Статті в журналах з теми "ADHD, ADHD subtypes, attention, memory"

Abstract Objective: This study analyzed differences in learning/acquisition and delayed recall between adult patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) Predominantly Inattentive and Combined subtypes and a control group using the Rey Auditory Verbal Learning Test (RAVLT). Method: This cross-sectional study analyzed data from a consecutive series of patients referred specifically for purposes of ADHD diagnostic clarification. Each was administered the RAVLT, as part of an extensive evaluation, to assess for verbal learning and memory. 155 patients (40.8%) met DSM-5 criteria for ADHD-Inattentive subtype and 165 (43.4%) for ADHD-Combined subtype. Sixty (15.8%) who did not meet criteria for ADHD, but who were diagnosed with a primary depressive/anxiety disorder or received no diagnosis served as a control group. Results: There were significant main effects found between the three groups on all trials analyzed on the RAVLT (Trial 1, p=.016; Trial 5, p=.003; Total Trials, p=.000; Trial 6, p=.001; Trial 7, p=.000). Effect sizes ranged from .022-.042. Posthoc analysis revealed that the ADHD-C group performed significantly worse than both the control group and ADHD-I group in both acquisition and delayed memory. Frequency distributions of impaired performance revealed the ADHD-C group had the largest rate of impairments (12-23%) on this measure. The ADHD-I group demonstrated 6-19% impairments. The control group ranged from 3-10% impairments. Conclusion: Verbal memory impairments are much more likely in adult patients diagnosed with ADHD than those without the diagnosis. While the inattentive and combined subtypes of ADHD both demonstrate deficiencies in verbal memory performance, the rate of likely impairments is much greater amongst the combined subtype.

Objective: To compare the neurocognitive profile of a subgroup of patients with ADHD who have a high academic-occupational functioning vs. patients with low functioning. Method: A total of 50 adults with ADHD, 10 with high academic-occupational functioning (ADHD/HF), 20 with low academic-occupational functioning (ADHD-LF), and 20 healthy controls were assessed with a standard neuropsychological battery. Independent sample tests and logistic regression were calculated to compare the performance of the three groups and to identify predictor variables. Results: Statistically significant differences were found in the forward digits subtest between the subtypes of ADHD, but not between ADHD-HF and controls, nor between controls and ADHD-LF. In matrix reasoning subtest, significantly lower performances were registered between both ADHD groups compared to the control group. In the letter number subtest, ADHD-LF obtained a significant lower performance than the control group, but the ADHD-HF group do not differ with the other two groups. Finally, regarding to the binary logistic regression analysis, it could be observed that the only variable that best predicted belonging to these groups has been forward digits, which according to the data of the model would be a protection factor. Conclusion: The profile of patients with high socio-occupational performance was characterized by a better conservation of working memory and the capacity for sustained attention, and a lower tendency to distraction.

AbstractObjective:Neuropsychological deficits are of major importance in ADHD, yet no previous studies have assessed clinically referred samples of older adults. The authors compared older adults with ADHD (60–75 years) with both younger adults with ADHD (18–45 years) and older healthy controls with regard to various neuropsychological deficits.Methods:Well-established tests were used to investigate working memory, inhibition, switching, planning, fluency, and speed of processing. Self-ratings of executive functioning and delay-related behaviors were also included. Both variable-oriented and person-oriented analyses were conducted.Results:Older adults with ADHD differed from controls with regard to working memory, inhibition, switching, and delay-related behaviors. In comparison to younger adults with ADHD, they performed at a similar level with regard to working memory and planning, but significantly better with regard to inhibition, switching, fluency, speed of processing, and delay aversion. Despite several significant group differences relative to controls, person-oriented analyses demonstrated that a majority of older adults with ADHD performed within the average range on each test and 20% showed no clear deficit within any neuropsychological domain.Conclusions:The results are in line with models of heterogeneity that have identified different neuropsychological subtypes in ADHD as well as a subgroup of patients without any clear neuropsychological deficits. For older adults with ADHD, it will be important to assess their functioning across time as normal aging is related to memory decline and these patients could therefore end up with severe deficits as they grow older, which in turn could have serious negative effects on daily life functioning.

Abstract Objective Working memory performance among adults with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrates variable results across literature. This investigation evaluated performance on a visuospatial working memory task relative to scores on measures of ADHD subtype and severity. Method A community sample aged 18 to 77 (n = 31; n men = 15) completed neuropsychological testing and measures of ADHD. The sample was predominantly White (64%; n = 20) and highly educated (Myears = 15.6). Participants were eligible if they were 18 or older, regardless of ADHD symptoms/diagnosis, and excluded if they had neuromedical/neuropsychiatric disorders. Spatial Addition (SA) from the Wechsler Memory Scale (WMS-IV) assessed working memory; the Adult ADHD Clinical Diagnostic Scale (ACDS) and Adult ADHD Investigator Symptom Rating Scale (AISRS) assessed ADHD subtype and burden. Results AISRS scores did not explain any variance in SA scores, R2 = 00, p = .970 (β = -.020, p = .970). A one-way between subjects ANOVA demonstrated no significant differences on SA scores between groupings based on ACDS: ADHD (n = 9, M = 13, SD = 4.12), and non-ADHD (n = 20, M = 13.95, SD = 5.27), (F(3,25) = .592, p = .626); ADHD (Inattentive (n = 2, M = 14.4, SD = .707); Hyperactive (n = 1, M = 18.00); Combined (n = 6, M = 11.7, SD = 4.8)). Adjustment for age and education did not change these findings. Conclusions Results failed to indicate any association between visuospatial working memory scores and ADHD symptoms but a larger, diversified sample is necessary to corroborate this null finding.

Objective: To explore whether clinical variables and initial cognitive abilities predict or moderate (far) transfer treatment outcomes of cognitive training. Method: A total of 98 children (aged 8-12 years) with ADHD were randomly assigned to Cogmed Working Memory Training or a new cognitive training called “Paying Attention in Class.” Outcome measures included neurocognitive assessment, parent and teacher rated questionnaires of executive functioning behavior and academic performance. Predictor/moderator variables included use of medication, comorbidity, subtype of ADHD, and initial verbal and visual working memory skills. Results: Parent and teacher ratings of executive functioning behavior were predicted and moderated by subtype of ADHD. Word reading accuracy was predicted by subtype of ADHD and comorbidity. Use of medication and initial verbal and visual spatial working memory skills only predicted and moderated near transfer measures. Conclusion: Cognitive training can be beneficial for certain subgroups of children with ADHD; individual differences should be taken into account in future trials.

Objective: The objective of this study was to review the dopamine theory of attention deficit hyperactivity disorder (ADHD) in terms of advances made over the last decade. Method: ‘Hyper’ and ‘hypo’ dopaminergic theories are discussed, as well as noradrenergic and neuropsychological findings in ADHD. A model incorporating both anterior and posterior attention systems, involved in orienting, inhibition, vigilance and working memory, is described. Neuropsychological studies of covert orienting are reviewed. Results: The dopamine theory is supported by neuroimaging, genetic and stimulant medication studies, which confirm an inhibitory dopaminergic effect at striatal/prefrontal level. Work in rodents and primates, as well as humans has shown that noradrenergic systems are also important in prefrontal regulation, in particular α2A noradrenergic agonists have a beneficial effect on cognitive tasks. Neuropsychological studies implicate posterior parietal mechanisms in the orienting of attention. Working memory may require integration of spatial and temporal information, involving anterior and posterior systems. Conclusions: Anterior and posterior attention systems are involved in inhibition, working memory and orientation. Attention deficit hyperactivity disorder symptoms and subtypes are likely to reflect deficits in both inhibition and working memory, and may be heterogenous. While the dopamine theory is supported by genetic and stimulant medication studies, the work of Arnsten and colleagues suggests a potential role for α2 noradrenergic agonists such as guanfacine.

Attention Deficit / Hyperactivity Disorders (ADHD) are developmental disorders in children with 3 symptom clusters, namely hyperactivity, attention deficit and impulsivity, and a combination. We investigated the prevalence of the 3 symptom clusters and their association with learning-related skills among children aged 6 to 7 years in Bloemfontein, Free State province, South Africa. The Aptitude Test for School Beginners (ASB) was applied to determine learning-related skills, and the Strength and Weaknesses of ADHD Symptoms Normal Behaviour rating scale (SWAN) was used to determine ADHD symptoms. Data on SWAN scores were available for 390 children, while data on both the SWAN and ASB were available for 345 children (189 girls and 156 boys) with a mean age of 6 years and 8 months. The prevalence of ADHD symptoms was as follows: 74.6% of the children did not fulfil the criteria for ADD/ADHD, 7.7% presented with the combined subtype, 6.7% presented with hyperactivity and impulsiveness, and 11.0% with inattentiveness. The presence of ADHD symptoms had a significant effect p = < 0.05 on reasoning, numerical abilities, gestalt, coordination and memory. We conclude that ADHD symptoms are a significant risk factor for 5 of the 8 learning-related skills in children, namely numerical skills, memory, reasoning, gestalt and coordination.

Objective: To provide an overview of the animal and human research literature on the link between fetal alcohol spectrum disorder (FASD) and attention-deficit hyperactivity disorder (ADHD). Method: We conducted a comprehensive literature review that addressed the history of, and current research on, fetal alcohol syndrome (FAS) and FASD, as well as that on ADHD in children. Results: In animal and human research, there is emerging clinical, neuropsychological, and neurochemical evidence of a link between FASD and ADHD. Conclusions: The evidence of the link between these 2 conditions has implications for clinical management. The clinical quality of ADHD in children with FASD often differs from that of children without FASD. For children with FASD, ADHD is more likely to be the earlier-onset, inattention subtype, with comorbid developmental, psychiatric, and medical conditions. Children with FASD are commonly not mentally retarded but present complex learning disabilities, especially a mixed receptive-expressive language disorder with deficits in social cognition and communication (reminiscent of sensory aphasia and apraxia), working memory problems, and frequently, a mathematics disorder. Comorbid psychiatric conditions include anxiety, mood, conduct, or explosive disorders. As well, cardiac, renal, or skeletal problems are more likely to be present. Because these children have a disturbance in brain neurochemistry, or even brain structure (that is, in the corpus callosum), their response to standard psychostimulant medication can be quite unpredictable.

Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to indirect informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy. Documenting “cool” executive-working memory (EWM) and “hot” self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type ( n = 33)/hyperactive-impulsive type ( n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/ SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed.

AbstractObjective:There is limited understanding of the cognitive profiles of Spanish-speaking children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study investigated the cognitive cluster profiles of Puerto Rican Spanish-speaking children with ADHD using the Wechsler Intelligence Scales for Children-Fourth Edition Spanish (WISC-IV Spanish) Index scores and examined the association between cognitive cluster profiles with other potentially relevant factors.Method:Hierarchical cluster analysis was used to identify WISC-IV clusters in a sample of 165 Puerto Rican children who had a primary diagnosis of ADHD. To examine the validity of the ADHD clusters, analysis of variances and chi-square analyses were conducted to compare the clusters across sociodemographics (e.g., age and education), type of ADHD diagnosis (ADHD subtype, Learning Disorder comorbidity), and academic achievement.Results:Clusters were differentiated by level and pattern of performance. A five-cluster solution was identified as optimal that included (C1) multiple cognitive deficits, (C2) processing speed deficits, (C3) generally average performance, (C4) perceptual reasoning strengths, and (C5) working memory deficits. Among the five clusters, the profile with multiple cognitive deficits was characterized by poorer performance on the four WISC-IV Spanish Indexes and was associated with adverse sociodemographic characteristics.Conclusions:Results illustrate that there is substantial heterogeneity in cognitive abilities of Puerto Rican Spanish-speaking children with ADHD, and this heterogeneity is associated with a number of relevant outcomes.

Abstract Objective Neonatal jaundice (hyperbilirubinemia) remains present in 60% of births in the United States1. Current literature links hyperbilirubinemia with neurodevelopmental problems, particularly with attention deficit hyperactivity disorder (ADHD), general learning difficulties, and non-progressive developmental delays. Moderate elevations in bilirubin are also suggested to increase the risk for cognitive, perceptual, motor, and auditory disorders. Imaging studies have shown selective patterns of injury to specific brain regions associated with deficits in executive function, including impulse control and working memory as well as different subtypes of attention problems grounded in reward circuitry system dysfunction in children with bilirubin encephalopathy. Method Neuropsychological functioning of a 12-year old Hispanic female with a history of high levels of perinatal bilirubin, and subsequent developmental and cognitive difficulties in speech, learning, attention and memory as well as problems with socialization and anxiety is presented with the purpose of adding to existing literature. Comprehensive neuropsychiatric interview and neuropsychological testing was completed. Results Results revealed several areas of neurocognitive weaknesses with deficits in areas of intellectual functioning, learning (reading and mathematics), expressive language, visual memory, attention, and auditory processing. Emotional and behavioral measures evidenced significant deficits in social-emotional functioning, particularly with interpersonal skills, sense of adequacy, and self-reliance, which resulted in increased anxiety contributing to cognitive and academic deficits. Conclusions Neuropsychological profile was consistent with cognitive, academic, behavioral and emotional manifestations theoretically associated with neuropathological findings in hyperbilirubinemia. Furthermore, similar to existing literature, cognitive deficits were observed in the absence of a clear cause of neonatal jaundice following a full-term, uncomplicated pregnancy.

The debate about diagnoses and treatment of attention deficit hyperactive disorder (ADHD) in children continue to range on between the developmental and biological perspectives. While there is increasing evidence that support the biological susceptibility of the disorder, a number of researches also emphasized the significant effect of environment on the syndrome. This study used developmental perspectives to evaluate and bring together various bio-psychosocial factors that impact on children diagnosed with ADHD. The study explored and integrated the existing and advancing study on ADHD to a more refined pattern that embraced developmental perspectives. The study also discussed how the linkage in childhood ADHD fits within the developmental psychopathology perspective. The study revealed that ADHD as a developmental disorder is influenced by prenatal, biological and psychosocial environmental risk factors, and suggested that better understanding of genomic susceptibilities, family environment and parental characteristics would transform the pathway for development of ADHD in children. References American Psychiatric Association.(2000). Diagnostic and StatisticalManual of MentalDisorders. 4th ed. Washington, DC: American Psychiatric Association. American Psychiatric Association.(2013). Diagnostic and StatisticalManual of MentalDisorders.5th ed. Washington, DC: American Psychiatric Association. Arnsten, A.F, (2007). Catecholamine and second messenger influenceson prefrontalcortical networks of “representational knowledge”:a rational bridge between genetics andthe symptoms of mental illness. Cerebral Cortex, 17, i6–i15. Arnsten, A.F, & Pliszka, S.R. (2011). Catecholamine influences on prefrontalcorticalfunction: relevance to treatment of attentiondeficit/hyperactivity disorder and relateddisorders. Pharmacology, Biochemistry and Behavior, 99, 211–216. Atladóttir H.O, Parner E.T, & Schendel D. (2007). Variation in incidence ofneurodevelopmental disorders with season of birth. Epidemiology, 18, 240–245. Barkley, R. A. (2006). Attention deficit/hyperactivity disorder: A handbook for diagnosisand treatment (3rd ed.). New York: Guilford Baumeister A.A, Hawkins M.F (2001). Incoherence of neuroimaging studies of attentiondeficit/ hyperactivity disorder. Clinical Neuropharmacology, 24, 2–10. Berger I. (2011). Diagnosis of attention deficit hyperactivity disorder: much ado aboutsomething. Israeli Medical Association Journal, 13, 571–574. Berger, A., Posner, M. I. (2000). Pathologies of brain attentionalnetworks. Neuroscienceand Biobehavioral Reviews, 24, 3–5. Biederman J, Faraone S.V, Keenan K, Knee D, &Tsuang M.T (1990): Familygenetic andpsychosocial risk factors in DSM-III attention deficit disorder. Journal of AmericanAcademy of Child and Adolescent Psychiatry, 29, 526 –533. Biederman J, Faraone SV, Keenan K, Tsuang MT (1991b): Evidence of familialassociationbetween attention deficit disorder and major affective disorders. Archives of GeneralPsychiatry, 48, 633–642. Biederman, J, Faraone, S.V, Keenan K, Benjamin, J, Krifcher, B. &Moore C. et al (1992).Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder.Patterns of comorbidity in probands and relativesin psychiatrically and pediatricallyreferred samples. Archives of General Psychiatry, 49, 728 –738. Biederman, J., Milberger, S., Faraone, S. V., Kiely, K., Guite, J.,Mick, E., Ablon, S., Warburton, R., & Reed, E. (1995). Family environment risk factors for attention deficithyperactivity disorder: A test of Rutter’s indicators of adversity. Archives of GeneralPsychiatry, 52, 464–470. Biederman, J., Faraone, S.V., Mick, E., Spencer,T.,Wilens,T., Kiely,K., Guite, J., Ablon, J.S., Reed, E., & Warburton, R. (1995). High risk for attention deficit hyperactivity disorderamong children of parents with childhood onset of the disorder: A pilot study. Journal ofAmerican Psychiatry, 152, 431–435. Biederman J, Faraone S.V, Monuteaux M, Spencer T, Wilens T, Bober M, et al (2004).Gender effects of attention deficit hyperactivity disorder inadults, revisited. BiologicalPsychiatry, 55, 692–700. Brookes, K.,Mill, J.,&Guindalini,C., et al (2006). Acommon haplotype of the dopaminetransporter geneassociated with attention-deficit/hyperactivity disorderand interactingwithmaternal use of alcohol duringpregnancy. Archives of General Psychiatry, 63, 74–81. Brophy, K., Hawi, Z., Kirley, A., Fitzgerald, M., & Gill, M. (2002). Synaptosomalassociated protein 25 (SNAP-25) and attention deficit hyperactivity disorder (ADHD):Evidence of linkage and association in the Irish population. Molecular Psychiatry, 7 , 913–917 Campbell, S. B. (2000). Attention-Deficit/Hyperactivity Disorder: A developmental view.In: Handbook of Developmental Psychopathology. (pp. 383–401). A. J. Sameroff, M.Lewis, & S. Miller (Eds.). New York: Kluwer Academic/Plenum. Carlson, E. A., Jacobvitz, D., & Sroufe, L. A. (1995). A developmental investigation ofinattentiveness and hyperactivity. Child Development, 66, 37–54. Childress, A.C, Berry, S.A (2012). Pharmacotherapy of attention-deficit hyperactivitydisorder in adolescents. Drugs, 72, 309–325. Cortese, S (2012). The neurobiology and genetics of attention-deficit/hyperactivitydisorder (ADHD): what every clinician shouldknow. European Journal of PaediatricNeurology, 16, 422–433. Dopheide, J.A (2005). ASHP therapeutic position statement on theappropriate use ofmedications in the treatment of attention deficit/hyperactivity disorder in paediatricpatients. American Journal of Health System Pharmacy, 62, 1502– 1509. Coghill, D., Nigg, J., Rothenberger, A., Sonuga-Barke, E., & Tannock, R. (2005). Withercausal models in the neuroscience of ADHD? Developmental Science, 8, 105–114. Cummings, E. M., Davies, P., & Campbell, S. B. (2000). Developmental Psychopathologyand Family Process: Research, Theory, and Clinical Implications. New York: Guilford. Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M.A., et al. (2005). Molecular genetics of attention-defi cit/hyperactivity disorder. BiologicalPsychiatry, 57 , 1313–1323. Faraone, S, Biederman, J, Krifcher Lehman, B, Keenan, K, Norman, D, Seidman, L. et al.(1993). Evidence for the independent familial transmission of attentiondeficit hyperactivitydisorder and learning disabilities: Results froma family genetic study. American Journalof Psychiatry, 150, 891– 895. Faraone, S. V, Tsuang, M. T. (1995). Methods in psychiatric genetics. In: Textbook inPsychiatric Epidemiology, Tohen, M, Tsuang, M., Zahner, G. (Eds). (pp. 81–134). NewYork: John Wiley& Sons. Faraone, S. V. & Biederman, J. (1998). Neurobiology of attentiondeficit hyperactivitydisorder. Biological Psychiatry, 44, 951–958. Faraone S.V, Biederman J, &MonuteauxM.C. (2001a). Attention deficit hyperactivitydisorder with bipolar disorder in girls: Further evidence for a familial subtype? Journal ofAffect Disorders, 64, 19 –26. Haraone S.V, Doyle A.E (2001): The nature and heritability of attentiondeficit/hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America,10, 299 –316, viii–ix. Faraone, S.V., & Biederman, J. (2000). Nature, nuture, and attentiondeficit hyperactivitydisorder. Developmental Review, 20, 568–581. Faraone S.V, Perlis R.H, Doyle A.E, Smoller J.W, Goralnick J, &Holmgren M.A, et al.(2005). Molecular genetics of attention deficit hyperactivity disorder. BiologicalPsychiatry, 57, 1313–1323. Gray, J. A., Feldon, J., Rawlins, J. N. P., Hemsley, D. R., & Smith, A. D. (1991) Theneuropsychology of schizophrenia. Behavioral and Brain Sciences, 14, 1–84. Gray, J. A. (1982). The neumpsychology of anxiety. New York: Oxford University Press. Halperin, J. M., & Healey, D. M. (2011). The infl uences of environmental enrichment,cognitive enhancement,and physical exercise on brain development: Can we alter thedevelopmental trajectory of ADHD? Neuroscience and Biobehavioral Reviews, 35 , 621–634. Hauschild K.M, Mouridsen S.E, & Nielsen S. (2005). Season of birth inDanish childrenwith language disorder born in the 1958–1976 period. Neuropsychobiology; 51, 93–99. Hudziak J.J, Rudiger L.P, Neale M.C, Heath A.C, & Todd R.D (2000). A twin study ofinattentive,aggressive, and anxious/depressed behaviors. Journal of the American Academyof Child and Adolescent Psychiatry, 39, 469 –476. Kahn, R. S., Khoury, J. & Nichols,W.C., et al (2003). Role of dopamine transportergenotype and maternal prenatal smoking in childhood hyperactive-impulsive,inattentive,and oppositional behaviors. Journal of Pediatrics, 143, 104–110. Kesner R.P, & Churchwell J.C (2011). An analysis of rat prefrontal cortexin mediatingexecutive function. Neurobiology of Learning and Memory, 96, 417–431. Kuntsi, J.,& Stevenson, J. (2000). Hyperactivity in children:Afocuson genetic research andpsychological theories. Clinical Child and Family Psychology Review, 3, 1–24. Langley, K., Rice, F., & van den Bree, M. B., et al (2005). Maternal smoking duringpregnancy as an environmental risk factor for attention deficit hyperactivity disorderbehaviour. A Review. Minerva Pediatrica, 57, 359–371. Manshadi M, Lippmann S, O’Daniel R, & Blackman A (1983): Alcohol abuse andattention deficit disorder. Journal of Clinical Psychiatry, 44, 379 –380 Martin N, Scourfield J, McGuffin P (2002).Observer effects and heritability ofchildhoodattention-deficit hyperactivity disorder symptoms. British Journal of Psychiatry, 80, 260 –265. Neale, B. M., Medland, S. E., Ripke, S., Asherson, P., Franke, B., Lesch, K. P., et al.(2010). Meta-analysis of genome-wide association studies of attention-defi cit/hyperactivity disorder. Journal of the American Academy of Child and AdolescentPsychiatry, 49 , 884–897. Nigg J, Nikolas M, & Burt S. A(2010). Measured gene-by-environment interaction inrelation to attention-deficit/hyperactivity disorder. Journal of the American Academy ofChild and Adolescent Psychiatry, 49, 863–73. Oades, R. D., Lasky-Su, J., Christiansen, H., Faraone, S.V., Sonuga-Barke, E. J., Banaschewski, T., et al. (2008). The influence of serotonin- and other genes onimpulsivebehavioral aggression and cognitive impulsivity in children with attentiondeficit/hyperactivity. A Developmental Perspective on ADHD disorder (ADHD): Findingsfrom a family-based association test (FBAT) analysis. Behavioral and Brain Functions, 4,4–48. Pastor P. N & Reuben C.A. (2008). Diagnosed attention deficit hyperactivity disorder andlearning disability: United States, 2004–2006. Vital Health Statistics, 10, 1–14. Quay, H. C. (1988a). Attention deficit disorder and the behavioral inhibitionsystem: Therelvance of the neuropsychological theory of Jeffrey A. Gray. In: Attention deficitdisorder: Criteria, cognition, intervention (pp. 117–126). L. M. Bloomingdale & J.Sergeant (Eds.). NewYork: Pergamon. Quay, H. C. (1988b). The behavioral reward and inhibition systems inchildhood behaviordisorder. In: Attentiondeficit disorder W; New research in treatment, psychopharnmcology,and attention (pp. 176–186). L. M. Bloomingdale (Ed.). NA: Pergamon. Quay, H. C. (1996, January). Gray'sbehavioral inhibition in ADHD:An update. Paperpresented at the annual meeting of the InternationalSociety for Research in Child andAdolescent Psychopathology, Los Angeles, CA. Rader, R, McCauley L,& Callen, E.C. (2009). Current strategies in thediagnosis andtreatment of childhood attention-deficit/hyperactivity disorder. American FamilyPhysician, 79, 657–665. Robbins, T. W. (2003). Dopamine and cognition. Currpin Neurol,16, (2), S1–S2. Rutter, M, Cox, A, Tupling, C, Berger, M, &Yule, W. (1975). Attainment and adjustmentin two geographical areas. 1—The prevalence of psychiatric disorders. British Journal ofPsychiatry, 126, 493–509. Rutter, M., &Sroufe, L. A. (2000). Developmental psychopathology: Concepts andchallenges. Development and Psychopathology, 12, 265–296. Sergeant, J. (2000). The cognitive-energetic model: An empiricalapproach to attentiondeficit hyperactivity disorder. Neuroscienceand Biobehavioral Reviews, 24, 7–12. Sherman D, McGue M, &Iacono W (1997). Twin concordance for attention deficithyperactivity disorder: A comparison of teachers’ and mothers’reports. American Journalof Psychiatry, 154, 532–535. Sonuga-Barke, E. J., Auerbach, J., Campbell, S. B., Daley, D., & Thompson, M. (2005).Preschool varieties of hyperactive and dysregulated behaviour: Multiple pathways betweenrisk and disorder. Developmental Science, 8 , 141–150. Sonuga-Barke, E. J., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathwaymodel: Evidence for the dissociation of timing, inhibitory, and delayrelated impairments inattention-defi cit/hyperactivity disorder. Journal of the American Academy of Child andAdolescent Psychiatry, 49 , 345–355. Sonuga-Barke, E. J., & Halperin, J. (2010). Developmental phenotypes and causalpathways in attention deficit/hyperactivity disorder: Potential targets for earlyintervention? Journal of Child Psychology and Psychiatry, 51, 368–398. Sprich-Buckminster S, Biederman J, Milberger S, Faraone S, &Krifcher LehmanB (1993):Are perinatal complications relevant to the manifestation ofADD? Issues of comorbidityand familiality. Journal of American Academy of Child and Adolescent Psychiatry,32,1032–1037 Swanson, J. M., Sunohara, G. A., Kennedy, J. L., Regino,R., Fineberg, E.,Wigal, T.,Lerner, M.,Williams, L., LaHoste,G. J.,&Wigal, S. (1998). Association of the dopaminereceptorD4 (DRD4) gene with a refined phenotype of attention deficithyperactivitydisorder (ADHD): A family–based approach.Molecular Psychiatry, 3, 38–41. Taylor, E. (1999). Developmental neuropsychopathology of attentiondeficit and impulsiveness. Development and Psychopathology, 11, 607–628. Thapar, A.,O’Donovan,M., &Owen,M. J. (2005b). The genetics of attention deficithyperactivity disorder. Human Molecular Genetics, 14, 275–282. Thapar, A., Langley, K.,O’Donovan,M. (2006). Refining the attention deficithyperactivity disorderphenotype formolecular genetic studies. Molecular Psychiatry, 11,714–720. Thapar A, Langley K, &Asherson P, (2007). Gene–environment interplay in attentiondeficit hyperactivity disorder and the importance of a developmental perspective. BritishJournal of Psychiatry 190, 1–3. Tochigi M, Okazaki Y, & Kato N, (2004). What causes seasonality of birth inschizophrenia? Neuroscience Res, 48, 1–11 Trent S & Davies W. (2012). The influence of sex-linked genetic mechanisms on attentionand impulsivity. Biological Psychology, 89, 1–13. United States, 2003 and 2007 (2010). Increasing prevalence of parent-reported attentiondeficit/hyperactivity disorder among children, MMWR Morb Mortal Wekly Rep, 59, 1439–43. Yehuda, R. (2000). Biology of posttraumatic stress disorder. Journal of ClinicalPsychiatry, 61, 14–21. Zimmer, L (2009). Positron emission tomography neuroimagingfor a better understandingof the biology of ADHD. Neuropharmacology, 57, 601–607.

AbstractPrefrontal cortex (PFC) represents one of the most evolved regions of primate brain that is thought to regulate human specific features such as cognition, emotion and behavior (Arnsten and Jin, 2012). PFC is a site of action of guanfacine, an agonist of alpha 2 adrenergic receptors. Compared to clonidine, another alpha adrenergic drug, guanfacine is more selective for α2A adrenergic receptor subtype (van Zwieten et al., 1994; Uhlen at al., 1995) and is weaker in producing hypotension andsedation (Jurado at al., 1998) resulting in better tolerability of the medication. Studies have shown that endogenous noradrenergic stimulation of alpha2A receptors is essential for PFC regulation of behavior, thought and emotion as blockade ofα2A receptors in the monkey dorsolateral PFC significantly impairs working memory (Li and Mei, 1994) and behavioral inhibition (Ma et al., 2003; Ma et al., 2003). So far FDA has approved guanfacine in treatment of attention deficit hyperactivity disorder in children but the medication is used off label for treatment of oppositional defiant disorder, conduct disorder, pervasive developmental disorders, motor tics and Tourette’s syndrome as well. Impulsivity as used in clinical terms is very broadly defined and encompasses personality traits as well as cognitive functions such as emotion regulation and behavioral inhibition. Numerous studies have shown effectiveness of extended release guanfacine in reducing impulsiveness in children with ADHD and recently in autism spectrum disorder (Scahill et al., 2015), however limited data is available on use of guanfacine in treatment of impulse control and aggression in adults.Funding AcknowledgementsNo funding.

Attention-deficit hyperactivity disorder (ADHD) is associated with reduced school performance. To determine which ADHD symptoms and subtypes have the strongest association, we used type and frequency of symptoms on the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) to create symptom scores for inattention and hyperactivity-impulsivity and define subtypes (ADHD-Inattentive [ADHD-I], ADHD-Hyperactive-Impulsive, ADHD-Combined [ADHD-C]). Regression methods were used to examine associations between symptoms and subtype and a composite measure of school performance. Children with ADHD-C and ADHD-I had higher adjusted odds of having reduced overall school performance (ADHD-C = 5.8, 95% confidence interval [CI] = 3.1-10.9; ADHD-I = 5.5, 95% CI = 3.1-10.1) compared with children without ADHD. All inattentive symptoms were significantly related to reduced school performance in reading, writing, and handwriting, while 6 of 9 symptoms were significantly associated in mathematics. Children with ADHD-I were significantly more likely than children with other ADHD subtypes to receive a school-based Individualized Education Program or 504 Plan. ADHD-I symptoms may be broadly linked to reduced school performance.

Objectives: To examine the performance on the Deese-Roediger-McDermott task of adults divided into ADHD subtypes and compares their performance to that of healthy controls to examine whether adults with ADHD are more susceptible to the production of false memories under experimental conditions. Method: A total of 128 adults with ADHD (50% females), classified into three Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV-TR) subtypes, were compared with 48 controls. Results: The results indicated that the ADHD participants recalled and recognized fewer studied words than the controls, the ADHD groups produced more false memories than the control group, no differences in either the false positives or the false negatives. The ADHD–combined (ADHD-CT) group recognized significantly more critical words than the control, ADHD–predominantly inattentive (ADHD-IA), and ADHD–predominantly hyperactive-impulsive (ADHD-HI) groups. The ADHD groups recalled and recognized more false positives, were more confident in their false responses, and displayed more knowledge corruption than the controls. The ADHD-CT group recalled and recognized more false positives than the other ADHD groups. Conclusion: The adults with ADHD have more false memories than the controls and that false memory formation varied with the ADHD subtypes.

AbstractThis study aimed to compare children with different ADHD subtypes and controls on measures of attention, and to examine the relationships between measures of attention and reading and spelling ability. Thirty-eight children with ADHD and sixteen controls were administered tests of four components of attention (viz., attention span, focused attention, selective attention and shifting attention) and two subtests (viz., reading and spelling) from the WRAT-3. The children with ADHD-Combined subtype were found to show deficits in attention span and focused attention, while the children with ADHD-Inattentive subtype were found to show deficits in shifting attention, and subtler deficits in attention span and focused attention. Measures of attention span were found to be significant predictors of reading ability, and measures of attention span and selective attention were found to be significant predictors of spelling ability. These results suggest that different ADHD subtypes show different patterns of attentional problems that have different neuroanatomical bases. Furthermore, academic problems in children with ADHD may be related to their attentional problems.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is the most common neuropsychological developmental disorder in children. ADHD is characterized by inattention, overactivity, and impulsivity. However, the attention skill is not clearly studied in children with ADHD in Indonesia. Objective: The aim of the present study was to investigate the differences in attention skill between children with ADHD and typically developing children (TD), and identify the differences between ADHD subtypes at primary schools in Bandung city Indonesia in terms of the parameter of attention. Methods: This study used the quantitative method. The population of this study was children with ADHD and typically developing (TD) school-age children. The data sampling technique was purposive sampling, consisting of 30 children as a group of ADHD children and 30 children as a group of TD children. The instrument to collect data was Wechsler Intelligence Scale for Children (WISC), Indonesian ADHD Rating Scale (IARS), and The D2 test of attention. The analysis method used t-test and SPSS V.24 for Windows. Results: This study showed significant differences in attention skill performance between children with ADHD and TD children in the variables including the total number of tasks completed, omission, commission, error rate, total amount minus errors or selective attention skill, fluctuation rate and concentration performance. There have been observed significant differences between ADHD subtypes in terms of total number, omission, commission, error rate, total amount minus errors or selective attention skill, and concentration performance. Conclusion: Children with ADHD were found to have lower results than typically developing children in terms of attention skill, inhibiting control, and ability in performance accuracy. Children with ADHD-C subtypes were found to have more inattentive tendencies, hyperactive, and impulsive compared to ADHD-I and ADHD-H. ADHD-C subtype showed more deficits than ADHD-I and ADHD-H in response inhibition and accuracy of performance.

AbstractApplication of theoretically based tasks to the study of the development of selective attention has led to intriguing new findings concerning the role of inhibitory mechanisms. This study examined inhibitory mechanisms using a countermanding task and an inhibition of return task to compare deficits in intentionally, versus reflexively, controlled inhibition of attention in children with attention deficit hyperactivity disorder. Fifty children with attention-deficit/hyperactivity disorder (ADHD) were classified into one of three subtypes: predominantly inattentive (ADHD/PI), combined (ADHD/C), and those children with ADHD/C who also met criteria for comorbid oppositional defiant disorder (ADHD/C + ODD). The groups were compared to a comparison group of children (n = 21). The countermanding task showed that the ADHD groups required more time to inhibit responses and this impairment did not differ among subtypes. With respect to reflexively controlled inhibition, compared with controls ADHD/C and ADHD/C + ODD groups showed impaired reflexive inhibition, whereas the ADHD/PI group was considerably less impaired. The findings highlight a dissociation between the two forms of inhibitory deficits among children with the inattentive subtype, and raise the possibility that the efficient operation of reflexive inhibitory mechanisms might be necessary for the development of effective intentional control of inhibition.

Previous research investigating attention and impulse control in individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) has largely ignored the symptomatic differences among the three subtypes of ADHD: ADHD-Inattentive Type, ADHD-Hyperactive/Impulsive Type, and ADHD-Combined Type. The present study examined attention and impulse control by focusing on these subtypes. Based on their self-reported symptoms of ADHD, participants belonged to one of four groups: ADHD-Inattentive, ADHD-Hyperactive/Impulsive, ADHD-Combined, and control. Cortical activity was recorded from participants during performance of a Go/NoGo task. The event-related potentials (ERP) measured at frontal and posterior sites discriminated between the control group and participants with symptoms of ADHD. The control group consistently exhibited a higher P3 amplitude than all the ADHD groups. The main difference occurred at the frontal site, indicating that individuals with ADHD symptoms have deficits in the anterior attentional system, which mediates signal detection. Behavioral measures of signal sensitivity revealed that the ADHD-Inattentive and the ADHD-Hyperactive/Impulsive groups had more difficulty with the attention-demanding Go/NoGo respond-to-target task, while behavioral measures of response bias indicated that the ADHD-Hyperactive/Impulsive and the ADHD-Combined groups responded more liberally in the inhibition-demanding Go/NoGo suppress-to-target task.

Research on the predominantly inattentive attention-deficit/hyperactivity disorder (ADHD-PI) subtype/presentation is important given its high prevalence, but paradoxically it is under-recognized and undertreated. The temporal stability of the inattention symptom could impact the high worldwide prevalence of ADHD-PI. Some evidence suggests differences in the nature of attentional deficit in ADHD-PI vs. that in other subtypes. Impairments in neuropsychological, neurocognitive, and social functioning are also evident in ADHD-PI, which could be specific to the subtype (e.g., processing speed, social perception, and skills), or differ from others in severity. Neuroimaging studies have also revealed ADHD-PI-specific neuropathological abnormalities and those that are shared with other subtypes. ADHD-PI is highly comorbid with learning and internalizing (e.g., anxiety and depression) disorders. There is no solid evidence for ADHD-PI-specific genetic etiologies and differential responses of subtypes to ADHD medications. Translational studies have used the Wistar Kyoto/NCrl substrain which requires further characterizations as an ADHD-PI model. Overall, ADHD-PI research has been conducted in the context of the Diagnostic and Statistical Manual, which arguably does not conform to the widely recognized “dimensional” view of ADHD. The Research Domain Criteria has been proposed to provide a novel framework for understanding the nature of neuropsychiatric illnesses and ultimately improve their diagnosis and treatment.

ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

Objective: Neuropsychological performance patterns associated with adult ADHD subtypes are unknown. The aim of the current systematic review was to identify and synthesize available literature regarding neuropsychological performance associated with adult ADHD subtypes. Method: Searches were completed using the databases PsycINFO and PubMed for studies published before March 2017 addressing adult ADHD subtypes and neuropsychological performance. Data characterizing the neuropsychological tests utilized in each study were obtained and sorted into eight domains. To summarize the results of all comparisons (ADHD subtype compared with control, or to each other), we counted the proportion of tests within each domain with significant group differences. Results/Conclusion: We deemed four domains informative in differentiating ADHD subtypes from controls. Of these, memory was the only domain that held promise in distinguishing ADHD-Inattentive and ADHD-Combined. Limitations of the available literature are highlighted and recommendations for future research are provided.

IntroductionNurturing children with neurodevelopmental disorders such as ADHD is associated with psychological burden to the caregivers. Oman has a pyramidal population structure with the bulk of the population are in the pediatric age group. Previous studies have indicated that ADHD is common in Oman.ObjectivesTo measure level of burden of care among caregivers of children with ADHD and the relationship between the degree of burden, subtypes of ADHD and socio-demographic factors.MethodsA cross sectional study conducted in a tertiary hospital in Oman. Arabic-version of the Zarit Burden Interview (ZBI) was used to evaluate the level of burden among the caregivers. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records.ResultsThe study included caregivers of 100 children with ADHD. The mean ZBI score was significantly high for the parents of children with ADHD. As for the relationship with socio-demographic background, mothers of children with ADHD reported a higher mean ZBI score compared to fathers. Factors such as income, number of siblings, and severity/subtypes of ADHD played significant roles.ConclusionTo our knowledge, this is the first study of Arab/Islamic population exploring the burden of care for children with ADHD. Some of the risk factors appear to have direct effects. If this study will withstand further scrutiny, concerted effort is needed in emerging economies such as Oman to address the issue of burden among the caregivers of children with ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders among school-going children. The aim of this study was to compare academic achievement of learners with and without ADHD in international primary schools of Mombasa (Kenya) and Kampala (Uganda). A comparative study was conducted among 377 respondents using Attention Deficit Hyperactivity Disorder Scale Questionnaire (SNAP-IV) which assessed the three ADHD subtypes in form of a closed-ended questionnaire. Results revealed that learners with ADHD had low overall academic achievement compared to those without ADHD in Mombasa (p <.001) and Kampala, (p <.001). Boys with ADHD in Mombasa had better grades than girls (M = 168.51, SD = 32.50 vs. M = 160.00, SD = 39.07) while girls with ADHD in Kampala had better grades than boys (M = 103.50, SD = 24.77 vs. M = 93.45, SD = 24.71). Learners with ADHD Inattentive subtype were greatly impaired compared to those with ADHD Hyperactive-Impulsive and Combined subtypes in both cities. ADHD significantly predicted academic achievement with higher variability in Kampala (55%) than Mombasa (10%). Attention-deficit hyperactivity disorder has a negative impact on academic achievement of learners with the condition. The study recommended integration of ADHD screening in school health services to enable early detection and management of the condition.

Attention-deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric disorder. Differences in the presentations of ADHD between boys and girls have been well established. Three subtypes of ADHD exist. In addition to sex difference, different mechanisms may underlie different subtypes. The present study enrolled 30 girls with the inattentive subtype of ADHD and 30 age-matched controls. Low-resolution electromagnetic tomography (LORETA) and instantaneous frequency were used to analyze electroencephalography (EEG) for investigating the brain area and EEG bands involved in girls with inattentive ADHD. We found that the instantaneous frequencies in all EEG channels in girls with ADHD were lower than those in controls. Alpha 2 was the only EEG band that showed significant difference in current density between the ADHD and control groups ( P = .0014). In the entire brain area, the posterior cingulate cortex, cingulate gyrus, and precuneus demonstrated the most significant difference between the ADHD and control groups. Our results suggest that brain maturation delay in the posterior areas might result in the inattention subtype of ADHD. In addition, posterior cingulate cortex, cingulate gyrus, and precuneus may play a critical role in the pathogenesis of ADHD. Our study provides a new approach method and possible mechanism of girls with inattentive subtype ADHD.

Objective: To examine the validity of the three subtypes of ADHD defined by DSM-IV. Method: Studies published in English were identified through searches of literature databases. Results: Estimates of the prevalence of ADHD have increased as a result of the introduction of DSM-IV criteria. Factor analytical and genetic studies provide some support for the validity of the distinction between the three subtypes. However, diagnosis of the combined subtype seems more reliable than the other two subtypes, although reliability is largely unknown for the latter. The hyperactive-impulsive subtype, the least common, differs from the other two subtypes in age distribution, association with other factors and neuropsychological parameters. Almost all treatment trials are based on participants with the combined type. Conclusion: Data supporting the validity of the inattentive and hyperactive-impulsive subtypes of ADHD a decade after the publication of DSM-IV are still scarce. Given that inattention is the hypothesized core ADHD symptom, it remains to be demonstrated that hyperactive-impulsive children who are not inattentive have the same condition. One of the main research deficits refers to data on treatment of the inattentive and hyperactive impulsive subtypes.

BackgroundThe unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) are not well characterized. Here, we examine symptom patterns and heritability of OCD and ADHD in TS families.MethodOCD and ADHD symptom patterns were examined in TS patients and their family members (N= 3494) using exploratory factor analyses (EFA) for OCD and ADHD symptoms separately, followed by latent class analyses (LCA) of the resulting OCD and ADHD factor sum scores jointly; heritability and clinical relevance of the resulting factors and classes were assessed.ResultsEFA yielded a 2-factor model for ADHD and an 8-factor model for OCD. Both ADHD factors (inattentive and hyperactive/impulsive symptoms) were genetically related to TS, ADHD, and OCD. The doubts, contamination, need for sameness, and superstitions factors were genetically related to OCD, but not ADHD or TS; symmetry/exactness and fear-of-harm were associated with TS and OCD while hoarding was associated with ADHD and OCD. In contrast, aggressive urges were genetically associated with TS, OCD, and ADHD. LCA revealed a three-class solution: few OCD/ADHD symptoms (LC1), OCD & ADHD symptoms (LC2), and symmetry/exactness, hoarding, and ADHD symptoms (LC3). LC2 had the highest psychiatric comorbidity rates (⩾50% for all disorders).ConclusionsSymmetry/exactness, aggressive urges, fear-of-harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and, rather than being specific subtypes of OCD, transcend traditional diagnostic boundaries, perhaps representing an underlying vulnerability (e.g. failure of top-down cognitive control) common to all three disorders.

IntroductionADHD is one of the most prevalent psychiatric disorders in children.ObjectiveADHD have co-morbidity with many other psychiatric disorders.AimsAim of this study was Comparing of prevalence of three subtypes of ADHD with psychiatric co- morbidity in primary school students of Arak-Iran.MethodsThis study was a descriptive analytic, cross- sectional one, which carried on 2000 (960 girls and 1040 boys) primary school students in 1st state of Arak in academic year of 2009–2010, which screened by Intelligence Raiven scale and 48 Canner’s questionnaire (parents and teachers)and if there were existed of any subtypes of ADHD, we have done K-SADS-E questionnaire (Schedule for Affective disorder and Schizophrenia -epidemiological version)for them, data were analyzed by using descriptive- statistical methods and Logistic- regression for obtaining R. R.Results2.3, 3.5 and 2.7 percent of children have one of the subtypes of ADHD. The findings showed that prevalence of hyperactivity and attention deficit subtypes decreased while combined type increased by increased age. The prevalence of two subtypes of hyperactivity and attention deficit in boys and girls were not significantly different but combined type was significantly different. Finally, there were differences between ADHD subtypes and co- morbidity of psychiatric disorders such as conduct, depressive, enuresis, schizophrenia, oppositional, obsessive- compulsive, mania and social phobia, but these differences were not significant between girls and boys.ConclusionsPrevalence of subtypes of ADHD were different between age and gender but there were not significant differences between Co morbidity of ADHD subtypes and psychiatric disorders

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that is very common among children and may last into their adulthood. It is known that ADHD affects the attention of patients due to problems with short-term memory. Therefore, analysis of attention and memory of these patients should come into consideration. In this study, the complexity and memory of Electroencephalogram (EEG) signals are analyzed to investigate the reduction in attention and memory of patients with ADHD compared to normal subjects while playing a serious game. To achieve this, the fractal dimension and sample entropy of EEG signals are analyzed to evaluate the alterations in the complexity of EEG signals. Moreover, the Hurst exponent of EEG signals for ADHD and non-ADHD subjects is calculated to discuss the memory of EEG signals. The results showed a smaller fractal dimension and sample entropy of EEG signals for patients with ADHD that reflects their lower attention. Besides, the Hurst exponent of EEG signals for these patients reflects their lower memory than normal subjects. Therefore, it can be concluded that the reductions of attention and memory in ADHD subjects are mapped on the reduction of complexity and memory of their EEG signals.

Abstract Objective ADHD is a neurodevelopmental disorder known to cause functional impairments. Few studies have identified impairments specific to girls with ADHD. The objective of this study was to explore the relationship between ADHD subtypes and measures of functional impairment in girls. Method Participants were chosen from a sample of girls ages 5 – 18 years old, diagnosed with ADHD at an outpatient ADHD clinic at a large children’s hospital (N = 303). Measures included parent and teacher BASC subscales of adaptability, homework problems, and comorbid clinical diagnoses based on the diagnostic interview for children and adolescents-revised parent version (DICA-R). Potential relationships between impairment measures and ADHD subtypes were assessed using multiple and logistic regressions to control for age and socioeconomic status (SES). Results Number of inattentive ADHD symptoms correlates positively with DICA diagnosis of ODD (x2 = 4.008, p = 0.045) and homework problems (r = 0.227, p = 0.0001). Number of combined ADHD symptoms is positively associated with DICA diagnosis of ODD (x2 = 26.812, p = 0.0001) and homework problems (r = 0.171, p = 0.0001) and negatively associated with parent reported social skills (r = 0.092, p = 0.006), adaptability (r = 0.146, p = 0.001) and teacher reported adaptability (r = 0.057, p = 0.01), after controlling for age and SES. Discussion Girls with ADHD exhibit functional impairments in the domains of comorbid diagnoses, homework problems, parent and teacher report of adaptability, and parent report of social skills. Additional research should include self-reports of functional impairment to determine self-perception of impairment.

Objective: The aim of the present study was to examine the effect of comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) on (i) symptom levels in attention-deficit–hyperactivity disorder (ADHD) and (ii) the relationship between neurocognitive impairment and ADHD symptom severity. Method: A total of 200 6–12-year-old children with DSM-IV ADHD, combined type (ADHD-CT) were identified in a specialist ADHD clinic in metropolitan Melbourne. From this initial group, 23 were identified with ADHD without ODD/CD (ADHD alone), 22 had ADHD and ODD and 20 had ADHD and CD. All the children were medication naïve. Twenty-five healthy control children were also recruited from local primary schools. The four groups did not differ in age, gender or full-scale IQ. A cross-sectional study of parent- and teacher-reported ADHD and externalizing symptoms, spatial span, spatial working memory, visuospatial memory, spatial recognition, spatial planning and behavioural inhibition was completed. Results: Parent-reported externalizing symptoms were higher in the ADHD + CD and ADHD + ODD groups compared to the ADHD alone group. There were no differences in neurocognitive function between children with ADHD-CT with and without ODD or CD. All the ADHD groups, however, performed worse than the healthy control group. Further, worse spatial span, spatial working memory and delayed matching to sample performance were associated with increased teacher-reported ADHD symptoms in the ADHD alone group. Also, worse spatial working memory performance was associated with increased teacher-reported ADHD symptoms in the ADHD + CD group. Conclusions: ADHD symptom severity is associated with the magnitude of impairment in executive functions in children with ADHD alone, but these relationships can be obscured by the presence of comorbid disruptive disorders. Children with ADHD + CD may demonstrate similar associations to children with ADHD alone, suggesting a similar underlying dysfunction. ADHD + ODD, however, may be better understood as a maladaptive response to the abnormal behaviours and neurocognitive functions in ADHD.

IntroductionADHD is one of the most prevalent psychiatric disorders in children.ObjectiveADHD have co-morbidity with many other psychiatric disorders.AimsAim of this study was Comparing of prevalence of three subtypes of ADHD with psychiatric Co- morbidity in primary school students of Arak-Iran.MethodsThis study was a descriptive analytic, cross- sectional one, which carried on 2000 (960 girls and 1040 boys)primary school students in 1st state of Arak in academic year of 2009–2010, which screened by Intelligence Raiven scale and 48 Canner’s questionnaire (parents and teachers)and if there were existed of any subtypes of ADHD, we have done K-SADS-E questionnaire(Schedule for Affective disorder and Schizophrenia -epidemiological version)for them, then data were analyzed by using descriptive- statistical methods and Logistic- regression for obtaining R. R.Results2.3, 3.5 and 2.7 percent of children have one of the subtypes of ADHD. The findings showed that prevalence of hyperactivity and attention deficit subtypes decreased while combined type increased by increasing age. The prevalence of two subtypes of hyperactivity and attention deficit in boys and girls were not significantly different but combined type was significantly different. Finally, there were differences between ADHD subtypes and Co morbidity of psychiatric disorders such as conduct, depressive,enuresis, tic, schizophrenia, oppositional, obsessive- compulsive, manic and social phobia, but these differences were not significant between girls and boys.ConclusionsPrevalence of subtypes of the ADHD were different between age and gender but there were not significant differences between Co morbidity of ADHD subtypes and psychiatric disorders.

AbstractAttention is considered to be the foundation of most cognitive and neuropsychological processes and it is often the subject of study in the common childhood disorder, attention-deficit/hyperactivity disorder (ADHD). This article reviews studies on the attentional functioning of children with subtypes of ADHD and children with learning disabilities (LD). First, an overview of ADHD including current conceptualisation and cognitive theories of the disorder are outlined. Second, attention is described as a multidimensional construct consisting of a number of components. This model of attention will be used as a framework for reviewing studies in the ADHD literature. In particular, the following comparisons of children will be examined: (1) ADHD compared with non-disordered controls, (2) ADHD compared with LD, and (3) hyperactivity/impulsive forms of ADHD compared with inattentive ADHD. Finally, the implications of a multi-modal framework of attention will be discussed within the context of theory and treatment of ADHD.

Objective: Oppositional Defiant Disorder (ODD) is highly prevalent in Attention-Deficit/Hyperactivity Disorder (ADHD) and may account for inconsistencies in findings on neurocognitive functioning in ADHD. Our aim was to assess cool and hot executive functioning (EF) and temporal processing in ADHD with and without comorbid ODD to elucidate the effects of comorbid ODD. Method: ADHD-only ( n = 82), ADHD + ODD ( n = 82), and controls ( n = 82), with mean age 16 years ( SD = 3.1), matched for age, gender, IQ, and ADHD type (clinical groups) were assessed on cool EF (inhibition, working memory), hot EF (reinforcement processing, emotion recognition), and temporal processing (time production and reproduction). Results: Individuals with ADHD + ODD showed abnormalities in inhibition, working memory, facial emotion recognition, and temporal processing, whereas individuals with ADHD-only were solely impaired in working memory and time production. Conclusion: Findings suggest that ODD carries a substantial part of the EF deficits observed in ADHD and contrast with current theories of neurocognitive impairments in ADHD.

ABSTRACTBackground:Research illustrates cognitive deficits in children and younger adults with attention-deficit/hyperactivity disorder (ADHD). Few studies have focused on the cognitive functioning in older adults. This study investigates the association between ADHD and cognitive functioning in older adults.Methods:Data were collected in a cross-sectional side study of the Longitudinal Aging Study Amsterdam (LASA). A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60–94). ADHD symptoms and diagnosis were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Cognitive functioning was assessed with tests in the domains of executive functioning, information processing speed, memory, and attention/working memory.Results:Regression analyses indicate that ADHD diagnosis and ADHD severity were only negatively associated with cognitive functioning in the attention/working memory domain. When adjusting for depression, these associations were no longer significant.Conclusion:The study shows that ADHD in older adults is associated with lower cognitive functioning in the attention/working memory domain. However, this was partly explained by depressive symptoms.

Children with attention deficit hyperactivity disorder (ADHD) are often reported to have deficits of time perception. However, there is a strong relation between performance on tasks of working memory and time perception. Thus, it is possible that the poor performance of children with ADHD on time perception results from their deficit of working memory. In this study, the working memory of participants was separately assessed; therefore, we could explore the relationship between working memory and time perception of children with ADHD. Fifty-six children with ADHD and those of healthy controls completed tasks measuring working memory and time perception. The results showed that the time discrimination ability of children with ADHD was poorer than that of controls. However, there was a strong association between time perception and working memory. After controlling working memory and intelligence, the time discrimination ability of children with ADHD was not significantly poorer than that of controls. We suggest that there is an interdependent relationship between time perception and working memory for children with ADHD.

Working memory training may help children with attention deficit hyperactivity disorder (ADHD), but robust evidence from systematic reviews is lacking. Children with poor Working memory ability struggle with academic and cognitive work compared to similar-aged peers without working memory deficits. Besides, working memory is correlated with inattention and disorganization in those with ADHD. The aim of this systematic review was to assess the effect of working memory training on symptoms and behaviors of children with ADHD. A search equation was proposed (ADHD OR attention deficit hyperactivity disorder AND working memory training), with twenty-four studies meeting the inclusion criteria in the Clarivate Analytics Web of Science Core Collection database. A bibliometric analysis was conducted to identify the importance of the research topic and a citation network was built to establish the lines of research. Finally, the citation network was exported to Gephi to visualize the research groups studying the topic. Findings suggest 3 lines of research: (a) Effects of working memory training on working memory, and academic performance in children with ADHD, (b) Effects of working memory training on executive functioning and child ADHD related symptoms, (c) Effects of working memory training on brain activity in child ADHD. Implications for clinical practice and school-based interventions are discussed

This study investigated quantitative electroencephalography (QEEG) subtypes as auxiliary tools to assess Attention Deficit Hyperactivity Disorder (ADHD). A total of 74 subjects (58 male and 16 female) were assessed using the Korean version of the Diagnostic Interview Schedule for Children Version IV and were assigned to one of three groups: ADHD, ADHD-Not Otherwise specified (NOS), and Neurotypical (NT). We measured absolute and relative EEG power in 19 channels and conducted an auditory continuous performance test. We analyzed QEEG according to the frequency range: delta (1–4 Hz), theta (4–8 Hz), slow alpha (8–10 Hz), fast alpha (10–13.5 Hz), and beta (13.5–30 Hz). The subjects were then grouped by Ward’s method of cluster analysis using the squared Euclidian distance to measure dissimilarities. We discovered four QEEG clusters, which were characterized by: (a) elevated delta power with less theta activity, (b) elevated slow alpha relative power, (c) elevated theta with deficiencies of alpha and beta relative power, and (d) elevated fast alpha and beta absolute power. The largest proportion of participants in clusters (a) and (c) were from the ADHD group (48% and 47%, respectively). Conversely, group (b) mostly consisted of the participants from the NOS group (59%), while group (d) had the largest proportion of participants from the NT group (62%). These results indicate that children with ADHD does not neurophysiologically constitute a homogenous group. We also identified a new subtype with increased alpha power in addition to those commonly reported in ADHD. Given the QEEG characteristics with increased alpha power, we should consider the possibility that this subtype may be caused by childhood depression. In conclusion, we believe that these QEEG subtypes of ADHD are expected to provide valuable information for accurately diagnosing ADHD.

Objective: To determine if decreased fluid intelligence was associated with ADHD, and was mediated by deficits in working memory and intraindividual variability in motor responding. Method: The present study tested 142 young adults from the general population on a range of working memory, response time, and fluid intelligence tasks, and an ADHD self-report symptoms questionnaire. Results: Total and hyperactive ADHD symptoms correlated significantly and negatively with fluid intelligence, but this association was fully mediated by both working memory and intraindividual variability in response time. However, inattentive symptoms were not associated with fluid intelligence. Conclusion: These results have important implications for clinicians using speeded psychometric tests as part of their assessment battery, working memory interventions for ADHD patients that focus on performance improvement without controlling for response consistency, and also demonstrate potential differences in the neuropsychological profiles of ADHD subtypes.

Objective. This study sought to examine the factors associated with spatial working memory and the use of strategies to impairments in spatial working memory in children with attention deficit hyperactivity disorder (ADHD). The developmental trajectories for spatial working memory in medicated and medication naïve children with ADHD were investigated. In addition, the effect of psychostimulant medication on deficits in spatial working memory was examined.Method. A cross-sectional study compared performance between 21 psychostimulant medicated children with ADHD, 27 medication naïve children with ADHD and 26 matched control subjects on computerized tests of spatial memory and spatial working memory.Results. Compared with the controls, performance in medication naïve children with ADHD was significantly worse on the spatial working memory task. There was no difference in performance between the medicated children with ADHD and the control subjects on this same task, despite the ongoing symptoms of ADHD in the former group. The pattern of normal and abnormal performance in the ADHD groups was age-independent.Conclusions. Deficits in executive functions related to spatial working memory do occur in children with ADHD, although the magnitude of these deficits is not related to the child's age or the level of ADHD symptoms. These deficits were not present in the current sample of children who were receiving psychostimulant medication.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at a higher risk of experiencing bully victimization compared with peers with and without disabilities. Yet the association between ADHD subtypes and bully victimization is not well understood. The current study examines which set of behaviors related to ADHD subtypes is influential in determining whether students are victimized. Using a latent class growth analysis, students with ADHD in a nationally representative special education sample ( n = 291) were grouped by victimization trajectory. Latent class analysis revealed three victimization profiles. Approximately one third of participants (35%) experienced moderately high victimization decreasing over time. A slightly larger group reported consistently low victimization (39%), and one fourth (25%) reported consistently high victimization. Behaviors representing inattention and hyperactivity/impulsivity were examined as covariates in the model. Hyperactive/impulsive behaviors were predictive of latent class assignment, initial victimization, and the trajectory of victimization. Study limitations are discussed. Recommendations are made to inform the creation of interventions tailored for students who have ADHD.

Objective: To explore neuropsychological performance in untreated Brazilian adolescents suffering from attention-deficit hyperactivity disorder (ADHD). Method: We assessed 30 untreated adolescents with ADHD and 60 healthy control subjects, aged 12 to 16 years, using a neuropsychological battery including the Wisconsin Card-Sorting Test (WCST), the Stroop Test (ST), the Digit Span, and the Word Span. Results: We found neuropsychological differences among the DSM-IV ADHD subtypes. Adolescents with the predominantly inattentive subtype (ADHD-I) performed more poorly than did control subjects on both the Digit Span and the ST. On both the Digit Span and the WCST, adolescents with the combined subtype (ADHD-C) presented significantly more impairments than did control subjects. Adolescents with the predominantly hyperactive-impulsive type (ADHD-HI) did not differ significantly from the control subjects in any measure assessed, but had a better performance than did those with ADHD-C on both the Digit Span and the WCST. In addition, adolescents with ADHD-HI performed better on the ST than did adolescents with ADHD-I. Conclusions: These findings suggest cognitive differences among ADHD subtypes, supporting the diagnostic distinction among them. Adolescents with ADHD-HI do not seem to have significant cognitive deficits.

BackgroundPrevious studies have reported mixed results on neuropsychological deficits in attention deficit hyperactivity disorder (ADHD) and only a few studies have focused on adolescents. There is also a debate about whether the executive function (EF) impairments in ADHD are primary deficits or have some contribution from the underlying non-EF processes. The aim of this study was to investigate the impairments in EF and neuropsychological function with relatively low executive demand (low-EF) in adolescents with childhood diagnosis of ADHD as a function of current ADHD status.MethodPsychiatric diagnostic interviews and computerized neuropsychological tests classified into EF and low-EF tasks were completed by 435 adolescents with a childhood diagnosis of ADHD (300 adolescents classified as persistent ADHD, 109 as subsyndromal ADHD and 26 as remitted ADHD based on the current diagnosis) and 263 typically developing (TD) adolescents.ResultsThere were significant EF (spatial working memory, spatial planning and verbal working memory) and low-EF (signal detectability, spatial span and visual recognition memory) impairments in persistent and subsyndromal ADHD. The impairments in EF were independent of low-EF despite significant moderate correlations between any two of these tasks. Adolescents with remitted ADHD showed no deficit in either EF or low-EF.ConclusionsThis study suggests that adolescents with persistent and subsyndromal ADHD have EF and low-EF impairments that might contribute to ADHD independently.

BackgroundExecutive functions have been proposed as endophenotypes for attention deficit hyperactivity disorder (ADHD); however, data regarding visual memory are lacking. We therefore assessed visual memory in adolescents with ADHD and their unaffected siblings compared with controls.MethodThe participants included 279 adolescents with ADHD, 108 unaffected siblings, and 173 unaffected school controls. They were assessed by using the visual memory tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB): Delayed Matching to Sample (DMS), Spatial Recognition Memory (SRM), Paired Associates Learning (PAL), and Pattern Recognition Memory (PRM).ResultsCompared with the controls, probands with ADHD had a significantly lower number of correct responses, a higher probability of an error following a correct response and following an error response in the DMS, and a lower percentage of correct responses in the SRM. Their unaffected siblings occupied an intermediate position between ADHD probands and controls in the probability of an error following a correct response and following an error response in the DMS, and in the percentage of correct responses in the SRM. In general, lower IQ and current use of and duration of treatment with methylphenidate were associated with more severe visual memory deficits.ConclusionsThe present results suggest that ADHD is associated with poorer visual memory function. Visual memory assessed by the DMS and SRM tasks in the CANTAB may be a useful endophenotype for ADHD.