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Background: Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum. Case presentation: A 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions. Conclusion: This case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies. [ABSTRACT FROM AUTHOR]

Background/Objectives: Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Traditional diagnostic methods, which depend on subjective assessments, often lack precision. This study evaluates the validity and reliability of a newly developed diagnostic tool, the Distractor-Embedded Auditory Continuous Performance Test (da-CPT), which integrates auditory stimuli with distractors to enhance the clinical utility of ADHD diagnosis. Methods: The study included 160 children aged 6–12 years, comprising 80 with a confirmed ADHD diagnosis and 80 controls. All participants completed the da-CPT, a web-based tool designed to assess inattention, hyperactivity, impulsivity, and timing via an auditory-based task. To validate the da-CPT, participants also completed the Conners' Parent Rating Scale—Revised Short Form (CPRS-R) and either the MOXO or IVA-2 tests. Data were analyzed using ROC curves and statistical correlations to assess sensitivity, specificity, and overall diagnostic accuracy. Results: The da-CPT demonstrated high diagnostic accuracy, with a sensitivity of 91.25% and specificity of 83.75%. ROC analysis indicated that the inattention index had the highest discriminatory power (AUC = 0.881), followed by timing, impulsivity, and hyperactivity (all p < 0.01). Furthermore, the da-CPT scores were strongly correlated with ADHD severity (p < 0.01). Conclusions: This study confirms that the da-CPT is a valid and reliable tool for diagnosing ADHD in children aged 6–12. By incorporating auditory stimuli and distractors, the tool offers a more ecologically valid assessment of ADHD symptoms in clinical settings, improving diagnostic precision and utility. [ABSTRACT FROM AUTHOR]

Background: The availability of information regarding neuropsychological tests threatens their confidentiality. This concern may be particularly relevant to Attention-Deficit/Hyperactivity Disorder (ADHD) considering its widespread online coverage. The present study explored simulators' online search strategies. Method: Simulators (n = 39) searched for information before undergoing an evaluation which included performing a continuous performance test (CPT). Their search strategies were analyzed, and their performance was compared to that of ADHD patients (n = 36) and healthy controls (n = 38). Results: Most simulators reached high-risk websites that provided written and video-based information regarding the test. Sixty percent, comprised mostly of 3rd-year students, reached Google Scholar. These students were also easier to detect as simulators. Common strategies included performing the CPT in accordance with typical ADHD symptoms and avoiding the endorsement of both unusual and stereotypical symptoms. Conclusion: Simulators can access online information that contains key test data. Higher education may increase the ability to reach academic research while decreasing the ability to convincingly feign impairment. While additional research is needed to examine coaching effects on neuropsychological testing, the risk to test security that many websites pose should be acknowledged and steps, including ones taken by test publishers, should be undertaken to minimize it. [ABSTRACT FROM AUTHOR]

Objectives: Randomized controlled trials (RCTs) have shown that attention-deficit/hyperactivity disorder (ADHD) medications significantly reduce symptomatology at a group level, but individual response to ADHD medication is variable. Thus, developing prediction models to stratify treatment according to individual baseline clinicodemographic characteristics is crucial to support clinical practice. A potential valuable source of data to develop accurate prediction models is real-world clinical data extracted from electronic healthcare records (EHRs). Yet, systematic information regarding EHR data on ADHD is lacking. Methods: We conducted a comprehensive review of studies that included EHR reporting data regarding individuals with ADHD, with a specific focus on treatment-related data. Relevant studies were identified from PubMed, Ovid, and Web of Science databases up to February 24, 2024. Results: We identified 103 studies reporting EHR data for individuals with ADHD. Among these, 83 studies provided information on the type of prescribed medication. However, dosage, duration of treatment, and ADHD symptom ratings before and after treatment initiation were only reported by a minority of studies. Conclusion: This review supports the potential use of EHRs to develop treatment response prediction models but emphasizes the need for more comprehensive reporting of treatment-related data, such as changes in ADHD symptom ratings and other possible baseline clinical predictors of treatment response. [ABSTRACT FROM AUTHOR]

Objectives: Stimulants, such as methylphenidate (MPH) and amphetamines, represent the first-line pharmacological option for attention-deficit/hyperactivity disorder (ADHD). Randomized controlled trials (RCTs) have demonstrated beneficial effects at a group level but could not identify characteristics consistently associated with varying individual response. Thus, more individualized approaches are needed. Experimental studies have suggested that the neurobiological response to a single dose is indicative of longer term response. It is unclear whether this also applies to clinical measures. Methods: We carried out a systematic review of RCTs testing the association between the clinical response to a single dose of stimulants and longer term improvement. Potentially suitable single-dose RCTs were identified from the MED-ADHD data set, the European ADHD Guidelines Group RCT Data set (https://med-adhd.org/), as updated on February 1, 2024. Quality assessment was carried out using the Cochrane Risk of Bias (RoB) 2.0 tool. Results: A total of 63 single-dose RCTs (94% testing MPH, 85% in children) were identified. Among these, only a secondary analysis of an RCT tested the association between acute and longer term clinical response. This showed that the clinical improvement after a single dose of MPH was significantly associated with symptom improvement after a 4-week MPH treatment in 46 children (89% males) with ADHD. The risk of bias was rated as moderate. A further RCT used near-infrared spectroscopy, thus did not meet the inclusion criteria, and reported an association between brain changes under a single-dose and longer term clinical response in 22 children (82% males) with ADHD. The remaining RCTs only reported single-dose effects on neuropsychological, neuroimaging, or neurophysiological measures. Conclusion: This systematic review highlighted an important gap in the current knowledge. Investigating how acute and long-term response may be related can foster our understanding of stimulant mechanism of action and help develop stratification approaches for more tailored treatment strategies. Future studies need to investigate potential age- and sex-related differences. [ABSTRACT FROM AUTHOR]

Background: Numerous investigations have examined the potential link between allergic rhinitis (AR) and attention deficit hyperactivity disorder (ADHD). However, some studies show no association between the two diseases. The connection between these two conditions remains inconclusive. This study aimed to conduct a meta-analysis exploring the correlation between AR and ADHD. Methods: We conducted systematic searches of the MEDLINE, EMBASE, Cochrane Library, ERIC, PubMed, Web of Science, and CINAHL databases, up to the year 2023. Subsequently, we conducted a meta-analysis using R 4.2.2, where we computed the pooled odds ratio with a 95% confidence interval to assess the relationship between AR and ADHD within studies exhibiting similar characteristics. Statistical heterogeneity was evaluated by computing the value using the Cochrane Intervention Manual's guidelines. Additionally, subgroup analyses were conducted by stratifying the study population according to gender, age, etc. Sensitivity analysis was performed by systematically removing individual studies. Results: In this systematic review, we incorporated 12 eligible studies, collectively encompassing a sample size of 530,360 participants. Within the included studies, heterogeneity was observed, and the utilization of a random-effects model demonstrated a noteworthy correlation between children with ADHD and the presence of AR. Similarly, children with AR exhibited a significant correlation with the occurrence of ADHD. We also found some relationships in subgroup analyses. Conclusion: A substantial correlation is evident between AR and ADHD in children and adolescents. AR may potentially contribute as a risk factor for the onset of ADHD, and conversely, ADHD may heighten the likelihood of developing AR. [ABSTRACT FROM AUTHOR]

Background/Objectives: The complex association between attention-deficit/hyperactivity disorder (ADHD) and methylphenidate (MPH) with precocious puberty (PP) is still unclear. This study aims to investigate the association between ADHD, MPH, and PP. Methods: This is a nationwide cohort study including a total of 3,342,077 individuals, 186,681 with ADHD and 3,155,396 without. First, we compared the risk of PP between ADHD cases and non-ADHD cases. Second, we compared the risk of PP between MPH users and non-MPH users in patients with ADHD. Results: Patients with ADHD were at a greater risk of PP (adjusted hazard ratio [aHR], 2.01 [95% CI, 1.91–2.11]). In our moderation analyses, the female gender was a positive additive effect modifier of the association between ADHD and PP, whereas tics and intellectual disability were negative effect modifiers. In patients with ADHD, MPH users had a significantly lower risk of PP (aHR, 0.63 [95% CI 0.57–0.70]), and females had a negative effect modification on the association between MPH and PP. Conclusions: Our study found that children with ADHD were at a greater risk of PP. Girls with ADHD were a group particularly vulnerable to PP. Comorbid tics or intellectual disability was associated with a lower risk of PP. Among patients with ADHD, MPH was protective against PP, especially in girls. However, these preliminary results need further validation due to the nature of them being from an electronic database study. Unmeasured confounding factors might affect the association between MPH and PP. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40–60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials. [ABSTRACT FROM AUTHOR]

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum. Case presentation A 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions. Conclusion This case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies.

Abstract Background Insecure adult attachment has been associated with psychiatric disorders characterized by emotional dysregulation, such as borderline personality disorder (BPD), bipolar disorder (BD) and attention deficit/hyperactivity disorder (ADHD). However, little is known about the differences in attachment patterns between these diagnostic groups. The aim of this study was to identify clusters of adult attachment style in a cross-diagnostic group of patients with BDP and/or BD and/or ADHD and explore the characteristics of these clusters based on temperament profile, childhood trauma and psychiatric diagnoses. Methods K-means cluster analysis was used to identify subgroups, based on the Attachment Style Questionnaire Short Form dimensions, in a clinical cohort of 150 young adults (113 women and 37 men, mean age ± SD = 23.3 ± 2.1) diagnosed with BPD, and/or BD, and/or ADHD. Results Three distinct clusters were identified: a secure, an insecure/avoidant-anxious and an insecure/avoidant cluster. These three clusters differed in temperament profile and related psychiatric diagnoses. Conclusions The three clusters of attachment in individuals with BPD, BD and/or ADHD could support differentiation between the disorders as well provide information usable for planning of treatment.

Adults with attention-deficit/hyperactivity disorder (ADHD) experience impairing levels of inattention and/or hyperactivity-impulsivity, while individuals without ADHD experience these symptoms to a lesser extent. Yet, ADHD self-report scales so far hardly captured continuous distributions across the general population. In addition, they focused on weaknesses and ignored strengths. To address these shortcomings, we present here the Strengths and Weaknesses of ADHD and Normal-Behavior Scale Self-Report (SWAN-DE-SB). The normal distribution of the data collected and the scale's internal consistency, and factorial and convergent validity were assessed using data from a general population sample. Its clinical utility was evaluated by comparing scores from a clinical sample and a sample of individuals without ADHD and by calculating optimal cut-off values for specificity and sensitivity. The SWAN-DE-SB demonstrated normal distribution of the data collected, high internal consistency, and factorial and convergent validity. It reliably discriminated individuals with and without ADHD, with high specificity and sensitivity. It should therefore be considered a psychometrically convincing measure to assess strengths and weaknesses of ADHD symptoms and normal behavior in clinical and general population samples. [ABSTRACT FROM AUTHOR]

Abstract Hyperfocus (HF), or intense, deep concentration on a task, has gained significant research attention in recent years, particularly in regard to clinical populations such as Attention-Deficit/Hyperactivity Disorder (ADHD). The present work aims to provide validation of the 12-item dispositional adult hyperfocus questionnaire (AHQ-D) as a quantitative metric of HF in adults. We preregistered the study design and hypotheses. We administered the AHQ-D and several additional questionnaires to 347 adults (mean ± SD age: 33 ± 11 years; 47% female). Exploratory factor analysis revealed high factor loadings (0.57–0.81) on a single HF factor; item response theory analysis suggested that the questionnaire items had high discrimination and covered a wide range of responses; and we report strong internal consistency metrics (Cronbach’s alpha 0.93, mean split-half reliability 0.93). Replicating our previous work, HF was positively correlated with Conners’ Adult ADHD Rating Scale (CAARS) scores (r(345) = 0.53), suggesting that HF may be related to ADHD traits (though in this sample we did not specifically recruit individuals with ADHD). The AHQ-D demonstrated the hypothesized convergent validity; HF on the AHQ-D was positively correlated with HF measured using a different HF scale (r(344) = 0.69), as well as flow (r(345) = 0.12) and mind wandering (r(345) = 0.39) scores. AHQ-D HF scores showed a weak negative correlation with grit (r(345) = − 0.29). Though there was a weak negative correlation between HF and social desirability response tendency (r(345) = − 0.24), suggesting that those who care more about what others think may report less HF, there was no relationship between HF and extrasensory perception beliefs (r(345) = 0.01), suggesting that participants were not simply biased in their response tendencies. Taken together, we demonstrate strong scale metrics for the AHQ-D, the expected convergent validity, and a general lack of response bias, in addition to replicating our previous association of HF with ADHD traits. We suggest that the AHQ-D can be confidently used in future work as a valid way to measure HF in adults.

Abstract Objective To evaluate the prevalence of and risk factors for attention‐deficit/hyperactivity disorder (ADHD) in children with epilepsy (CWE). Methods We conducted a systematic search in PubMed and Embase for the meta‐analysis. The pooled prevalence of ADHD was calculated using a random‐effects model; subgroup analyses were performed to explore heterogeneity. We collected raw data from articles reporting potential risk factors, which were included in the subsequent risk factor analysis. Results Forty‐six articles met the inclusion criteria for the meta‐analysis, which showed a pooled ADHD prevalence of 30.7% in CWE, with a predominance of the inattentive subtype of ADHD; the heterogeneity of prevalence was related to population source/study setting (clinic based, community based, or database based) and method of ADHD diagnosis (with or without clinical review). Risk factors for ADHD in epilepsy included younger age, intellectual/developmental disabilities, a family history of epilepsy, earlier epilepsy onset, absence epilepsy, more frequent seizures, and polytherapy; In contrast, risk factors such as sex, generalized epilepsy or seizures, epilepsy etiology, and electroencephalogram abnormalities were not significantly associated with the occurrence of ADHD. Significance The prevalence of ADHD in CWE is high and several potential risk factors are associated with it. This study contributes to a better understanding of ADHD in epilepsy for screening and treatment. Plain Language Summary This systematic review summarizes the prevalence of attention‐deficit/hyperactivity disorder (ADHD) occurring in children with epilepsy and analyses the risk factors for comorbid ADHD in epilepsy. By reviewing 46 articles, we concluded that the overall prevalence of ADHD in children with epilepsy was 30.7% and that intellectual/developmental disabilities were the most significant risk factor for combined ADHD in children with epilepsy. This study provides a wealth of information on comorbid ADHD in epilepsy, which will help clinicians identify and treat potential ADHD in children with epilepsy in a timely manner.

Abstract Introduction Although psychoeducational group interventions are increasingly used for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), a comprehensive review focused on the feasibility and acceptability indicators of these interventions remains lacking. Furthermore, although previous research has explored various aspects of psychoeducation for ADHD, such as its definition and approaches, limited research has focused on the synthesis for outcome measures and patients’ experiences related to these interventions. Therefore, this scoping review aims to map the existing evidence reported on psychoeducational group interventions for adults diagnosed with ADHD. The objective is to provide a comprehensive overview of feasibility indicators, acceptability, and outcome measures used in psychoeducational group interventions. Method A comprehensive structured literature search on the topic was performed in seven bibliographic databases, and the resulting records were independently screened, and their data extracted by two reviewers. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-S) to ensure the transparency and rigor of this scoping review. Results The searches yielded 7510 records. Eight studies met the inclusion criteria. These included studies were conducted in European countries and the United States. Among these, six studies used a randomized control design, one an open feasibility trial, and one a pre-post intervention design. All the studies reported some feasibility and acceptability indicators. While all the studies reported on the severity of symptoms of ADHD as an outcome measure, some also reported on outcomes related to psychological or mental-health problems, quality of life, changes in knowledge regarding ADHD, or the level of self-esteem, functioning, and impairment. Conclusion This scoping review revealed that psychoeducational group interventions are generally acceptable for patients in terms of patient satisfaction with the group intervention. All included studies reported some feasibility indicators, with some reporting good attendance and relatively low dropout rates. Most studies reported positive effects on ADHD and mental health symptoms, suggesting that these interventions are beneficial for adults with ADHD. However, several gaps exist regarding the reporting on the feasibility indicators, acceptability, and outcome measures employed across studies.

Provided the significant overlap in features of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), there is a critical need to identify transdiagnostic markers that could meaningfully stratify subgroups. The objective of this study was to compare the visual evoked potential (VEP) between 30 autistic children, 17 autistic children with co-occurring ADHD presentation (ASD + ADHD), and 21 neurotypical children (NTC). Electroencephalography was recorded while children passively viewed a pattern-reversal stimulus. Mean amplitude of the P1 event-related potential was extracted from a midline occipital channel and compared between groups. P1 mean amplitude was reduced in the ASD + ADHD group compared to the ASD and NTC groups, indicating a distinct pattern of brain activity in autistic children with co-occurring ADHD features. [ABSTRACT FROM AUTHOR]

Growing evidence indicates that family-based mind-body therapy programs (FMBTs) act as an important alternative for attention-deficit/hyperactivity disorder (ADHD) treatment in the youth with minimal side-effects. Moreover, FMBTs contribute to improving the family functioning of those affected by ADHD. To summarize and analyze the benefits and mechanisms, an extensive literature search of the EBSCOhost, PubMed, Web of Science, and Scopus databases was conducted to identify eligible studies. Fifteen studies published between 2010–2023 were reviewed. The included FMBTs were implemented with 850 children/adolescents and 996 parents/caregivers, of whom 201 parent couples attended the programs together with their children. All included FMBTs adopted mindfulness/meditation as the core practice to enhance the participants' mental focus and attention, and were designed for long-term engagement, with six including parent–child joint session(s). Positive changes were observed in both children and adolescents, including improvements in ADHD symptoms, behavioral problems, executive function, and school performance. Additionally, parents experienced positive changes in ADHD traits/symptoms, mental health, and parenting behaviors. Furthermore, FMBTs were found to enhance family functioning by delivering mindful strategies to family, restoring psychological capacity and interpersonal skills in family members, and improving parent–child relationships. The reviewed FMBTs demonstrated high levels of feasibility and participant satisfaction. The factors and issues potentially influencing the effectiveness and feasibility of FMBTs are also discussed. The findings indicate that FMBT holds promise as an ADHD treatment option in home settings. Future efforts may focus on optimizing the design of FMBTs to better address the diverse needs of families in varying circumstances. [ABSTRACT FROM AUTHOR]

This study analyzes whether the association between parental internalizing symptoms (depression, anxiety, stress) and child symptoms of attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) is mediated by positive and negative parenting behaviors. Cross-sectional data of 420 parents of children (age 6–12 years) with elevated levels of externalizing symptoms were collected in a randomized controlled trial. Measures included parent ratings of their internalizing symptoms and parenting behaviors and of their child's externalizing symptoms. Two mediation models were examined, one including ADHD symptoms and one including ODD symptoms as the dependent variable. Parental internalizing symptoms were modeled as the independent variable and positive and negative parenting behaviors were modeled as parallel mediators. Regression analyses support negative parenting behavior as a mediator of the association between parental internalizing symptoms and child ODD symptoms. For the ADHD model, no significant mediator could be found. Future studies should use prospective designs and consider reciprocal associations. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of and risk factors for attention‐deficit/hyperactivity disorder (ADHD) in children with epilepsy (CWE). Methods: We conducted a systematic search in PubMed and Embase for the meta‐analysis. The pooled prevalence of ADHD was calculated using a random‐effects model; subgroup analyses were performed to explore heterogeneity. We collected raw data from articles reporting potential risk factors, which were included in the subsequent risk factor analysis. Results: Forty‐six articles met the inclusion criteria for the meta‐analysis, which showed a pooled ADHD prevalence of 30.7% in CWE, with a predominance of the inattentive subtype of ADHD; the heterogeneity of prevalence was related to population source/study setting (clinic based, community based, or database based) and method of ADHD diagnosis (with or without clinical review). Risk factors for ADHD in epilepsy included younger age, intellectual/developmental disabilities, a family history of epilepsy, earlier epilepsy onset, absence epilepsy, more frequent seizures, and polytherapy; In contrast, risk factors such as sex, generalized epilepsy or seizures, epilepsy etiology, and electroencephalogram abnormalities were not significantly associated with the occurrence of ADHD. Significance: The prevalence of ADHD in CWE is high and several potential risk factors are associated with it. This study contributes to a better understanding of ADHD in epilepsy for screening and treatment. Plain Language Summary: This systematic review summarizes the prevalence of attention‐deficit/hyperactivity disorder (ADHD) occurring in children with epilepsy and analyses the risk factors for comorbid ADHD in epilepsy. By reviewing 46 articles, we concluded that the overall prevalence of ADHD in children with epilepsy was 30.7% and that intellectual/developmental disabilities were the most significant risk factor for combined ADHD in children with epilepsy. This study provides a wealth of information on comorbid ADHD in epilepsy, which will help clinicians identify and treat potential ADHD in children with epilepsy in a timely manner. [ABSTRACT FROM AUTHOR]

Introduction: Response inhibition is an impaired cognitive function in attention-deficit/ hyperactivity disorder (ADHD) individuals. This primary deficit during the cancelation of an intended movement is observed even in the minimal demanding cognitive tasks. Studies have shown that transcranial magnetic stimulation (TMS), especially on the dorsolateral prefrontal cortex (DLPFC), can improve response inhibition. Nevertheless, TMS has a low spatial resolution, and its effect may not be observed in a single-session intervention. Studies show that low-intensity TMS has higher spatial resolution. Therefore, in this study, we aimed to evaluate the effectiveness of this method for intervention of response inhibition in ADHD individuals. Methods: In a double-blind paradigm, the performance of the adults with ADHD while executing a Stroop color and word test (SCWT) was measured during a sham or a real stimulation of the DLPFC. Subsequently, the response inhibitions of the participants were measured before and after the stimulation. The number of correct, wrong, and missed answers to 96 computerized trials and the response times of the answers were measured. In addition, changes in electrocortical activities during the rest phase before and after the stimulation were also evaluated. Results: After checking for data normality, the paired t-test between behavioral data showed that low-intensity magnetic stimulation of the DLPFC can improve response inhibition (reduce errors) even in a single-session intervention of ADHD individuals. The answering times did not change significantly. The behavioral changes were associated with significant changes in the power of EEG in delta and beta frequency bands at the frontal areas. Conclusion: The proposed stimulation protocol with low-intensity TMS had a fair effect on the response inhibition in adults with ADHD. Therefore, it could be suggested as a treatment protocol for response inhibition in ADHD individuals. [ABSTRACT FROM AUTHOR]

Introduction: Although psychoeducational group interventions are increasingly used for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), a comprehensive review focused on the feasibility and acceptability indicators of these interventions remains lacking. Furthermore, although previous research has explored various aspects of psychoeducation for ADHD, such as its definition and approaches, limited research has focused on the synthesis for outcome measures and patients' experiences related to these interventions. Therefore, this scoping review aims to map the existing evidence reported on psychoeducational group interventions for adults diagnosed with ADHD. The objective is to provide a comprehensive overview of feasibility indicators, acceptability, and outcome measures used in psychoeducational group interventions. Method: A comprehensive structured literature search on the topic was performed in seven bibliographic databases, and the resulting records were independently screened, and their data extracted by two reviewers. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-S) to ensure the transparency and rigor of this scoping review. Results: The searches yielded 7510 records. Eight studies met the inclusion criteria. These included studies were conducted in European countries and the United States. Among these, six studies used a randomized control design, one an open feasibility trial, and one a pre-post intervention design. All the studies reported some feasibility and acceptability indicators. While all the studies reported on the severity of symptoms of ADHD as an outcome measure, some also reported on outcomes related to psychological or mental-health problems, quality of life, changes in knowledge regarding ADHD, or the level of self-esteem, functioning, and impairment. Conclusion: This scoping review revealed that psychoeducational group interventions are generally acceptable for patients in terms of patient satisfaction with the group intervention. All included studies reported some feasibility indicators, with some reporting good attendance and relatively low dropout rates. Most studies reported positive effects on ADHD and mental health symptoms, suggesting that these interventions are beneficial for adults with ADHD. However, several gaps exist regarding the reporting on the feasibility indicators, acceptability, and outcome measures employed across studies. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore whether the motor developmental level is associated with the attention deficit/hyperactivity disorder (ADHD) symptoms severity reported by parents in preschool children.MethodsPreschool children aged 4–6 years old with the chief complaint of reported inattention or hyperactivity by kindergarten teachers or parents were recruited in this study. All participants were consulted by at least one experienced developmental behavior pediatrician, according to DSM-V diagnostic criteria of ADHD. Their neuromotor developments were assessed by the Children's Neuropsychological and Behavior Scale and recorded as developmental quotient (DQ) score in gross motor, fine motor, and other domains. Regarding the evaluation of ADHD symptoms, parents of the 4-year-old group completed the Conners' Parent Symptom Questionnaire, while parents of the 5-year-old group completed The Vanderbilt ADHD Diagnostic Parent Rating Scale.ResultsA total of 137 preschool children aged 4–4.9 years (4-year-old group) and 252 were aged 5.0–5.9 years (5-year-old group) were included in the study. Children exhibiting ADHD symptoms were at a much higher risk of fine motor delays compared to gross motor delays, particularly among the younger age group. Correlation analysis and hierarchical regression showed that in the 4-year-old ADHD group, better gross motor development was associated with increased severity of parent-reported ADHD symptoms. In the 5-year-old ADHD group, poorer fine motor development was linked to higher ADHD symptom severity. For children who do not meet ADHD diagnostic criteria, no significant correlations were found between gross or fine motor developmental quotients (DQ) and the severity of ADHD symptoms.ConclusionsPreschool children exhibiting ADHD symptoms are at a notable high risk of fine motor delays. Motor development in preschool children who meet ADHD diagnostic criteria is related to the severity of their symptoms. It is important to monitor both fine and gross motor development in preschool children with ADHD.

Background Numerous investigations have examined the potential link between allergic rhinitis (AR) and attention deficit hyperactivity disorder (ADHD). However, some studies show no association between the two diseases. The connection between these two conditions remains inconclusive. This study aimed to conduct a meta-analysis exploring the correlation between AR and ADHD. Methods We conducted systematic searches of the MEDLINE, EMBASE, Cochrane Library, ERIC, PubMed, Web of Science, and CINAHL databases, up to the year 2023. Subsequently, we conducted a meta-analysis using R 4.2.2, where we computed the pooled odds ratio with a 95% confidence interval to assess the relationship between AR and ADHD within studies exhibiting similar characteristics. Statistical heterogeneity was evaluated by computing the value using the Cochrane Intervention Manual’s guidelines. Additionally, subgroup analyses were conducted by stratifying the study population according to gender, age, etc. Sensitivity analysis was performed by systematically removing individual studies. Results In this systematic review, we incorporated 12 eligible studies, collectively encompassing a sample size of 530,360 participants. Within the included studies, heterogeneity was observed, and the utilization of a random-effects model demonstrated a noteworthy correlation between children with ADHD and the presence of AR. Similarly, children with AR exhibited a significant correlation with the occurrence of ADHD. We also found some relationships in subgroup analyses. Conclusion A substantial correlation is evident between AR and ADHD in children and adolescents. AR may potentially contribute as a risk factor for the onset of ADHD, and conversely, ADHD may heighten the likelihood of developing AR.

Shiyu Zhang,1,2 Caili Chen,1,2 Yi Zhou,1,2 Meirong Pan,1,2 Haimei Li,1,2 Mengjie Zhao,1,2 Min Dong,1,2 Feifei Si,1,2 Lu Liu,1,2 Yufeng Wang,1,2 Qiujin Qian1,2 1Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, People’s Republic of China; 2NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, People’s Republic of ChinaCorrespondence: Qiujin Qian, Peking University Sixth Hospital/ Institute of Mental Health, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191, People’s Republic of China, Email qianqiujin@bjmu.edu.cnPurpose: With the further development of attention-deficit/hyperactivity disorder (ADHD) research, more and more assessment tools related to ADHD have been used. However, there is still no measurement instrument to evaluate the compensatory behavior of ADHD in China. This study aimed to examine the reliability and validity of the Compensatory ADHD Behaviors Scale (CABS) adapted in Chinese and explore ecological characteristics in adults with ADHD using the CABS.Patients and Methods: Data were collected from a sample of 306 adults (Mage = 26.43 years, SD = 5.32; 46.08% male). The original version CABS was translated into Chinese using the forward and backward translation procedures. Participants completed the CABS and questionnaires assessing ADHD symptoms and executive function. We utilized content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion validity to test the validity. Internal consistency and test-retest reliability were employed to test the reliability. Analysis of variance (ANOVA) was employed to compare ADHD subgroups based on gender, ADHD subtype, comorbidities, and medication status, while controlling for demographic variables as covariates.Results: CABS exhibited good construct validity (two factors: present-oriented and future-oriented), content validity (content validity index: 0.98), internal consistency reliability (Cronbach’s alpha coefficient: 0.85 to 0.87) and test-retest reliability (intraclass correlation coefficient: 0.59 to 0.88). The results of CFA showed acceptable fitness for each subscale. CABS demonstrated significant associations with inattention symptoms and plan/organizational abilities. Medicated ADHD individuals scored higher on future-oriented effectiveness subscale of CABS than non-medicated (F = 6.106, p = 0.014).Conclusion: The results indicate that the Chinese CABS exhibited good validity and reliability. It can be considered a valid tool for assessing compensatory behaviors in Chinese adults with ADHD. Further research is needed to explore the connection between medication and compensatory behavior.Keywords: attention-deficit/hyperactivity disorder, adult, compensatory behaviors, reliability, validity, ecological characteristics

Abstract Background In Mexico, this pioneering research was undertaken to assess the accessibility of timely diagnosis of Dyads [Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and their primary caregivers] at specialized mental health services. The study was conducted in two phases. The first phase involved designing an “Access Pathway” aimed to identify barriers and facilitators for ADHD diagnosis; several barriers, with only the teacher being identified as a facilitator. In the second phase, the study aimed to determine the time taken for dyads, to obtain a timely diagnosis at each stage of the Access Pathway. As well as identify any disparities based on gender and socioeconomic factors that might affect the age at which children can access a timely diagnosis. Method In a retrospective cohort study, 177 dyads participated. To collect data, the Acceda Survey was used, based on the robust Conceptual Model Levesque, 2013. The survey consisted of 48 questions that were both dichotomous and polytomous allowing the creation of an Access Pathway that included five stages: the age of perception, the age of search, the age of first contact with a mental health professional, the age of arrival at the host hospital, and the age of diagnosis. The data was meticulously analyzed using a comprehensive descriptive approach and a nonparametric multivariate approach by sex, followed by post-hoc Mann-Whitney’s U tests. Demographic factors were evaluated using univariable and multivariable Cox regression analyses. Results 71% of dyads experienced a late, significantly late, or highly late diagnosis of ADHD. Girls were detected one year later than boys. Both boys and girls took a year to seek specialized mental health care and an additional year to receive a formal specialized diagnosis. Children with more siblings had longer delays in diagnosis, while caregivers with formal employment were found to help obtain timely diagnoses. Conclusions Our findings suggest starting the Access Pathway where signs and symptoms of ADHD are detected, particularly at school, to prevent children from suffering consequences. Mental health school-based service models have been successfully tested in other latitudes, making them a viable option to shorten the time to obtain a timely diagnosis.

Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant deficits in executive function and adverse work-related outcomes. This study aimed to explore the role of executive function deficits in job burnout of employees with ADHD. We hypothesized that employees with ADHD, relative to employees without ADHD, will experience higher levels of job burnout and deficits in executive function. We also hypothesized that the ADHD-job burnout relationship would be mediated through executive function deficits, specifically by self-management to time and self-organization/problem-solving. A field study with 171 employees provided support for the research hypotheses and mediation model in which the employees' ADHD-job burnout relationship was mediated through executive function deficits. Additional mediation analyses indicated that the specific executive function of self-management to time and self-organization/problem-solving mediated the effect of ADHD on job burnout and its facets. Specifically, for physical fatigue, the mediation was realized through self-management to time, and for emotional exhaustion and cognitive weariness, the mediation was significant through self-organization/problem-solving. The present findings shed light on the relevance of referring ADHD among employees, their vulnerability to job burnout, and the role of executive function deficits in job burnout of employees with ADHD.

Abstract Coping with academic demands can be challenging for university students with Attention-Deficit/Hyperactivity Disorder (ADHD). Treatment can help them cope and prevent related mental health issues. The present study aimed to investigate the feasibility of a randomized controlled trial for group Cognitive Behavioural Therapy (CBT), including the use of an app for CBT homework assignments, and to explore the effects of CBT for university students with ADHD. University students (n = 36) participated in the first phase of the study, involving the design of an app to present CBT homework assignments, by evaluating prototypes of the app along with the development team. In the second phase, a pre- vs. post-test design was used. Students with ADHD (n = 7) were offered manual-based CBT once a week for 6 weeks using the app or a paper manual to do the homework, as preferred. University students who took part in the development of the app noted that they would rather use the app than a printed manual. On the other hand, participants in the CBT feasibility study preferred doing homework on paper rather than using the developed app. They all found group CBT and the key elements in the CBT manual helpful. The findings suggest that providing group CBT for university students with ADHD through 6 sessions is feasible and assessing its effects in a randomized controlled trial (RCT) is feasible. Such treatment might improve coping with ADHD symptoms and related mental health issues. Further studies on the development of an app supporting CBT are needed. Trial registration Registry name: Cognitive Behavioural Therapy for University Students with Attention-deficit Hyperactivity Disorder (ADHD). URL: https://register.clinicaltrials.gov . Registration number: NCT 04714866.

Background: Stimulant medication is commonly prescribed as treatment for attention-deficit/hyperactivity disorder (ADHD). While we previously found that short-term stimulant-treatment influences apparent cortical thickness development in an age-dependent manner, it remains unknown whether these effects persist throughout development into adulthood. Purpose: Investigate the long-term age-dependent effects of stimulant medication use on apparent cortical thickness development in adolescents and adults previously diagnosed with ADHD. Methods: This prospective study included the baseline and 4-year follow-up assessment of the "effects of Psychotropic drugs On the Developing brain-MPH" ("ePOD-MPH") project, conducted between June-1-2011 and December-28-2019. The analyses were pre-registered (https://doi.org/10.17605/OSF.IO/32BHF). T1-weighted MR scans were obtained from male adolescents and adults, and cortical thickness was estimated for predefined regions of interest (ROIs) using Freesurfer. We determined medication use and assessed symptoms of ADHD, anxiety, and depression at both time points. Linear mixed models were constructed to assess main effects and interactions of stimulant medication use, time, and age group on regional apparent cortical thickness. Results: A total of 32 male adolescents (aged mean ± SD, 11.2 ± 0.9 years at baseline) and 24 men (aged mean ± SD, 29.9 ± 5.0 years at baseline) were included that previously participated in the ePOD-MPH project. We found no evidence for long-term effects of stimulant medication use on ROI apparent cortical thickness. As expected, we did find age-by-time interaction effects in all ROIs (left prefrontal ROI: P=.002, right medial and posterior ROIs: P<.001), reflecting reductions in apparent cortical thickness in adolescents. Additionally, ADHD symptom severity (adolescents: P<.001, adults: P=.001) and anxiety symptoms (adolescents: P=0.03) were reduced, and more improvement of ADHD symptoms was associated with higher medication use in adults (P=0.001). Conclusion: We found no evidence for long-term effects of stimulant-treatment for ADHD on apparent cortical thickness development in adolescents and adults. The identified age-dependent differences in apparent cortical thickness development are consistent with existing literature on typical cortical development. [ABSTRACT FROM AUTHOR]

This study aims to investigate the structural relationships among adult Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, Sluggish Cognitive Tempo (SCT), and driving behavior with the mediation of procrastination. This study employed a descriptive-correlational design and recruited a convenience sample of 250 licensed drivers in Tabriz, Iran. The data were collected using four instruments, namely, Adult ADHD Self-Report Scale (ASRS), Adult Concentration Inventory (ACI), Tuckman Procrastination Scale (TPS), and Manchester Driving Behavior Questionnaire (MBDQ). Correlation and structural equation modeling techniques which were performed by SPSS 20 and AMOS 24 software, were used to analyze the data. The study conducted a statistical analysis that revealed several significant relationships. Firstly, there was a significant association between ADHD symptoms ( β = 0.25 , p < 0.05 ) and SCT symptoms (β = 0.18 , p < 0.05) with driving behavior. Secondly, the study found a significant correlation between ADHD (β = 0.52 , p < 0.05) and SCT symptoms (β = 0.33 , p < 0.05) with procrastination. Procrastination was also significantly related to driving behavior (β = 0.37 , p < 0.05) . Moreover, the study identified that ADHD (β = 0.19 , p < 0.05) and SCT symptoms (β = 0.12 , p < 0.05) had a significant effect on driving behavior, with procrastination serving as a mediator. Based on the results, this study has identified additional SCT dimensions associated with adult hyperactivity and procrastination, which contribute to the current understanding of the topic. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to delineate the moderating roles of negative experiences related to the coronavirus disease 2019 (COVID-19) on the association between Attention-Deficit/Hyperactivity Disorder symptoms and anxiety symptoms and internalizing behaviors during Fall 2020. Method: Participants were 200 college students. Using a moderated moderation model, researchers found that attention-deficit/hyperactivity disorder symptoms predicted anxiety symptoms for those who internalized behaviors and experienced COVID-19 more negatively. Results: Results suggested that ADHD symptoms were playing a role in the manifestation of anxiety symptoms during the COVID-19 pandemic and that college students who internalize behaviors experienced worsened ADHD symptoms. Conclusion: Clinical implications underscore the importance of providing mental health resources for students on campus, particularly during the COVID-19 pandemic. Specialized treatment may include help with developing time management skills and teaching interventions such as mindfulness exercises that may help alleviate anxiety and improve attention and concentration. [ABSTRACT FROM AUTHOR]

To investigate developmental changes in emotion dysregulation (ED) and associated symptoms of emotional lability, irritability, anxiety, and depression, among girls and boys with and without ADHD from childhood through adolescence. Data were collected from a sample of 8–18-year-old children with (n = 264; 76 girls) and without (n = 153; 56 girls) ADHD, with multiple time-points from a subsample of participants (n = 121). Parents and youth completed rating scales assessing child ED, emotional lability, irritability, anxiety, and depression. Mixed effects models were employed to examine effects and interactions of diagnosis, sex [biological sex assigned at birth], age among boys and girls with and without ADHD. Mixed effects analyses showed sexually dimorphic developmental patterns between boys and girls, such that boys with ADHD showed a greater reduction in ED, irritability, and anxiety with age compared to girls with ADHD, whose symptom levels remained elevated relative to TD girls. Depressive symptoms were persistently elevated among girls with ADHD compared to boys with ADHD, whose symptoms decreased with age, relative to same-sex TD peers. While both boys and girls with ADHD showed higher levels of ED during childhood (compared to their sex-matched TD peers), mixed effects analyses revealed substantial sexually dimorphic patterns of emotional symptom change during adolescence: Boys with ADHD showed robust improvements in emotional symptoms from childhood to adolescence while girls with ADHD continued to show high and/or increased levels of ED, emotional lability, irritability, anxiety and depression. [ABSTRACT FROM AUTHOR]

Poor parental mental health and stress have been associated with children's mental disorders, including attention-deficit/hyperactivity disorder (ADHD), through social, genetic, and neurobiological pathways. To determine the strength of the associations between parental mental health and child ADHD, we conducted a set of meta-analyses to examine the association of parent mental health indicators (e.g., parental depression, antidepressant usage, antisocial personality disorder, and stress and anxiety) with subsequent ADHD outcomes in children. Eligible ADHD outcomes included diagnosis or symptoms. Fifty-eight articles published from 1980 to 2019 were included. We calculated pooled effect sizes, accounting for each study's conditional variance, separately for test statistics based on ADHD as a dichotomous (e.g., diagnosis or clinical cutoffs) or continuous measurement (e.g., symptoms of ADHD subtypes of inattentiveness and hyperactivity/impulsivity). Parental stress and parental depression were significantly associated with increased risk for ADHD overall and both symptoms and diagnosis. Specifically, maternal stress and anxiety, maternal prenatal stress, maternal depression, maternal post-partum depression, and paternal depression were positively associated with ADHD. In addition, parental depression was associated with symptoms of ADHD inattentive and hyperactive/impulsive subtypes. Parental antisocial personality disorder was also positively associated with ADHD overall and specifically ADHD diagnosis. Prenatal antidepressant usage was associated with ADHD when measured dichotomously only. These findings raise the possibility that prevention strategies promoting parental mental health and addressing parental stress could have the potential for positive long-term impacts on child health, well-being, and behavioral outcomes. [ABSTRACT FROM AUTHOR]

Students with attention-deficit/hyperactivity disorder (ADHD) may engage in disruptive classroom behaviors. The Caught Being Good Game (CBGG) has been identified as an intervention for managing class-wide behaviors. The purpose of the current study was to evaluate the effect of the CBGG in increasing class-wide academically engaged behavior (AEB) and decreasing disruptive behaviors (DB) among target students diagnosed with ADHD. This study used a multiple baseline design across three elementary classrooms. The results indicated that all participants' AEB increased when the CBGG was implemented. The results also suggested that the CBGG decreases DB among target students diagnosed with ADHD. Using the CBGG as part of classroom management could reduce the time teachers spend managing student behavior and increase the time they spend on teaching. [ABSTRACT FROM AUTHOR]

Background/objectives: Impulsive aggressive behaviour, although not a core symptom, is often part of the clinical presentation of attention-deficit/hyperactivity disorder (ADHD). Recently, impulsive aggression has been attributed to emotion dysregulation, which is currently conceptualised as a transdiagnostic factor and seems to contribute to the co-occurrence of other problems in ADHD. Thus, this study investigated the presence of impulsive aggressive behaviour and explored whether emotion dysregulation mediates the relationship between inhibitory control difficulties and aggressive behaviour in children with ADHD. Because ADHD may act as a risk factor for the development of other conditions, such as internalising problems, we aimed to understand whether depressive symptoms contribute to this relationship. Methods: Seventy-two children were recruited from a hospital and the community, 38 of whom had ADHD and 34 were typically developing (TD). Parents completed the Child Behaviour Checklist, the Behaviour Rating Inventory of Executive Function, and the Emotion Regulation Checklist. Simple mediation and serial mediation models were performed to test our hypotheses. Results: Aggressive behaviour was significantly higher in ADHD children compared to TD children. Emotion dysregulation fully mediated the relationship between inhibitory control difficulties and aggressive behaviour in ADHD children. Adding depressive symptoms to the model increased the explained variance in aggressive behaviour. Conclusion: The main result of our study supports the role of emotion dysregulation and depressive symptoms in mediating the relationship between inhibitory control difficulties and impulsive aggressive behaviour in children with ADHD. This highlights that aggressive behaviour is, in part, a result of the inability of the child to appropriately regulate their emotions. Future interventions may be tailored to improve emotion regulation skills to address aggressive behaviour. [ABSTRACT FROM AUTHOR]

Background: The diagnostics and treatment of attention-deficit/hyperactivity disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period, and (peri)menopause are neglected, even though they impact ADHD symptoms and associated mood disorders. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. Methods: We describe the group programme and underlying rationale, offering a qualitative analysis of the participants' evaluation. Results: The seven bi-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25–47 years) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable, and the structure suited them well. Completing the premenstrual calendar augmented the awareness and recognition of individual cyclical symptoms. A lifespan approach increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care. Conclusions: Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD. [ABSTRACT FROM AUTHOR]

Working memory impairments are an oft-reported deficit among children with ADHD, and complementary neuroimaging studies implicate reductions in prefrontal cortex (PFC) structure and function as a neurobiological explanation. Most imaging studies, however, rely on costly, movement-intolerant, and/or invasive methods to examine cortical differences. This is the first study to use a newer neuroimaging tool that overcomes these limitations, functional Near Infrared Spectroscopy (fNIRS), to investigate hypothesized prefrontal differences. Children (aged 8–12) with ADHD (N = 22) and typically developing (N = 18) children completed phonological working memory (PHWM) and short-term memory (PHSTM) tasks. Children with ADHD evinced poorer performance on both tasks, with greater differences observed in PHWM (Hedges' g = 0.67) relative to PHSTM (g = 0.39). fNIRS revealed reduced hemodynamic response among children with ADHD in the dorsolateral PFC while completing the PHWM task, but not within the anterior or posterior PFC. No between-group fNIRS differences were observed during the PHSTM task. Findings suggest that children with ADHD exhibit an inadequate hemodynamic response in a region of the brain that underlies PHWM abilities. The study also highlights the use of fNIRS as a cost-effective, noninvasive neuroimaging technique to localize/quantify neural activation patterns associated with executive functions. [ABSTRACT FROM AUTHOR]

Summary: Adolescents with attention‐deficit/hyperactivity disorder (ADHD) often experience greater sleep difficulties compared to those without. However, findings are mixed, and other mental health conditions are often overlooked. This study aimed to examine the relationship between sleep problems, ADHD, and other mental health conditions in a sample of adolescents. Data from 373 adolescents aged 10–19 years was used as part of the wider 'Healthy Brain Network' study, which targets children and adolescents experiencing mental health and neurodevelopmental difficulties. Mental health conditions were assessed via a comprehensive assessment. Sleep was measured by self‐ and parent‐report, as well as via up to a month of actigraphy data. Actigraphy data were analysed using mixed‐methods modelling, while subjective sleep data were analysed using multiple regression. Subjectively‐reported sleep was generally worse in adolescents who had ADHD and other mental health conditions compared to those with ADHD but no other conditions. There were no associations between ADHD status and objective sleep measures or self‐reported measures, but a significant association was found between ADHD status and parent‐reported sleep difficulties, even when accounting for other conditions. Parent‐reported sleep problems were associated not only with ADHD, but also with anxiety, depression, and externalising disorders. The strength of association between ADHD and sleep problems is potentially not as strong as previously thought when considering the role of other mental health conditions. Clinicians should consider the role of other mental health conditions when sleep problems are present, and vice versa. The study also highlights the importance of comprehensive, multi‐informant assessment of mental health conditions, including sleep. [ABSTRACT FROM AUTHOR]

Reading comprehension skills, which involve numerous executive functions (EFs), are crucial for the academic success of school-aged children. Because children with attention-deficit/hyperactivity disorder (ADHD) have difficulties with language comprehension and EFs, achieving reading comprehension may be challenging for them. This study evaluated the distinct contributions of language comprehension and EF components to reading comprehension in order to reveal the possible mechanisms underlying poor reading comprehension among children with ADHD. A total of 69 Chinese-speaking children aged 8–12 years who were typically developing (TD, n = 36) or had ADHD (n = 33) participated in this study. All participants were assessed through intelligence, reading, and language comprehension tests. EF skills were measured using a verbal working memory (WM) test and four behavior tasks: the go/no-go task, a spatial WM (SWM) task, the Tower of London (ToL) task, and the Wisconsin Card Sorting Task (WCST). Results indicated that the ADHD group exhibited significantly lower language and reading comprehension scores than did the TD group. Moreover, the TD and ADHD groups had equivalent ToL scores but notably different go/no-go, WCST, SWM, and verbal WM test scores. After age, sex, and nonverbal intelligence quotient were controlled for, hierarchical regression models revealed the contributions of language skills to reading comprehension in both groups, but the contributions of EFs differed between the groups. Inhibition and verbal WM were significant predictors of reading comprehension in the ADHD group. In sum, the abilities to disregard irrelevant information and maintaining linguistic information of multiple episodes are important for Chinese-speaking children with ADHD to build a coherent mental representation of the text during reading comprehension. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental conditions and is highly heterogeneous in terms of symptom profile, associated cognitive deficits, comorbidities, and outcomes. Heterogeneity may also affect the ability to recognize and diagnose this condition. The diagnosis of ADHD is primarily clinical but there are increasing research efforts aiming at identifying biomarkers that can aid the diagnosis. We first discuss the definition of biomarkers and the necessary research steps from discovery to implementation. We then provide a broad overview of research studies on candidate diagnostic biomarkers in ADHD encompassing genetic/epigenetic, biochemical, neuroimaging, neurophysiological and neuropsychological techniques. Finally, we critically appraise current limitations in the field and suggest possible ways forward. Despite the large number of studies and variety of techniques used, no promising biomarkers have been identified so far. Clinical and biological heterogeneity as well as methodological limitations, including small sample size, lack of standardization, confounding factors, and poor replicability, have hampered progress in the field. Going forward, increased international collaborative efforts are warranted to support larger and more robustly designed studies, develop multimodal datasets to combine biomarkers and improve diagnostic accuracy, and ensure reproducibility and meaningful clinical translation. [ABSTRACT FROM AUTHOR]

Coping with academic demands can be challenging for university students with Attention-Deficit/Hyperactivity Disorder (ADHD). Treatment can help them cope and prevent related mental health issues. The present study aimed to investigate the feasibility of a randomized controlled trial for group Cognitive Behavioural Therapy (CBT), including the use of an app for CBT homework assignments, and to explore the effects of CBT for university students with ADHD. University students (n = 36) participated in the first phase of the study, involving the design of an app to present CBT homework assignments, by evaluating prototypes of the app along with the development team. In the second phase, a pre- vs. post-test design was used. Students with ADHD (n = 7) were offered manual-based CBT once a week for 6 weeks using the app or a paper manual to do the homework, as preferred. University students who took part in the development of the app noted that they would rather use the app than a printed manual. On the other hand, participants in the CBT feasibility study preferred doing homework on paper rather than using the developed app. They all found group CBT and the key elements in the CBT manual helpful. The findings suggest that providing group CBT for university students with ADHD through 6 sessions is feasible and assessing its effects in a randomized controlled trial (RCT) is feasible. Such treatment might improve coping with ADHD symptoms and related mental health issues. Further studies on the development of an app supporting CBT are needed. Trial registration Registry name: Cognitive Behavioural Therapy for University Students with Attention-deficit Hyperactivity Disorder (ADHD). URL: https://register.clinicaltrials.gov. Registration number: NCT 04714866. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a rapidly globalizing medical category, and there is a need to attend to the on the-ground processes through which laypeople deploy the ADHD label in different local contexts. Based on in-depth interviews with Israeli mothers of children with ADHD, this article explores how mothers, as lay actors in the social field of diagnosis, interpreted the origins and meanings of their child's 'troubles'. The temporal perspective on mothers' meaning-making processes revealed a progression of four common phases through which mothers revisited their understanding of ADHD, and recast their own responsibilities and moral roles. We found that mothers' self-understanding was crucially impacted by the invisibility of the disability and the fact that diagnosis did not fully relieve them from blame for their children's stigmatizing behavior. While not all mothers accepted the validity of the diagnosis, participating in the medicalization of their child's condition allowed them to reach similar pragmatic and narrative goals. We discuss the cultural and institutional features of the Israeli ADHD landscape that shape mothers' narratives of their children, and their relations with expertise. We point to a culturally unique framing of children with ADHD in Israel as those characterized by emotional vulnerability and risk of social exclusion. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials.

Background/Objectives: The complex association between attention-deficit/hyperactivity disorder (ADHD) and methylphenidate (MPH) with precocious puberty (PP) is still unclear. This study aims to investigate the association between ADHD, MPH, and PP. Methods: This is a nationwide cohort study including a total of 3,342,077 individuals, 186,681 with ADHD and 3,155,396 without. First, we compared the risk of PP between ADHD cases and non-ADHD cases. Second, we compared the risk of PP between MPH users and non-MPH users in patients with ADHD. Results: Patients with ADHD were at a greater risk of PP (adjusted hazard ratio [aHR], 2.01 [95% CI, 1.91–2.11]). In our moderation analyses, the female gender was a positive additive effect modifier of the association between ADHD and PP, whereas tics and intellectual disability were negative effect modifiers. In patients with ADHD, MPH users had a significantly lower risk of PP (aHR, 0.63 [95% CI 0.57–0.70]), and females had a negative effect modification on the association between MPH and PP. Conclusions: Our study found that children with ADHD were at a greater risk of PP. Girls with ADHD were a group particularly vulnerable to PP. Comorbid tics or intellectual disability was associated with a lower risk of PP. Among patients with ADHD, MPH was protective against PP, especially in girls. However, these preliminary results need further validation due to the nature of them being from an electronic database study. Unmeasured confounding factors might affect the association between MPH and PP.

Even though the number of studies aiming to improve comprehension of ADHD pathology has increased in recent years, there still is an urgent need for more effective studies, particularly in understanding adult ADHD, both at preclinical and clinical levels, due to the increasing evidence that adult ADHD is highly distinct and a different entity from childhood ADHD. This review paper outlines the symptoms, diagnostics, and neurobiological mechanisms of ADHD, with emphasis on how adult ADHD could be different from childhood-onset. Data show a difference in the environmental, genetic, epigenetic, and brain structural changes, when combined, could greatly impact the behavioral presentations and the severity of ADHD in adults. Furthermore, a crucial aspect in the quest to fully understand this disorder could be through longitudinal analysis. In this way, we will determine if and how the pathology and pharmacology of ADHD change with age. This goal could revolutionize our understanding of the disorder and address the weaknesses in the current clinical classification systems, improving the characterization and validity of ADHD diagnosis, specifically those in adults. [ABSTRACT FROM AUTHOR]

Background: Cognitive functions represent foundational factors for mental health and quality of life (QoL). In Tourette syndrome (TS), psychiatric comorbidities are common and have been inconsistently reported to affect the cognition and QoL of patients, while the role of tic disorder duration has not been yet explored. Methods: To examine how comorbidities and TS duration may influence cognition and QoL, N = 80 children with TS (6–16 years) were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV). Standardized questionnaires were used to assess the presence and severity of TS main comorbidities and QoL. Data were interpreted using linear correlations, regression, and mediation analysis. Results: Depression and attention-deficit/hyperactivity disorder (ADHD) symptoms accounted for poorer cognitive performance. Anxiety oppositely predicted better cognitive performance, while no significant role for obsessive compulsive disorder (OCD) was observed. Disease duration was associated with lower total IQ, verbal reasoning, and working memory abilities. Depression, anxiety, and TS duration also deeply influenced QoL measures. Conclusions: TS common comorbidities have a differential impact on the cognitive abilities of children and adolescents, which translates into a complex influence on their perceived QoL. A longer clinical history of tics was related to worse cognitive outcomes, which prompts further consideration of disease duration in both clinical and research settings involving children and adolescents. [ABSTRACT FROM AUTHOR]

Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant deficits in executive function and adverse work-related outcomes. This study aimed to explore the role of executive function deficits in job burnout of employees with ADHD. We hypothesized that employees with ADHD, relative to employees without ADHD, will experience higher levels of job burnout and deficits in executive function. We also hypothesized that the ADHD-job burnout relationship would be mediated through executive function deficits, specifically by selfmanagement to time and self-organization/problem-solving. A field study with 171 employees provided support for the research hypotheses and mediation model in which the employees' ADHD-job burnout relationship was mediated through executive function deficits. Additional mediation analyses indicated that the specific executive function of self-management to time and self-organization/problem-solving mediated the effect of ADHD on job burnout and its facets. Specifically, for physical fatigue, the mediation was realized through self-management to time, and for emotional exhaustion and cognitive weariness, the mediation was significant through selforganization/problem-solving. The present findings shed light on the relevance of referring ADHD among employees, their vulnerability to job burnout, and the role of executive function deficits in job burnout of employees with ADHD. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate if temperament and experience of childhood trauma differed between young psychiatric patients with borderline personality disorder (BPD), bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD). Diagnoses were based on the Structured Clinical Interview for DSM Axis I and Axis II. Temperament was assessed by the Temperament and Character Inventory (TCI) and childhood trauma by the Early Trauma Inventory-Self Report-Short Form (ETI-SR-SF). Temperament and childhood trauma were compared between the BPD group (n = 19) and the non-BPD group (BD/ADHD) (n = 95). Interactions between trauma and temperament were evaluated using a logistic regression model with a BPD diagnosis as outcome variable. Participants in the BPD group showed higher novelty seeking (NS) and harm avoidance (HA). Traumatic experiences in childhood were common but the BPD group differed very little from the others in this regard. The interaction between temperament and trauma had low explanatory power for a BPD diagnosis in this sample. Temperament might be useful to distinguish BPD when symptoms of impulsivity and affective instability are evaluated in psychiatric patients. The results from the interaction analysis support the multifactorial background to BPD. [ABSTRACT FROM AUTHOR]

Background: Adults with attention-deficit/hyperactivity disorder (ADHD) may experience sleep problems doubly suffering from the disease and side effects of stimulant medications. Physical activity (PA) is known to produce numerous beneficial effects in adults. However, it was not well-characterized whether PA would still be effective in this situation. The main objective of the current study was to examine the relationship between PA and sleep among adult ADHD patients who were using stimulant medications and quantify the form of this association. Methods: Adult ADHD participants with stimulant medications use condition from the National Health and Nutrition Examination Survey (NHANES) database between January 1, 2013, and March 2020 (prepandemic) were included in the cross-sectional analysis. Weighted logistic regression was performed to assess the relationship between PA level and sleep. A restricted cubic spline model was used to relax the linear relationship assumptions and investigate the associations between the risk of trouble sleeping and time spent engaging in moderate-tovigorous PA per week. Results: A total of 162 eligible adult ADHD participants who reported using stimulant medicines were included. Participants who adhered to the general recommendation of guidelines in the US of 150 min per week of moderate-tovigorous PA had a significant lower risk of complaining of trouble sleeping (OR: 0.26, 95% CI: 0.10-0.67, p = 0.006), and this association was seen in men (OR: 0.23, 95% CI: 0.09-0.56, p = 0.002), but was not seen in women (OR: 0.71, 95% CI: 0.27-1.88, p = 0.500). Restricted cubic spline analysis showed that the incidence of trouble sleeping gradually decreased after at least 105 min of moderateintensity PA per week in participants (OR: 1.02, 95% CI: 0.92-1.14). A significant difference appeared after 341 min (OR: 0.87, 95% CI: 0.76-0.99), and the curve leveled after 1,250 min (OR: 0.60, 95% CI: 0.46-0.79). Conclusion: Our findings observed associations between PA and sleep condition in the adult ADHD patients with stimulant medication use population. Moderateto- vigorous PA may be beneficial to sleep in adults with ADHD who were using stimulants and thus should be recommended as part of a healthy lifestyle. Gender difference should be considered as an important factor for further studies to examine these associations and explore potential mechanisms. [ABSTRACT FROM AUTHOR]