Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression,anxiety and disease impact

Abstract

Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.

Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).

Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r?=?0.57, p < .001), anxiety (BAI; r?=?0.56, p < .001) and childhood ADHD symptoms (WURS; r?=?0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).

Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.     

The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17?770 twins

Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) often occur together. To obtain more insight in potential causes for the co-occurrence, this study examined the genetic and environmental etiology of the association between specific ASD and ADHD disorder dimensions. Self-reported data on ASD dimensions social and communication difficulties (ASDsc), and repetitive and restricted behavior and interests (ASDr), and ADHD dimensions inattention (IA), and hyperactivity/impulsivity (HI) were assessed in a community sample of 17 770 adult Swedish twins. Phenotypic, genetic and environmental associations between disorder dimensions were examined in a multivariate model, accounting for sex differences. ASDr showed the strongest associations with IA and HI in both sexes (r_p 0.33 to 0.40). ASDsc also correlated moderately with IA (females r_p 0.29 and males r_p 0.35) but only modestly with HI (females r_p 0.17 and males r_p 0.20). Genetic correlations ranged from 0.22 to 0.64 and were strongest between ASDr and IA and HI. Sex differences were virtually absent. The ASDr dimension (reflecting restricted, repetitive and stereotyped patterns of behavior, interests and activities) showed the strongest association with dimensions of ADHD, on a phenotypic, genetic and environmental level. This study opens new avenues for molecular genetic research. As our findings demonstrated that genetic overlap between disorders is dimension-specific, future gene-finding studies on psychiatric comorbidity should focus on carefully selected genetically related dimensions of disorders.     

Evaluation of adult attention deficit hyperactivity disorder in smokers and Maras powder users

Abstract

Background: The aim of this study was to evaluate adult attention deficit and hyperactivity disorder (ADHD) in smokers, Maras powder users and non-users of tobacco products by using the Adult Attention Deficit and Hyperactivity Disorder Self-report Scale (ASRS). Methods: The study was performed on 446 males presenting to family health centers in Kahramanmara, Turkey. Of 446 participants, 104 were Maras powder users, 133 were smokers and 209 were volunteers not using any tobacco products. Data were collected with a questionnaire composed of questions about socio-demographic features and features of smoking and Maras powder use, and the Fagerström Nicotine Dependence Scale and the ASRS. P < 0.05 was considered significant. Results: The mean age of the participants was 33.94 ± 10.68 years (min = 18, max = 64). There was no significant difference in age between the study groups (P = 0.089). Thirty-one participants (7.0%) received scores higher than the cut-off value (≥ 14 points) for the short form of the ASRS. Twenty-one participants (4.7%) achieverd scores higher than the cut-off value (≥ 44 points) for the ASRS. The smokers received the highest scores of 8.42 ± 3.79 for all the subscales of the short version of the ASRS, 26.87 ± 10.46 for the ASRS, 12.57 ± 6.47 for the attention deficit subscale and 14.30 ± 5.35 for the hyperactivity and impulsivity subscale. Conclusion: Higher rates of the smokers and the Maras powder users had symptoms of ADHD. Considering nicotine may decrease symptoms of ADHD, it can be assumed that the rates of the smokers and Maras powder users with ADHD are higher.     

Symptomatic overlap between attention-deficit/hyperactivity disorder and borderline personality disorder in women: the role of temperament and character traits

ObjectiveThere is substantial symptomatic overlap between attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults, but the nature of the relationship between these disorders needs further clarification. The role of temperament and character traits in the differentiation of classes of patients with similar ADHD and BPD symptom profiles was examined and possible pathways between early temperament and future ADHD and/or BPD were hypothesized.MethodsStructured diagnostic interviews were conducted in 103 female patients to assess current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptoms of ADHD and BPD, and parent interviews were used to assess ADHD symptoms in childhood. Classes of subjects with homogeneous symptom profiles were identified using latent class analysis. Temperament and character traits were assessed using the Temperament and Character Inventory of Cloninger et al; scores were then compared across the latent classes.ResultsLatent class analysis revealed 4 mutually exclusive classes of patients: 1 with only ADHD symptoms; 1 with BPD symptoms and ADHD symptoms of hyperactivity; 1 with BPD symptoms and ADHD symptoms of inattention, hyperactivity, and impulsivity; and 1 with BPD symptoms and ADHD symptoms of inattention and hyperactivity. High Novelty Seeking was found in all classes except for the class with symptoms of BPD and only the hyperactivity aspect of ADHD. The highest Novelty Seeking temperament scores were found in that class of patients with both symptoms of BPD and symptoms in all areas of ADHD. High Harm Avoidance, low Cooperativeness, and low Self-directedness were specifically related to classes containing BPD symptoms.ConclusionsClasses of ADHD and BPD symptoms are associated with specific temperament and character configurations. Novelty Seeking was associated with the inattention symptoms of ADHD. An outspoken Novelty Seeking temperament suggests vulnerability for the development of ADHD and co-occurring BPD. Contrary to patients with combined ADHD and BPD symptoms, patients with only symptoms of ADHD showed normal character development and thus an absence of a personality disorder. Assessment of temperament and character traits can improve our understanding of the complex relationship between ADHD and BPD.     

Psychopathological,temperamental, and characteristic factors in adults with remaining childhood attention-deficit hyperactivity symptoms

Objectives: To investigate differences in psychopathological, temperamental and characteristic factors between young adults with and without persistent Attention-Deficit Hyperactivity disorder (ADHD) symptoms.

Methods: A total of 429 university students were divided into three groups: persistent adult ADHD (n?=?53), only childhood ADHD (n?=?56) and healthy controls (n?=?320). The Korean Adult ADHD Scale, Korean Wender-Utah Rating Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Barratt Impulsiveness Scale, Korean Young Internet Addiction Scale, and Temperament Character Inventory-Revised (TCI-R; based on Cloninger’s seven factor model of temperament and character) were used to evaluate psychopathological factors.

Results: Participants with persistent adult ADHD symptoms had significantly higher levels of childhood ADHD, depression, anxiety and the Internet addiction symptoms than did the only-childhood ADHD and control groups. The adult ADHD group also had significantly higher tendencies toward novelty seeking, harm avoidance, and self-transcendence, as well as low self-directedness and cooperativeness.

Conclusions: Results suggest that persistent ADHD is associated with several unfavourable psychopathological, temperamental and characteristic factors. Therefore, thorough evaluation of these factors for childhood ADHD could help predict prognoses and provide treatment plans for preventing persistent ADHD into adulthood.     

Temperament,executive function,and attention-deficit/hyperactivity disorder (ADHD) in adolescents: The mediating role of effortful control

Introduction: Temperament dimensions may be related to executive functions (EF) and may be involved in the expression and maintenance of symptoms of attention-deficit/hyperactivity disorder (ADHD). The current study aimed to assess whether effortful control (EC) mediates the relationship between EF and inattentive symptoms, and whether surgency (S) and negative affectivity (NA) mediate the relationships between EF and hyperactive–impulsive ADHD symptoms in adolescents.

Method: Working individually, participants aged between 12 and 16 years (N = 118; 75 with ADHD) performed tests of cognitive EF (working memory, planning, flexibility, and inhibition), and parents and teachers completed a multi-informant assessment focusing on measures of ADHD symptoms and temperament dimensions (EC, S, and NA).

Results: There were significant differences between ADHD and control participants in EF and temperament dimensions. ADHD participants had lower scores than controls in working memory, planning, and inhibition EF; they also had lower scores in EC and higher scores in S and NA. Structural equation modeling indicated differential associations between EC, S, and NA temperament dimensions, and working memory, planning and inhibition EF, and ADHD symptoms. Mediation analysis suggested that EF exerted indirect effects on the inattentive and hyperactive–impulsive symptoms, via EC; higher EF abilities were related to higher levels of EC, which in turn were related to lower scores of inattentive and hyperactive–impulsive ADHD symptoms. S and NA did not mediate relations among EF and hyperactive–impulsive symptoms.

Conclusion: The findings expand on those of previous studies of the complex relationship between temperament dimensions and EF and confirm the differential association between impairments in some EF, low EC, and the expression of inattentive and hyperactive–impulsive symptoms in adolescents, which may account for the ADHD–control group differences.     

Low self-awareness of ADHD in adults using a self-report screening questionnaire

IntroductionAwareness of attention deficit hyperactivity disorder (ADHD) in adults has been growing over the last decade. One of the most interesting issues related to this topic is these adults’ self-awareness of their ADHD symptoms and their estimation of their own impairments. Our hypothesis while studying young adult ADHD populations was that there would be a significant difference between their self-report and their clinical assessment.MethodOne hundred and three students volunteered for this study. In order to validate our ADHD screening questionnaire (ADHD-SQ), and to assess the level of awareness they have of their own symptoms, participants underwent a complete clinical assessment for ADHD. They were divided into a control group (n = 24), and an ADHD study group (n = 79), which in turn was composed of two sub-groups, one comprising 24 ADHD predominantly inattentive (ADHD-I) and the other 55 ADHD combined type (ADHD-C).ResultsFactor analysis yielded two factors explaining 41% of the variance. The Inattention (IA) subscale score tended to be higher in both ADHD sub-groups as compared to the control group (6.5 ± 2.1 vs. 2.34 ± 2.3 with P < 0.001), with no significant difference between the two ADHD sub-groups. Hyperactivity Impulsivity (HI) subscale was significantly higher for the ADHD-C sub-group than in the ADHD-I sub-group, whose score was similar to that of the control group (control: 1.6 ± 2.1; ADHD-I: 1.55 ± 1.0; ADHD-C: 4.5 ± 2.6, P < 0.0001). Receiver Operating Characteristics (ROC) analysis showed similar results. The area under the curve (AUC) of IA subscale score was 0.90 (95% confidence: 0.83–0.96) and for HI subscale score was 0.75, (95% confidence: 0.63–0.86). Classification into groups used a cut-off point of 3+ items out of nine, in the SQ and 6+ items out of nine in the clinical assessment. These two classifications showed 68% agreement (46% sensitivity and 95% specificity). In both ADHD sub-groups, the self-reported average number of positive symptoms per student was relatively low for both clusters; this phenomenon was pronounced in the specific subtypes. The self-rated HI cluster score was considerably low in the ADHD-C sub-group (4.5 ± 2.6), and the IA one was particularly low in the ADHD-IADHD-I sub-group (5.9 ± 1.9).ConclusionThis study's results indicate that ADHD symptoms are under-reported for both inattentive and hyperactive-impulsive clusters, indicating that adults with ADHD tend to under-estimate their own ADHD-related impairments. We suggest that this questionnaire may be used both in research and academic settings to help counsellors and students to obtain early indication of ADHD and to refer students suspected of having ADHD to full clinical assessment.     

Attention‐deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients

Aim

We aimed to examine the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders.

Methods

Cross‐sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care, which included psychiatric outpatients aged 18–65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan from April 2014 to January 2015 (N = 864). The Adult ADHD Self‐Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior.

Results

After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose–response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD‐10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder, ADHD symptoms were significantly linked to all forms of suicidal behavior.

Conclusion

ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior.     

The relationship of Internet addiction severity with Attention Deficit Hyperactivity Disorder symptoms in Turkish University students; impact of personality traits,depression and anxiety

Aim

The aim of this study was to investigate the relationship of Internet addiction (IA) with Attention Deficit Hyperactivity Disorder (ADHD) symptoms while controlling the effect of personality traits, depression and anxiety symptoms in Turkish university students.

Methods

A total of 271 university students participated in the present study. The students were assessed through the Internet Addiction Scale (IAS), the Wender Utah Rating Short Scale (WURS-25), the Turkish version of the Adult ADHD Self-Report Scale (ASRS), the Eysenck Personality Questionnaire Revised Abbreviated Form (EPQR-A), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI).

Results

According to IAS, participants were separated into three groups, namely, moderate/high, mild and without IA groups. The rates of groups were 19.9% (n = 54), 38.7% (n = 105) and 41.3% (n = 112), respectively. Correlation analyses revealed that the severity of IAS is positively correlated with WURS-25, ASRS (total, inattention and hyperactivity/impulsivity subscales), neuroticism personality trait, depression and anxiety scores, whereas it is negatively correlated with extraversion personality trait. Hierarchical regression analysis indicated that depression and anxiety symptoms, introversion and neuroticism personality traits and the severity of ADHD symptoms (particularly hyperactivity/impulsivity symptoms) are the predictors for IAS score, respectively.

Conclusions

The severity of ADHD symptoms has predicted the severity of IA even after controlling the effect of personality traits, depression and anxiety symptoms among Turkish university students. University students with severe ADHD symptoms, particularly hyperactivity/impulsivity symptoms may be considered as a risk group for IA.     

Temperamental and character profiles of preschool children with ODD,ADHD, and anxiety disorders

BackgroundThe aim of the present research was to identify profiles of Cloninger's temperament and character dimensions associated with anxiety disorders, oppositional defiant disorder (ODD) and attention- deficit/hyperactive disorder (ADHD) in preschoolers.MethodThe parents of 120 children (mean age = 4.65 years; S.D. = .88) completed the Preschool Temperament and Character Inventory (PsTCI). The sample consisted of 4 groups (n = 30 per group): ADHD, anxious, ODD and control children. To diagnose the different disorders, the Preschool Age Psychiatric Assessment and Child Behavior Checklist 1.5-5 was administered to the parents.ResultsThe discriminant analysis showed that three temperamental dimensions (Harm Avoidance, Novelty Seeking and Persistence) enabled the correct classification of 75% of cases within their own group, which demonstrated an adequate accuracy rate. The ADHD children showed a temperamental profile that was characterized by high Novelty Seeking, low Reward Dependence and low Persistence, while the anxious children obtained high scores in Harm Avoidance. The profiles of the ODD children shared some common features (high Novelty Seeking) with the ADHD children, but the ODD children were characterized by higher Persistence and Harm Avoidance compared with ADHD children.ConclusionsThe present results indicate that Cloninger's temperamental dimensions allow to differentiate the three most frequent psychiatric disorders in preschoolers.     

The WHO Adult ADHD Self-Report Scale: Reliability and Validity of the Korean Version

Objective

A self-report scale of adult attention-deficit/hyperactivity disorder, the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) was developed and demonstrated good psychometric properties. The purpose of the present study is to investigate the psychometric properties of the ASRS in Korean samples.

Methods

The ASRS includes 18 questions regarding the frequency of recent DSM-IV Criterion A symptoms of adult ADHD. We examined the factor structure, internal consistency, and convergent validity of the ASRS in Korean samples.

Results

The ASRS demonstrated good internal consistency and test-retest reliability. Correlations between the ASRS and other adult ADHD measures were high, providing evidence of convergent validity. A subsequent exploratory factor analysis indicated that a two-factor solution provided the best fit.

Conclusion

It is expected that this scale would be helpful in clinical settings and research in Korea.     

The association between traumatic brain injury and ADHD in a Canadian adult sample

ObjectiveThis study describes the association between lifetime traumatic brain injury (TBI) and attention deficit and hyperactivity disorder (ADHD) among Canadian adults.MethodA cross-sectional sample of 3993 Ontario adults aged 18 or older were surveyed by Computer Assisted Telephone Interviewing (CATI) throughout 2011 and 2012 as part of the CAMH Monitor, a rolling survey assessing the health, mental health and substance use of Ontario adults. TBI was defined as trauma to the head that resulted in loss of consciousness for at least five minutes or overnight hospitalization. ADHD was measured by the 6-item ASRS screener for adult ADHD, and self-reported history of diagnosed ADHD.ResultsAmong adults with a history of TBI, 6.6% (95% CI: 4.7, 9.4) screened ADHD positive, and 5.9% (95% CI: 3.6, 9.5) reported having been diagnosed with ADHD in their lifetime. Adults with lifetime TBI had significantly greater odds of scoring positive on the ADHD/ASRS screen (OR = 2.49, 95% CI: 1.54, 4.04), and of reporting a history of diagnosed ADHD (OR = 2.64, 95% CI: 1.40, 4.98) than without TBI, when holding values of sex, age, and education constant.ConclusionSignificant positive associations between lifetime TBI and both current and past ADHD were observed among adults in this population. More research to understand these associations, and their significance for the etiology and management of TBI and ADHD, is needed.     

Attention deficit hyperactivity disorder symptoms and cannabis use after 1 year among students of the i-Share cohort

BackgroundCannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use.MethodsStudents in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year.ResultsIncrease in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio [OR]: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)).ConclusionsHigh levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.     

Internet addiction and attention-deficit / hyperactivity disorder symptoms in adolescents with autism spectrum disorder

AimSeveral studies have reported that internet addiction (IA) is more prevalent in adolescents with autism spectrum disorder (ASD). However, the characteristics of ASD adolescents with IA are unclear. The objective of this study was to investigate the prevalence of IA in ASD adolescents, and compare the characteristics between the IA and the non-IA groups in adolescents with ASD.MethodsThe study included 55 participants who were outpatients at Ehime University Hospital and Ehime Rehabilitation Center for Children in Japan, aged 10–19 years, diagnosed with ASD. Patients and their parents answered several questionnaires including the Young's Internet Addiction Test (IAT), Strengths and Difficulties Questionnaire (SDQ), Autism Spectrum Quotient (AQ), and Attention Deficit Hyperactivity Disorder Rating Scale-IV (ADHD-RS).ResultsBased on the total IAT score, 25 out of 55 participants were classified as having IA. Although there were no significant differences in AQ and Intelligence Quotient, the higher scores of ADHD symptoms in SDQ and ADHD-RS were observed in the IA group than the non-IA group. The IA group used portable games more often than the non-IA group.ConclusionThe ADHD symptoms were strongly associated with IA in ASD adolescents. More intensive prevention and intervention for IA are needed especially for the ASD adolescents with ADHD symptoms.     

Temperament and character profiles of patients with tension-type headache and migraine

The aim of this present study was to evaluate the temperament and character profiles of persons with tension-type headache (TTH) and migraine, and to compare the results with those of healthy controls. The study population consisted of 81 patients with TTH (60 female, 21 male) and 56 patients with migraine (34 female, 17 male) aged 18-50 years, according to the criteria of the International Headache Society with age and gender - matched healthy control subjects (54 female, 28 male). All participants were instructed to complete a self-administered 240-item temperament and character inventory (TCI) questionnaire and Beck Depression Inventory (BDI). The TCI assesses four dimensions of temperament, namely, novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P), and three dimensions of character, being self-directedness (SD), cooperativeness (C) and self-transcendence (ST). According to the TCI biosocial model, the temperament dimension HA is suggested to indicate central serotonergic turnover, which is further correlated with depressive state. It was found that mean BDI scores were significantly higher in patients with TTH and migraine than in those of the controls. The BDI scores were positively correlated with HA scores (r = 0.295, P < 0.001) and negatively correlated with SD (r = -0.386, P < 0.001) and C scores (r = -0.164, P= 0.016). Multivariate analysis showed that BDI scores had significant covariation for HA, SD and C. Despite using the BDI score as a covariate, TTH patients had higher HA scores (P = 0.01) than did the control subjects. No significant differences were found between the groups regarding main NS, RD, P, SD, C and ST scores. Based on the main results of this study, it is suggested that higher serotonergic activity related to HA scores in TTH patients and their relationship with depressive symptomatology supports the role of central serotonergic involvement in TTH.     

Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder: Investigation of Slow Cortical Potential Neurofeedback—Preliminary Results

Attention deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention, impulsivity, and hyperactivity. Compared to ADHD in children, only a few studies have investigated ADHD in an adult population, and even less have investigated new forms of treatment such as neurofeedback. Neurofeedback has been applied effectively in various areas, especially in the treatment of children with ADHD, and symptom improvements were associated with increased amplitude of the contingent negative variation (CNV). This study investigated if any behavioral and electrophysiological changes reflected in the CNV can be observed after 15 sessions of SCP neurofeedback training. Furthermore, a comparison of CNV amplitude in adults with ADHD and a healthy control group was conducted. Continuous 22-channel EEG was acquired from 10 adults who met DSM–IV criteria for ADHD and 8 matched healthy controls. EEG recordings were collected pre/midtreatment and included resting EEG, P300, and CNV tasks as well as ADHD behavioral questionnaires. The adult ADHD group received 15 sessions of SCP training at Cz (referenced to A1, ground A2). The control group only underwent the EEG recording. After 15 sessions of SCP-training a significant improvement in self-ratings of ADHD symptoms was reported. In addition, a trend in increasing CNV mean amplitude was observed after training. A significant difference in baseline CNV between the adult ADHD group and the healthy control group was observed. These results give a promising outlook to the outcome after the completion of 30 sessions of SCP training. The differences in CNV amplitude between the ADHD group and healthy controls are in line with other studies about adult ADHD and CNV. This supports the idea of impaired self-regulation in adult ADHD. The behavioral improvements and increase in CNV after SCP training suggests that SCP training has a positive effect on adult ADHD symptoms and their origin.     

The protective effect of character maturity in child aggressive antisocial behavior

BackgroundChildhood aggressive antisocial behavior (CD) is one of the strongest predictors of mental health problems and criminal behavior in adulthood. The aims of this study were to describe personality profiles in children with CD, and to determine the strength of association between defined neurodevelopmental symptoms, dimensions of character maturity and CD.MethodsA sample of 1886 children with a close to equal distribution of age (9 or 12) and gender, enriched for neurodevelopmental and psychiatric problems were selected from the nationwide Child and Adolescent Twin Study in Sweden. Their parents rated them according to the Junior Temperament and Character Inventory following a telephone interview during which information about the children's development and mental health was assessed with the Autism-Tics, AD/HD and other Comorbidities inventory.ResultScores on the CD module significantly and positively correlated with scores on the Novelty Seeking temperament dimension and negatively with scores on character maturity (Self-Directedness and Cooperativeness). In the group of children with either neurodevelopmental or behavioral problems, the prevalence of low or very low character maturity was 50%, while when these two problems coexisted the prevalence of low or very low character maturity increased to 70%. Neurodevelopmental problems (such as: oppositional defiant disorder, symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder) and low scores on character maturity emerged as independently significant predictors of CD; in a multivariable model, only oppositional defiant symptoms and impulsivity significantly increased the risk for coexisting CD while a mature self-agency in a child (Self-Directedness) remained a significant protective factor.ConclusionThese results suggest that children's willpower, the capacity to achieve personally chosen goals may be an important protective factor – even in the presence of neurodevelopmental and psychiatric problems – against progressing into persistent negative outcomes, such as aggressive antisocial behaviors.     

Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and selfreported symptoms of ADHD,anxiety, and depression among parents of school-aged children with and without ADHD

Background

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders.

Aim

Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents.

Methods

A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). One parent for each enrolled child completed three self-report scales: the ADHD Adult Self Report Scale (ASRS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales.

Results

Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers (but not fathers) of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents.

Conclusion

School-aged children with ADHD commonly suffer from comorbid anxiety and depressive disorders, and the severity of these symptoms parallels the level of anxiety and depressive symptoms in their parents. Self-reported symptoms of ADHD are significantly more common in parents of children with ADHD than in parents of children without ADHD. Longitudinal studies are needed to disentangle the genetic, biological, and social factors responsible for these complex inter-relationships.     

Temperament and character dimensions associated with clinical characteristics and treatment outcome in attention-deficit/hyperactivity disorder boys

Background

Although differential patterns of temperament and character have been documented in subjects with attention-deficit/hyperactivity disorder (ADHD), few studies have investigated relations between these dimensions, clinical features of ADHD, and treatment outcome.

Methods

Ninety-five boys with ADHD and 87 controls participated in the study; 88.5% of the referred patients were reassessed after optimal titration of methylphendiate treatment.

Results

Compared with controls, boys with ADHD showed a temperament profile of high novelty seeking, low reward dependence, and persistence, as well as low scores on both self-determination and cooperativeness character dimensions. No significant differences were found between subjects with ADHD and controls in harm avoidance. Temperament and character traits were related to specific symptom domains and comorbidity but did not predict global severity of ADHD. Persistent and immature children with ADHD were more likely to experience short-term remission.