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Introduction: Adults with attention-deficit/hyperactivity disorder (ADHD) have unhealthy eating habits, associated with overweight/obesity. We explored whether they present with different food-related benefit/risk perceptions, compared to those without ADHD. Methods: One hundred five university students with (n = 36) and without (n = 69) ADHD, aged 22–30, participated in the study. They rated the level of frequency and likelihood of food consumption, as well as the perceived attractiveness, convenience, and risk of 32 healthy and unhealthy food items. Results: The findings revealed significantly lower healthy/unhealthy food frequency consumption ratios for the ADHD group compared with the non-ADHD one but no differences in the ratios of estimated likelihood of food consumption and perceptions (attractiveness, convenience, and risk). Conclusion: The results of this study demonstrated a discrepancy between the eating behavior (more unhealthy eating patterns in adults with ADHD compared with controls) and their food-related perceptions (same perceptions regarding the benefit and risk of foods in both groups).

The study examined the engagement in risk-taking behaviors and their onset in children with attention-deficit/hyperactivity disorder (ADHD) compared with children with primary headaches. Whether ADHD is associated with higher engagement in risk-taking behavior compared with other neurodevelopmental disorders (and not only typical development) has yet to be demonstrated. A sample of 189 children, 10 to 18 years old, undergoing neurological surveillance for ADHD (N = 144) or primary headaches (N = 45) participated in the study. The children and their parents reported the children's engagement in various risk-taking behaviors. The ADHD group reported a higher level of general risk-taking behavior relative to the headache group. The differences remained significant even after controlling for demographic and clinical variables. No differences in the age of onset of risk-taking behaviors were found. It is concluded that risk-taking behavior is more common in children with ADHD under active neurological surveillance than in children followed for primary headaches.

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 ADHD-related different types of antisocial behaviors (severe/mild violent behavior, verbal violence, property crimes, public disorder, and drug abuse). 2260 participants aged 15-50 completed online questionnaires assessing the level of ADHD symptoms, antisocial behaviors, and SOC. An interaction between ADHD and SOC was found in predicting each type of antisocial behavior. The link between ADHD 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 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, justifying further prospective and intervention studies.

We assessed 85 children with Attention-Deficit/Hyperactivity Disorder (ADHD) and 50 typically developing children (TD) (Mage = 11.59, 57.8% boys) with the Hungry Donkey Task (HDT) at baseline and 2-year follow-up, and the Iowa Gambling Task at 10-year follow-up (75% retention). Improvement in the proportion of advantageous choices was observed from two- to 10-year follow-up, but the ADHD group improved less and was outperformed by the TD group at the 10-year follow-up. More advantageous choices on the HDT at baseline predicted less risky behaviour at 10-year follow-up. Male sex and more inattentive or externalizing symptoms at base line predicted more risky behaviour.

Objective: ADHD is linked to increased engagement in risky behavior (ERB). Recent work suggests that this link is mediated by the perceived benefits of the behaviors, but not by the perceived risks or the attitudes toward the risks. Here we examine this hypothesis, using the psychological risk-return and psychometric multidimensional measurement models. Method: Adults with or without ADHD completed questionnaires measuring the likelihood of different risky behaviors and the perceived risks and benefits ascribed to these behaviors. Participants’ ratings of 25 characteristics of various risky behaviors allowed us to derive two factors corresponding to perceived risk and perceived benefit of ERBs. Overall attitudes toward the perceived risks and benefits were extracted. Results: Perceived benefit mediated the link between ADHD and ERB, in both models. Attitudes toward the perceived risks mediated that link in the psychometric model only. Conclusion: Perceived benefit plays an important role in the link between ADHD and ERB.

Objective: The COVID-19 outbreak created numerous multidimensional stressors, to which people show different levels of vulnerability. The current paper examines whether symptoms of ADHD are associated with poorer adaptation. Method: After the first quarantine in Israel, 2,055 adults participated in an online survey. Participants completed scales probing adaptation indicators: financial status, adherence to preventive measures, mental health, and COVID-19 related perceptions. Background measures, including the level of symptoms of ADHD, were collected. Results: Adaptation indicators negatively correlated with the level of symptoms of ADHD. Financial decline explained a small portion of the link between ADHD and decreased mental health. Background risk-taking, anti-social, and pro-social behavior partially explained the link between ADHD and non-adherence to preventive measures. COVID-19 related perceptions also partially explained that link. Conclusion: This study suggests that people with ADHD are more vulnerable to the challenges created by the COVID-19 pandemic and therefore deserve special attention and care.

Background: ADHD predicts higher levels of antisocial behaviour and distress while religiosity is related to lower levels of both. This raises the hitherto unexplored question of how these variables interact. Aims: The objective of this study was to explore how religious individuals with ADHD fare in terms of these psychosocial outcomes. Method: 806 secular, religious and Ultra-Orthodox Jewish adults in Israel completed measures of ADHD symptoms and treatment, emotional strengths and difficulties, religious belonging, religious behaviour and antisocial behaviour. Results: Findings supported an additive-interactive model in which religiosity (a) correlates with lower levels of ADHD symptoms and diagnosis, (b) directly relates to less antisocial behaviour and less distress and (c) moderates the negative effects of ADHD on antisocial behaviour and distress. Findings further suggest that religious observance rather than religious belonging drives most of the moderating effect of religiosity, while religious belonging rather than religious observance drives negative attitudes towards ADHD. Conclusions: Implications include the importance of treating religious individuals with ADHD in a more nuanced manner and of providing more information on ADHD to religious communities.

Objective. The COVID-19 outbreak created numerous multidimensional stressors, to which people show different levels of vulnerability. The current paper examines whether ADHD symptoms are associated with poorer adaptation. Method. 2055 adults participated in an online survey after the first quarantine in Israel. Participants completed scales probing adaptation indicators: financial status, adherence to preventive measures, mental health, and COVID-19 related perceptions. Background measures, including the level of ADHD symptoms, were collected.Results. Adaptation indicators negatively correlated with the level of ADHD symptoms. Financial decline explained a small portion of the link between ADHD and decreased mental health; background risk-taking, anti-social, and pro-social behavior partially explained the link between ADHD and non-adherence to preventive measures; COVID-19 related perceptions also partially explained the same link.Conclusion. The current study suggests that people with ADHD are more vulnerable to the challenges created by the COVID-19 pandemic and therefore deserve special attention and care.

Objective: ADHD is related to decision-making deficits in real-life (e.g., substance abuse) and on experimental tasks(increased preference for risky options). In most tasks, risk and expected value are confounded (risky options have lowest expected value), making it impossible to disentangle risky from suboptimal (i.e., not choosing highest expected value)decision-making. We differentiated between risky and suboptimal decision-making in ADHD in two studies. Method and Results: First, on a multilevel meta-regression analysis (k = 48, n_ADHD = 1,144, n_Control = 1,108), ADHD and controls differed if the risky option was suboptimal (ADHD choosing more risky/suboptimal), whereas groups performed similar if the risky option was not suboptimal. Second, an empirical study showed that adults with ADHD (n = 40) made more suboptimal, but not more risky choices than controls (n = 40). Conclusion: These results contribute to a growing body of evidence that decision-making deficits in ADHD are driven by suboptimal decision-making and not by risk seeking.

Hyperphagia leading to severe obesity with increased morbidity and mortality is the major manifestation of Prader-Willi syndrome. Caring for these individuals in a home environment is challenging and stressful for caregivers and families. Residential hostels specifically for PWS adults offer programs of diet, exercise, and vocational opportunities, but long-term effects of PWS hostel living have not been reported. We studied long-term changes in body mass index (BMI) for PWS adults living in residential hostels compared with age-matched controls living with families at home. The study included all 34 individuals (18 men) aged >17 years with genetically confirmed PWS living in residential hostels. BMI was recorded at the time of yearly clinic visits and compared to 23 PWS adults (10 men) living at home. BMI on entering the hostel was 36.3 ± 11.0 kg/m2 and decreased to 27.0 ± 5.6 kg/m2 (p

Attachment insecurity, emotional dysregulation, and attention-deficit/hyperactivity disorder (ADHD) have all been implicated across the literature with various forms of negative life outcomes and increased risk-taking behavior (RTB). Furthermore, abundant research has demonstrated that the three seem to go together. Given these intercorrelations, it is unclear if any of them possess exclusive links with RTB independent of the others across multiple life domains. The present study examined the relations among attachment styles, emotional dysregulation, ADHD symptoms, and hypothetical RTBs across multiple real-life domains. Including a total of 155 mostly undergraduate students, we found in the main analysis that only ADHD symptoms were associated with RTB over and above all other variables. Specifically, the links between both attachment insecurity and emotional dysregulation with RTB disappeared when ADHD symptoms were included in the final model, but not vice versa. An exploratory analysis suggested that attachment insecurity was linked to romantic/sexual RTB over and above the others. These results further substantiate the link between ADHD symptoms and a general propensity for RTB and demonstrate that the link between the two seems to be inherent to the disorder and independent of its co-occurrence with attachment insecurity and emotional dysregulation.

Background To determine factors that predict non-adherence to preventive measures for COVID-19 during the chronic phase of the pandemic. Methods A cross-sectional, general population survey was conducted in Israel. Sociodemographic, health-related, behavioral and COVID-19-related characteristics were collected. Results Among 2055 participants, non-adherence was associated with male gender, young age, bachelorhood, being employed, lower decrease in income, low physical activity, psychological distress, ADHD symptoms, past risk-taking and anti-social behavior, low pro-sociality, perceived social norms favoring non-adherence, low perceived risk of COVID-19, low perceived efficacy of the preventive measures, and high perceived costs of adherence to the preventive measures. Conclusion There appears to be a need for setting out and communicating preventive measures to specifically targeted at-risk populations.

International audience; Delay discounting refers to the tendency of people to evaluate immediate rewards as being more valuable than those that are distant in time. Several models explain this phenomenon by a set of intrinsic and extrinsic features. Intrinsic features are related to the inherent traits and neurological conditions of the individual, whereas extrinsic features are related to the characteristics of the reward. In this study, we refer to extraversion and attention-deficit/hyperactivity disorder symptoms (attention and hyperactivity-impulsivity) as intrinsic features, and to fungibility, perishability, and magnitude of the reward as extrinsic features. Whereas there is a known main effect to these intrinsic and extrinsic features, the current research examines their additive and interactive contributions to delay discounting. A total of 222 participants filled out an online questionnaire measuring intrinsic features and presenting decision tasks with different types of rewards. The scores of the intrinsic variables and the delay discounting rate for each reward were calculated and analyzed. The results replicated previous findings showing main effects of hyperactivity, fungibility, perishability, and magnitude. They also provided new findings on an interaction between fungibility-perishability and hyperactivity—the effect of hyperactivity on delay discounting was larger when the rewards were fungible and nonperishable than when the rewards were perishable and nonfungible. This interaction has practical implications that can help in moderating delay discounting in clinical treatments of impulsivity as well as in constructing efficient economic models for consumers.

ImportanceIdentifying risk factors for adherence to public health instructions for the COVID-19 pandemic may be crucial for controlling the rate of transmission and the pandemic’s health and economic impacts.ObjectiveTo determine sociodemographic, health-related, risk-related, and instruction-related factors that predict non-adherence to instructions for the COVID-19 pandemic.DesignCross-sectional survey in Israel collected between March 28 and April 10, 2020.SettingPopulation-based study.ParticipantsA convenience sample completed an online survey.ExposuresSociodemographic, health-related, risk-related, and instruction-related characteristics of the participants that have been linked to adherence to medical instructions.Main Outcome and MeasureNon-adherence to instructions defined by a mean score of less than 4 on a 1 to 5 adherence scale consisting of 19 instruction items.ResultsAmong 654 participants (413 [64.8%] female, age 40.14 [15.23] years), 28.7% were defined as non-adherents. Non-adherence was associated with male gender [adjusted odds ratio (aOR) = 1.54, CI 1.03– 2.31], not having children [aOR = 1.73, 1.13–2.65], smoking [aOR = 2.27, CI 1.42–3.62], high levels of ADHD symptoms [aOR = 1.55, CI 1.07–2.25], high levels of past risk-taking behavior [aOR = 1.41, CI 1.10–1.81], as well as by current high psychological distress [aOR = 1.51, CI 1.14–2.01], low perceived risk of COVID-19 [aOR = 1.52, CI 1.22–1.89], low exposure to the instructions [aOR = 1.45, CI 1.14–1.82], and low perceived efficacy of the instructions [aOR = 1.47, CI 1.16–1.85]. Adjusted OR of age, economic status, physical health status, and exposure to media did not reach the significance level.Conclusions and RelevancePeople with the above characteristics may have increased risk for non-adherence to public health instructions. There appears to be a need for setting out and communicating instructions to specifically targeted at-risk populations.Key PointsQuestionWhat factors are associated with non-adherence to public health instructions during COVID-19?FindingsIn a cross-sectional study of 654 Israeli participants, non-adherence to instructions was associated with male gender, not having children, smoking, high levels of attention-deficit/hyperactivity disorder (ADHD) symptoms, low level of pro-sociality, and high levels of past risk-taking behavior, as well as by current high psychological distress, high perceived risk of the COVID-19, high exposure to the instructions, and high perceived efficacy of the instructions.MeaningThe findings suggest that in setting out and communicating public health instructions, policymakers should consider the above sociodemographic, health-related, risk-related, and instruction-related characteristics.

Objective: previous research in adults with ADHD showed high rates of obesity and unhealthy food choices. There is evidence that contextual cues, e.g., advertisements, influence food choices. This study assessed the sensitivity of university students with ADHD to advertised food.Method: university students (N = 457) with and without ADHD participated in a cafeteria field experiment. Food choices were examined in periods of advertising either healthy or unhealthy sandwiches. Results: the findings revealed that students with ADHD (1) chose less healthy food items; (2) were more influenced by advertising; (3) showed the same overall healthy food choices as controls when exposed to healthy advertising.Conclusion: university students with ADHD were more likely to opt for more unhealthy foods at the cafeteria but were also more influenced by advertising. Exposure to healthy food advertisements eliminated ADHD-related unhealthy food choices. As this population has strong association with unhealthy dietary patterns, it is important to continue the research of food cues and the influence on their eating habits.

Objective: ADHD in adolescents and low level of parental monitoring have been associated with increased risk-taking behavior. The present study examined whether parental knowledge of the child’s whereabouts mediates the correlations between adolescent ADHD symptoms and risk-taking behavior. Method: Ninety-two adolescents and their parents completed questionnaires assessing perceptions of parents’ monitoring, engagement in risk-taking behaviors, and ADHD symptoms. Results: Greater engagement in risk-taking behavior correlated with higher levels of ADHD symptoms and decreased parental monitoring. Mediation analysis revealed both direct effect of ADHD symptoms on risk-taking behavior and an indirect effect mediated by level of parental knowledge. Conclusion: These findings suggest that parental knowledge is negatively affected by the presence of ADHD symptoms, and may in turn lead to risk-taking behavior. The findings emphasize the need to target parenting and in particular parental knowledge of the child’s whereabouts to reduce risk-taking behaviors among youth with ADHD.

Prader–Willi Syndrome (PWS) is the most common genetic syndrome causing life-threatening obesity. Strict adherence to a low-calorie diet and regular physical activity are needed to prevent weight gain. Direct measurement of maximal oxygen uptake (VO2 max), the “gold standard” for assessing aerobic exercise capacity, has not been previously described in PWS. Assess aerobic capacity by direct measurement of VO2 max in adults with PWS, and in age and BMI-matched controls (OC), and compare the results with values obtained by indirect prediction methods. Seventeen individuals (12 males) age: 19–35 (28.6 ± 4.9) years, BMI: 19.4–38.1 (27.8 ± 5) kg/m2 with genetically confirmed PWS who exercise daily, and 32 matched OC (22 males) age: 19–36 (29.3 ± 5.2) years, BMI: 21.1–48.1 (26.3 ± 4.9) kg/m2. All completed a medical questionnaire and performed strength and flexibility tests. VO2 max was determined by measuring oxygen consumption during a graded exercise test on a treadmill. VO2 max (24.6 ± 3.4 vs 46.5 ± 12.2 ml/kg/min, p

Objective Extreme obesity is a core phenotypic feature of Prader–Willi syndrome (PWS). Among numerous metabolic regulators, the endocannabinoid (eCB) system is critically involved in controlling feeding, body weight, and energy metabolism, and a globally acting cannabinoid-1 receptor (CB1R) blockade reverses obesity both in animals and humans. The first-in-class CB1R antagonist rimonabant proved effective in inducing weight loss in adults with PWS. However, it is no longer available for clinical use because of its centrally mediated, neuropsychiatric, adverse effects. Methods We studied eCB ‘tone’ in individuals with PWS and in the Magel2-null mouse model that recapitulates the major metabolic phenotypes of PWS and determined the efficacy of a peripherally restricted CB1R antagonist, JD5037 in treating obesity in these mice. Results Individuals with PWS had elevated circulating levels of 2-arachidonoylglycerol and its endogenous precursor and breakdown ligand, arachidonic acid. Increased hypothalamic eCB ‘tone’, manifested by increased eCBs and upregulated CB1R, was associated with increased fat mass, reduced energy expenditure, and decreased voluntary activity in Magel2-null mice. Daily chronic treatment of obese Magel2-null mice and their littermate wild-type controls with JD5037 (3 mg/kg/d for 28 days) reduced body weight, reversed hyperphagia, and improved metabolic parameters related to their obese phenotype. Conclusions Dysregulation of the eCB/CB1R system may contribute to hyperphagia and obesity in Magel2-null mice and in individuals with PWS. Our results demonstrate that treatment with peripherally restricted CB1R antagonists may be an effective strategy for the management of severe obesity in PWS., Highlights • Circulating levels of endocannabinoids are increased in individuals with PWS. • Magel2 is a negative regulator of hypothalamic endocannabinoid ‘tone’. • Peripherally-restricted CB1 receptor blockade reverses obesity in Magel2-null mice.

Objective: ADHD has been linked to higher engagement in risky behaviors in circumscribed domains such as dangerous driving, substance abuse, and gambling. This study tests whether ADHD is associated with a pervasive tendency to engage in risky behavior across a spectrum of activities and domains, and whether this tendency is driven by comorbid disorders. Method: A sample of 97 adults with ADHD and 103 typically developing controls completed a self-report questionnaire measuring the likelihood and frequency of engaging in a broad range of risky behaviors. ADHD, comorbid psychiatric disorders, and demographic variables were extensively assessed using standardized instruments. Results: Participants with ADHD reported a pervasive tendency to engage in risky behaviors across multiple activities. This tendency was associated with ADHD over and above the contribution of comorbid psychiatric disorders. Conclusion: These results suggest that ADHD is uniquely linked to a pervasive pattern of engagement in risky behaviors.

Attention deficit/hyperactivity disorder (ADHD) has been linked to higher engagement in sexual risk-taking behavior (SRTB). The current study aims to establish the link between ADHD symptoms and SRTB in the general population and to examine whether an exaggerated perceived benefit of the positive outcomes of SRTB explains that link. A scale for measuring the frequency, likelihood, perceived benefit, and perceived risk of SRTB was developed. Young adult sexually active participants who did not have a stable partnership completed the above scale, as well as a scale of ADHD symptoms. The level of ADHD symptoms positively correlated with the frequency and likelihood of SRTB, even when the overall level of sexual behavior was controlled for. ADHD symptoms also correlated with the perceived benefit of SRTB, but not with the perceived risk of SRTB. Mediation analysis confirmed an indirect pathway: ADHD symptoms predicted perceived benefit of SRTB, which in turn predicted increased likelihood to engage in SRTB. These findings suggest a positive link between ADHD symptoms and SRTB in the general population, which is accounted for by an exaggerated perceived benefit of SRTB.

Objective: Previous research on adults with ADHD revealed high rates of overweight and obesity, as well as unhealthy diet habits. Other studies demonstrated that social-affective contexts can influence food choice. This study examines the sensitivity of adults with ADHD to cues of food attractiveness and convenience, for healthy and unhealthy foods. Method: One hundred and seventy-two university students with (n = 59) and without (n = 113) ADHD, aged 19–40, participated in the study. Participants rated the level of appeal of 32 pictures of healthy and unhealthy foods, which varied in the degree of attractiveness and convenience. Results: The findings reveal a higher level of appeal of attractive food items compared to non-attractive ones (p < .001), as well as of convenient compared to non-convenient food items (p = .005). Type of diagnostic group did not have an effect on the level of appeal. Conclusion: Increasing the attractiveness and convenience of food items increased the level of appeal for both students with and without ADHD. These findings emphasize the importance of environmental health intervention to potentially reduce abnormal eating pattern in the ADHD adult population, which may contribute in preventing the reported higher risk of obesity in this population.

Purpose of ReviewAttention deficit/hyperactivity disorder (ADHD) is associated with several forms of risk-taking behavior (RTB). This paper aims to examine the scope of ADHD-related RTB, to highlight potential underlying mechanisms of this association, and to review initial evidence for interventions aimed to treat ADHD-related RTB.Recent FindingsMultiple lines of evidence indicate that ADHD is associated with real-life RTB across several domains (e.g., reckless driving, substance use, and unprotected sex), which is corroborated by evidence on laboratory risk–taking tasks. Several individual differences, some of them informed by decision theory, e.g., comorbid disorders, parental monitoring, and perceived enlarged benefits of RTB, may explain the link between ADHD and RTB. A number of studies showed that interventions designed for ADHD may reduce RTB.SummaryADHD is linked to RTB across several domains. Decision theory may serve as a conceptual framework for understanding the underlying mechanisms, and thus may inform future research.

Background: Individuals with PWS require marked caloric restriction and daily exercise to prevent morbid obesity. Lower energy expenditure compared to BMI-matched controls along with hypotonia, decreased muscle mass, and cognitive impairment make exercise particularly challenging for this population. Exercise guidelines include resistance training as an important component. Myokine responses to resistance exercise may have beneficial metabolic effects. Objectives: Determine if young PWS adults can perform a resistance exercise program. Evaluate myokine responses to acute resistance exercise in young adults with PWS and compare responses with age and BMI-matched controls. Methods: Each study group included 11 participants (7M/4F). Mean±SD ages were 30.7±4.6 and 30.1±4.3 years for PWS and controls (NS). BMI values were 28.3±4.3 and 28.2±4.2 kg/m2 for PWS and controls, respectively (NS). Blood samples for glucose, creatine kinase (CK), lactate, hemoglobin A1c (HbA1C) and myokines were obtained before performing a program of eight resistance exercises lasting 45-60 minutes. Additional blood samples were drawn immediately after, and 30 and 60 minutes after completing the exercises. Myokines were assayed using a multiplex myokine panel (Merck Millipore). Paired t-test was used for comparing results for PWS vs controls. The unpaired t-test was used for comparing peak laboratory values with basal levels. Results: Basal levels (mean±SEM) of glucose, hemoglobin A1c, and lactate were similar for PWS and controls but CK was lower in PWS vs controls (62±16 vs 322±100 U/L, p

ObjectiveTo investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits.MethodsWe studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored.ResultsPatients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits.ConclusionBinge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.

Objective: Effort allocation is a multi-faceted process driving both the decision to choose a high effort–high reward alternative over a low effort–low reward alternative, and the execution of this decision by recruiting sufficient effort. The objectives of our study were to examine whether children with ADHD would (a) show different reward–effort cost trade-off, and (b) have difficulty executing their decision. Method: 50 children, aged 9 to 15, with and without ADHD, had to choose between high effort–high reward and low effort–low reward alternatives using a handheld dynamometer and to execute their choice. Results: Children with ADHD and controls made similar number of high-effort choices ( p = .806). However, children with ADHD executed their high-effort choices less frequently compared with controls ( p = .029). Conclusion: These findings suggest that children with ADHD are not characterized by different effort–reward trade-off but rather by difficulties in recruiting effort for their preferences implementation.

This study aimed to examine whether adult attention deficit hyperactivity disorder (ADHD) in students is associated with overeating or with unhealthy food choices. Sixty university students with and without ADHD, aged 20 to 30 years, completed the Food Frequency Questionnaire and reported their height and weight. Students with ADHD had a higher body mass index compared with students without ADHD. Although participants in both groups consumed similar amounts of servings, calories, and nutrients, students with ADHD reported lower healthy/unhealthy food consumption ratio. These findings suggest that ADHD in students is not associated with general overeating, but with a biased proportion of unhealthy versus healthy food consumption.

Among a multitude of hormonal and metabolic complications, individuals with Prader-Willi syndrome (PWS) exhibit significant bone abnormalities, including decreased BMD, osteoporosis, and subsequent increased fracture risk. Here we show in mice that loss of Magel2, a maternally imprinted gene in the PWS critical region, results in reduced bone mass, density, and strength, corresponding to that observed in humans with PWS, as well as in individuals suffering from Schaaf-Yang syndrome (SYS), a genetic disorder caused by a disruption of the MAGEL2 gene. The low bone mass phenotype in Magel2-/- mice was attributed to reduced bone formation rate, increased osteoclastogenesis and osteoclast activity, and enhanced trans-differentiation of osteoblasts to adipocytes. The absence of Magel2 in humans and mice resulted in reduction in the fatty acid amide bone homeostasis regulator, N-oleoyl serine (OS), whose levels were positively linked with BMD in humans and mice as well as osteoblast activity. Attenuating the skeletal abnormalities in Magel2-/- mice was achieved with chronic administration of a novel synthetic derivative of OS. Taken together, Magel2 plays a key role in modulating bone remodeling and mass in PWS by affecting OS levels and activity. The use of potent synthetic analogs of OS should be further tested clinically as bone therapeutics for treating bone loss. © 2018 American Society for Bone and Mineral Research.

Aim To investigate the impact of auditory stimulation on motor function in children with cerebral palsy (CP) and disabling hypertonia. Method 9 matched pairs (age: 7y5m, SD 4y1m; 13 boys; gross-motor-functional-classification-scale: median 4; manual-ability-classification-system: median 4) were randomized to receive either auditory stimulation embedded in music (study, n = 9) or music alone (sham, control, n = 9) for at least 10 minutes 4 times a week for 4 weeks. Goal-Attainment-Scale, Care-and-Comfort-Hypertonicity-Questionnaire, Gross-Motor-Function–Measure and Quality-of-Upper-Extremity-Skills-Test (QUEST) were assessed before and 5 months following intervention. Result Children receiving auditory stimulation attained more goals than children who listened to music alone (p = 0.002). Parents reported improved care and comfort in children in the study group compared to a slight deterioration in controls (p = 0.002). Upper extremity skills improved in the study group compared to controls (p = 0.006). Similar gross motor function changes were documented in both groups (p = 0.41). One participant reported increased seizure frequency; no other participants with epilepsy reported increased seizure frequency (n = 6/18) and no other adverse events were reported. Interpretation Auditory stimulation alleviated hypertonia and improved fine and gross motor functions.

Study question At what age does the type of hypogonadism, namely hypothalamic or primary gonadal defect, become established in men and women with Prader-Willi syndrome (PWS)? Summary answer The type of hypogonadism becomes established only in late adolescence and early adulthood. What is known already The etiology of hypogonadism in PWS is heterogeneous and the clinical expression is variable. Primary testicular failure is common in PWS men, while combinations of ovarian dysfunction and gonadotrophin deficiency are seen in women. Study design, size, duration This is a prospective study of a cohort of 106 PWS patients followed for a mean duration of 4.5 years. Serial blood samples were obtained and assayed for gonadotrophins, inhibin B, anti-Mullerian hormone (AMH), dehydroepiandrosterone sulfate (DHEAS), testosterone (males), and estradiol (females). Results were compared with normal reference values obtained from the literature. For the purpose of this study, we defined the following age groups: infants 20 years. Participants/materials, setting, methods Study participants were 49 males (aged 2 months to 36 years) and 57 females (aged 1 month to 37 years) with genetically confirmed diagnoses of PWS (deletions 60, uniparental disomy 54, imprinting center defect 2) followed in the Israel national multidisciplinary PWS clinic. Main results and the role of chance Serum LH levels were in the normal range (1.0-6.0 mIU/ml) for 7/10 adult men, and high in 3, while FSH (normal range 1.0-6.1 mIU/ml) was elevated (34.4 ± 11.5 mIU/ml) in 6 and normal (3.5 ± 1.6 mIU/ml) in 4 men. Testosterone was low (5.7 ± 3.4 nmol/l) compared with the normal range of 12.0-34.5 nmol/l in the reference population in all men >20 years. AMH showed a normal decrease with age, despite low testosterone levels. Inhibin B was normal (241 ± 105 pg/ml) in infant boys, but low or undetectable in most adult men. Hormonal profiles were more heterogeneous in women than in men. Estradiol was consistently detectable in only 7/13 adult women. Inhibin B was low or undetectable in all PWS females although occasional samples showed levels within the normal range of 15-95 pg/ml. Vaginal bleeding was reported to occur for the first time in eight women at a median age of 20 years (13-34 years), but only one had regular monthly menses. The type of hypogonadism (primary or secondary) in PWS can be determined only after age 20 years. Limitations, reasons for caution The study cohort was heterogeneous, showing variability in BMI, cognitive disability and medical treatment. Wider implications of the findings Demonstration of the natural history of reproductive hormone development in PWS suggests that androgen replacement may be indicated for most PWS boys in mid-adolescence. Recommendations for hormone replacement in PWS women need to be individually tailored, serial measurements of inhibin B should be performed, and contraception should be considered in those women who may have the potential for fertility.

Inept probabilistic decision making is commonly associated with ADHD. In experimental designs aimed to model probabilistic decision making in ADHD, feedback following each choice was, in the majority of studies, part of the paradigm. This study examined whether feedback processing plays a role in the maladaptive choice behavior of subjects with ADHD by comparing feedback and no-feedback conditions. Sixty adolescents (49 males), ages 13-18, with and without ADHD, performed a descriptive probabilistic choice task in which outcomes and probabilities were explicitly provided. Subjects performed the task either with or without feedback. Under the no-feedback condition, adolescents with ADHD and controls performed similarly, whereas under the feedback condition, subjects with ADHD chose the unfavorable outcomes more frequently and risked smaller sums than controls. These finding demonstrate the crucial role of feedback in the decision making of adolescents with ADHD.

Objective: Prader–Willi syndrome (PWS) is a genetic multisystem disorder with various medical, cognitive, behavioral and psychiatric problems. PWS is caused by the lack of expression of paternal genes on chromosome 15q2-q13 due to a deletion (70–75%), uniparental disomy (25–30%) or imprinting center defect (

Adults with attention deficit/hyperactivity disorder (ADHD) are prone to suboptimal decision making and risk taking. The aim of this study was to test performance on a theoretically-based probabilistic decision making task in well-characterized adults with and without ADHD, and examine the relation between experimental risk taking and history of real-life risk-taking behavior, defined as cigarette, alcohol, and street drug use. University students with and without ADHD completed a modified version of the Cambridge Gambling Test, in which they had to choose between alternatives varied by level of risk, and reported their history of substance use. Both groups showed similar patterns of risk taking on the experimental decision making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD. These finding question the validity of experimental probabilistic decision making task as a valid model for ADHD-related risk-taking behavior.

Risk taking is commonly attributed to individuals with attention deficit hyperactivity disorder (ADHD). This study investigated whether adolescents with ADHD would choose to take greater risks on a probabilistic task in which contingencies are explicitly presented. Adolescents with and without ADHD, aged 13 to 18 years, performed a modified version of the Cambridge Gambling Task. The subjects with ADHD risked smaller sums and chose the unfavorable outcomes more frequently than did the controls but had the same speed of decision and risk adjustment. The results indicate that their poor decisions were not due to impulsivity or insensitivity to the concept of probability and that increased risk taking is not always associated with ADHD. Moreover, in situations that do not demand learning of contingencies, ADHD may be associated with decreased, rather than increased, risk taking. Language: en

Prader–Willi syndrome (PWS) is a neurodevelopmental disorder characterized by an insatiable appetite, dysmorphic features, cognitive and behavioral difficulties, and hypogonadism. The heterogeneous reproductive hormone profiles indicate that some PWS women may have symptoms of hypoestrogenism, while others may potentially be fertile. We describe our experience in the assessment and treatment of hypogonadism in adolescents and adult females with PWS. The study population consisted of 20 PWS females, age ≥16 years (27.3 ± 7.9 years), followed in our clinic (12 deletion, 7 uniparental disomy, 1 imprinting-center defect). General physical examination, pubertal assessment, body mass index (BMI), gynecological examination, ultrasonography, bone densitometry, and hormonal profiles [FSH, LH, inhibin B, estradiol, prolactin, and TSH] were performed. The relevant assessed factors were: FSH and inhibin B, menstrual cycles (oligo/amenorrhea or irregular bleeding), ultrasound findings (endometrial thickness, uterine/ovarian abnormalities), BMI, bone densitometry, and patient/caregivers attitude. We classified seven women with inhibin B >20 ng/ml as potentially fertile. Following the assessment of the above factors, we recommended the individual-specific treatment; contraceptive pills, intra-uterine device, estrogen/progesterone replacement, and cyclic progesterone, in 3, 1, 4, and 1 patients, respectively. Four patients did not follow our recommendations due to poor compliance or family refusal. We recommended contraception pills for one 26-year-old woman with inhibin B and FSH levels 53 ng/ml and 6.4 IU/L; however, she refused treatment, conceived spontaneously and had an abortion. Guidelines for hormonal replacement therapy in PWS need to be tailored individually depending on physical development, hormonal profiles, bone density, and emotional and social needs of each PWS adolescent and adult. © 2013 Wiley Periodicals, Inc.

Tourette's syndrome (TS) is a developmental disorder that has one of the highest familial recurrence rates among neuropsychiatric diseases with complex inheritance. However, the identification of definitive TS susceptibility genes remains elusive. Here, we report the first genome-wide association study (GWAS) of TS in 1285 cases and 4964 ancestry-matched controls of European ancestry, including two European-derived population isolates, Ashkenazi Jews from North America and Israel and French Canadians from Quebec, Canada. In a primary meta-analysis of GWAS data from these European ancestry samples, no markers achieved a genome-wide threshold of significance (P

Objective: This is a randomized control trial examining the efficiency of computerized cognitive training (CCT) for adults with ADHD, comparing two training conditions with graded levels of executive cognitive demands. Method: Adults with ADHD ( n = 60) were randomized into study ( n = 34) and control ( n = 26) groups. Training was conducted with the computerized AttenFocus program. Control group received a simple, non-hierarchical version with less executive demands. Results: Significant positive changes in symptoms ratings, ecological measures of executive functions, and occupational performance were found in both groups. No significant changes were found in variables of neurocognitive performance battery and quality of life. No significant time by group interaction effects were found. Conclusion: No benefits of the intervention were found relative to the control. Lack of interaction effects may be due to insufficient power, non-specific cognitive training or placebo effects. Results demonstrate some positive findings for general CCT, yet do not support the inclusion of specific higher level executive training.