ADHD) experience more alcohol-related negative consequences and higher rates of impairment in their daily substance-free lives, relative to their peers without ADHD. This study also highlighted significant daily effects of alcohol demand, substance-free reinforcement, and positive reinforcement for goal-directed behaviors on alcohol use and/or alcohol-related negative consequences, regardless of ADHD status. [ABSTRACT FROM AUTHOR]

This is a commentary on Danielson and colleagues' report entitled "ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment," which provides updated prevalence rates related to ADHD diagnosis and treatment utilization using data from the 2022 National Survey of Children's Health (NSCH). This timely article is among the first to report on ADHD prevalence rates since the COVID-19 pandemic, and highlights important patterns related to ADHD diagnosis and treatment utilization. In this commentary, we contextualize these findings with consideration to the COVID-19 pandemic and within the existing literature on health disparities among youth with ADHD and their families. We end with recommendations for future work involving researchers, clinicians, and policymakers with the intention of reducing disparities in ADHD diagnosis and treatment in the U.S. [ABSTRACT FROM AUTHOR]

One method for addressing barriers disabled college students face is by increasing access to academic accommodations. However, for college students with ADHD, little is known about the associations between receipt of accommodations and academic performance, behavioral functioning, and mood status. Considering college students with ADHD are at a higher risk of experiencing academic difficulties and internalizing symptoms compared to their peers without ADHD, further research into these relations is warranted. To address the existing knowledge gap, we compared academic, behavioral, and mood functioning among college student drinkers with ADHD who self-reported having been granted academic accommodations (n = 23) to those who denied ever receiving academic accommodations (n = 88). The present study also explored reasons college students with ADHD receiving academic accommodations may not utilize their provided accommodations consistently. Results indicated that self-reported use of accommodations was not associated with college grade point average (GPA), self-reported symptoms of ADHD, executive dysfunction, depression, emotion dysregulation, or overall functional impairment. Common reasons for not using academic accommodations (e.g., not feeling they were needed, being too difficult to obtain) highlight the salience of cognitive and systemic barriers to utilization. The results broadly imply that academic accommodations may be perceived as beneficial by college students with ADHD, but not sufficient to improve academic performance or indirectly impact mood- and behavior-related concerns. [ABSTRACT FROM AUTHOR]

Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi‐method, longitudinal study examined whether young children's observed and parent‐reported BI in social versus non‐social contexts predicts different long‐term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non‐social contexts ("non‐social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non‐social novelty at 9 months and non‐social fear at 48 months. At 15 years, anxiety was assessed via adolescent‐ and parent‐reports, and global internalizing and externalizing problems were assessed via parent‐reports. Confirmatory factor analysis showed that a two‐factor model fit the BI data significantly better than a single‐factor model, providing evidence for the dissociation of BI in social versus non‐social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non‐social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non‐social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non‐social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems. [ABSTRACT FROM AUTHOR]

Preschoolers who display extremely inhibited behavior are at risk for the development of anxiety disorders. However, behavioral inhibition (BI) is a multifaceted characteristic. Some children with BI are fearful when confronted by unfamiliar adults, peers, and objects; others are fearful when separated from their parents. In the present study, we examined specific features of BI that predicted observed friendship formation among preschoolers who are behaviorally inhibited. We also examined whether teacher ratings of classroom behaviors predicted friendship formation. Sixty highly inhibited children (35 female, Mage = 52.57 months) were observed during eight weekly free-play sessions with initially unfamiliar inhibited peers. Free-play periods occurred before weekly intervention sessions for children with BI and their parents. An observational protocol was developed to identify children who made a friend during the eight weekly sessions. Before the first session, different subtypes of BI were assessed by parents; preschool teachers assessed the children's classroom behaviors with familiar peers. Twenty-six children met the criteria for having made and kept a friend. Probit regression analyses revealed that parent ratings of BI among unfamiliar peers and teacher ratings of children's social anxiety before the intervention were associated with a decreased probability of making a friend. No evidence was found linking children's responses to the intervention and friendship formation. Results suggest that extremelyinhibited preschoolers are capable of making friends. Implications for future research and intervention efforts that focus on individual differences of children with BI are discussed. Public Significance Statement: Behavioral inhibition (BI) is a temperament construct reflecting a child's expression of anxiety, distress, or wariness when in the company of unfamiliar people, objects, or situations. In the present study, we found that preschoolers high on BI who were able to establish a friendship with an initially unfamiliar peer were those who were less anxious when among familiar classmates than those who were unable to make a friend. Moreover, children whose inhibition tendencies were present when among unfamiliar people rather than when faced with unfamiliar objects or situations were less likely to establish a friendship. Our findings suggest that (a) BI is a multifaceted construct and (b) those preschoolers with BI who are socially anxious and who have difficulty when introduced to unfamiliar age-mates would do well to participate in interventions that are focused on the development of social skills and the regulation of wariness when in the peer group. [ABSTRACT FROM AUTHOR]