Methylphenidate and attributions in boys with attention-deficit hyperactivity disorder.

In Exp 1, 28 attention-deficit hyperactivity disorder (ADHD) boys underwent a double-blind, placebo-controlled medication assessment in a summer day-treatment program. Daily, boys were asked questions to assess their attributions for and evaluations of their behavior. Objective measures showed improved behavior with methylphenidate; however, boys tended to attribute their performance to effort rather than to medication, particularly when medicated. Exp 2 involved 38 ADHD boys the following summer and replicated the procedures in Exp 1, with the addition of a no-pill condition and a comparison of attributions for success and failure outcomes. Simply taking a pill (no-pill vs placebo comparison) did not show significant effects, whereas the results of Exp 1 were replicated with placebo–methylphenidate comparisons. Across drug conditions a self-enhancing attributional pattern was obtained; the majority of attributions for success were to ability or effort, whereas attributions for failure were to the pill or to counselors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent outcome of boys with attention-deficit/hyperactivity disorder and social disability: Results from a 4-year longitudinal follow-up study.

IQ-achievement discrepancy methodology similar to that used in defining learning disabilities has recently been used to identify a subset of boys with attention-deficit/hyperactivity disorder (ADHD) evidencing marked impairment in social functioning. In this study, 2 issues were examined: (a) What is the longitudinal outcome of boys with ADHD identified at baseline as "socially disabled?" (b) Is social disability at baseline a significant predictor of severe long-term outcomes (such as substance use disorders) in boys with ADHD? If so, are its predictive relationships accounted for by conditions that are comorbid with ADHD? Results showed that, at follow-up, ADHD boys with ADHD who also had social disability evidenced significantly higher rates of mood, anxiety, disruptive, and substance use disorders, compared with nonsocially disabled boys with ADHD and comparison boys without ADHD. Findings also showed that social disability at baseline in boys with ADHD was a significant predictor of later conduct disorder and most substance use disorders after baseline mood and conduct disorders and behavior checklist ratings of aggressive behavior and attention problems were controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning disabilities and executive dysfunction in boys with attention-deficit/hyperactivity disorder.

The effect of comorbid reading or arithmetic learning disabilities (LDs) on neuropsychological function in attention-deficit/hyperactivity disorder (ADHD) was studied. Participants were young males diagnosed with ADHD, with and without LD, and non-ADHD, non-LD male controls of similar age. LD was defined by combined regression-based and low-achievement classifications. Analyses adjusted for the effect of psychiatric comorbidity, age, and socioeconomic status on neuropsychological function. Children who had both ADHD and LD were significantly more impaired on both executive and nonexecutive functions than ADHD children without LD. Neuropsychological performance was most impaired in ADHD with combined arithmetic and reading disability. These data indicate that comorbid LD, especially arithmetic disability, significantly increases the severity of executive function impairment in ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Covert antisocial behavior in boys with attention-deficit hyperactivity disorder: External validation and effects of methylphenidate.

Covert antisocial behaviors such as stealing, destroying property, and cheating carry high risk for delinquency. An individual laboratory setting was devised in which youngsters could take desired objects and use answer keys to assist with worksheets. 22 boys with attention-deficit hyperactivity disorder (ADHD) and 22 comparison boys were observed on 2 occasions, with the ADHD Ss receiving a methylphenidate–placebo crossover. Lab stealing and property destruction were positively correlated with maternal and staff ratings of parallel behaviors. Methylphenidate resulted in significant reductions of these acts, but it also effected an increase in cheating, presumably because of its enhancement of task involvement. The generalizability of the lab findings, actions of stimulants in this domain, and the ethics of experimental investigations of covert antisocial behavior are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aspects of social and emotional competence in adult attention-deficit/hyperactivity disorder.

Social and emotional competence were evaluated using self-report and behavioral measures in adults with attention-deficit/hyperactivity disorder (ADHD) and controls. Adults with ADHD viewed themselves as less socially competent but more sensitive toward violations of social norms than controls. Films depicting emotional interactions were used to assess linguistic properties of free recall and perceived emotional intensity. Although adults with ADHD used more words to describe the scenes, they used fewer emotion-related words, despite rating the emotions depicted as more intense than did controls. In contrast, no group differences for words depicting social or cognitive processes were observed. Overall, adults with ADHD appear more aware of their problems in social versus emotional skills. Findings may have implications for improving the psychosocial functioning of these adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contraction of time in attention-deficit hyperactivity disorder.

Attention-deficit hyperactivity disorder (ADHD) has been associated with anomalies in dopamine systems. Recent advances in the understanding of the core cognitive deficits in ADHD suggest that dopamine dysfunction might be expressed through shortened time scales in reward-based learning. Here this perspective is extended by the conjecture that temporal span in working memory systems might generally be shortened. As a test of this conjecture the authors focus on the implicit memory system involved in rhythmic movement, assessing the minimum tempo at which rhythmic feeling can be sustained in adults with diagnosed ADHD and in a control group of normal adults. The authors found that people with ADHD do in fact have a rhythm cut-off that is faster in tempo than those without ADHD. This finding is consistent with the idea that impaired dopamine dynamics have systemic consequences for cognitive function, essentially recalibrating the clock that sets the time scale for the subjective experience of temporal events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting attention-deficit/hyperactivity disorder and oppositional defiant disorder from preschool diagnostic assessments.

The present study examined the power of measures of early preschool behavior to predict later diagnoses of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD)/conduct disorder (CD). Participants were 168 children with behavior problems at age 3 who underwent a multimethod assessment of ADHD and ODD symptoms and were followed annually for 3 years. Fifty-eight percent of 3-year-old children with behavior problems met criteria for ADHD and/or ODD/CD 3 years later. Using a diagnostic interview and rating scales at age 3, the authors could accurately predict later diagnostic status for 3/4 of children for ADHD and for 2/3 of children for ODD/CD. Predictive power of the best models did not increase significantly at age 4 and age 5 compared with age 3. Results provide support for the validity of early diagnoses of ADHD, although caution is needed in making diagnoses because a significant minority of children with early hyperactivity and inattention do outgrow their problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal attributions and child oppositional behavior: A longitudinal study of boys with and without attention-deficit/hyperactivity disorder.

The authors examined changes over a 1-year period in mothers' attributions for child behavior and child oppositional behavior among 53 mothers and nonproblem sons and 44 mothers and sons with attention-deficit/hyperactivity disorder (ADHD). Boys averaged 8 years of age (SD = 11 months) at Time 1. Families were primarily of European Canadian cultural background and most were middle to upper middle class. Initial levels of child oppositionality did not predict changes in mothers' attributions over time. However, initial levels of mothers' attributions of oppositional child behavior to internal, stable, and global causes positively predicted child oppositional behavior, controlling for ADHD versus nonproblem status and the child's initial level of oppositional behavior. Although initial levels of overreactive and nonresponsive parenting also positively predicted child oppositional behavior, the contribution of mothers' attributions remained significant even with parenting variables controlled. Results suggest that mothers' attributions of child oppositional behavior to internal, stable, and global causes may contribute to maintenance of child problems over time and that these parenting cognitions have importance as intervention targets. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation and management of attention-deficit hyperactivity disorder

Attention-deficit hyperactivity disorder is the most common pediatric psychiatric disorder, involving one of every 20 children. It is often a disabling condition and is frequently accompanied by high levels of frustration and comorbidity. Diagnosis of attention-deficit hyperactivity disorder requires a detailed history from the family and use of rating scales to collect observations from two or more settings. Effective treatment, including behavior management, appropriate educational placement and stimulant medication, will improve academic performance and behavior in most patients. Armed with an organized approach and a broad general knowledge of stimulant therapy, the family physician can effectively evaluate and coordinate the initial therapy for many of these troubled children within the office setting. Children in whom initial management fails or for whom the diagnosis is unclear or complicated should be referred to appropriate mental health professionals.     

A comparison of the cognitive deficits in reading disability and attention-deficit/hyperactivity disorder.

This study used a nonreferred sample of twins to contrast the performance of individuals with reading disability (RD; n?=?93), attention-deficit/hyperactivity disorder (ADHD; n?=?52), RD and ADHD (n?=?48), and neither RD nor ADHD (n?=?121) on measures of phoneme awareness (PA) and executive functioning (EF). Exploratory factor analysis of the EF measures yielded underlying factors of working memory, inhibition, and set shifting. Results revealed that ADHD was associated with inhibition deficits whereas RD was associated with significant deficits on measures of PA and verbal working memory. The RD?+?ADHD group was most impaired on virtually all measures, providing evidence against the phenocopy hypothesis as an explanation for comorbidity between RD and ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blink rate in childhood-onset schizophrenia: comparison with normal and attention-deficit hyperactivity disorder controls

Several lines of evidence have implicated central dopaminergic pathways in the modulation of blink rate. In the present study, blink rate during smooth pursuit was examined in 17 children with childhood-onset schizophrenia, on and off of clozapine, and compared to that of age-matched normal children and unmedicated children with attention-deficit hyperactivity disorder (ADHD). As has been observed in adolescent and adult schizophrenics, blink rate was significantly higher in schizophrenic children relative to normal and ADHD controls. Within the schizophrenic group, blink rate did not significantly change with the introduction of clozapine and was not related to clinical variables. Blink rate was positively correlated with deterioration in smooth pursuit in normal subjects.     

Cocaine abuse and attention-deficit hyperactivity disorder: Implications of adult symptomatology.

Forty-three men between the ages of 18 and 48, in treatment for cocaine abuse or dependence, were evaluated for history of childhood attention-deficit hyperactivity disorder (ADHD) and adult symptoms (residual state). Participants completed a quantitative cocaine history and an interview designed to explore subjective cocaine experience. High ADHD scores were significantly correlated with high gram use of cocaine, r(41)?=?.37, p?r(41)?=?–.62, p?r(41)?=?.42, p?r(41)?=?.31, p?r(41)?=?.32, p?     

Masculinized finger-length ratios of boys, but not girls, are associated with attention-deficit/hyperactivity disorder.

Gonadal hormones may exert permanent organizational effects on sexually dimorphic finger-length ratios and sexually dimorphic behavior expressed in childhood attention deficit- hyperactivity disorder (ADHD). This study extended recent work examining associations between finger-length ratios (specifically, 2D:4D) and ADHD in a well-characterized, clinically diagnosed, community-recruited sample of boys and girls. A multistage, diagnostic procedure was utilized to identify 113 children with ADHD and 137 non-ADHD comparison children. Right-hand digit ratios showed significant mean differences by gender, as well as associations with ADHD diagnosis. Boys with ADHD had more masculinized digit ratios than control-group boys. More masculine right 2D:4D and 3D:4D ratios were correlated with parent- and teacher-rated inattentive and hyperactive-impulsive symptoms in boys but not in girls. Masculinized finger-length ratios were associated with hyperactive-impulsive and oppositional- defiant symptoms, but associations were largest with symptoms of inattention. It is concluded that prenatal, organizational effects of gonadal hormones may play a role in the development of ADHD and contribute to explaining sex differences in the prevalence rates of this childhood disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stroop interference and attention-deficit/hyperactivity disorder: A review and meta-analysis.

Previous reviews and meta-analyses that addressed abnormal Stroop interference in attention-deficit/hyperactivity disorder (ADHD) yielded mixed results. The authors of the present study argue that the inconsistencies may reflect the problematic nature of 2 frequently used methods to quantify Stroop interference-the difference score and Golden's method (C. J. Golden, 1978). Golden's method correction for base-word reading is inadequate, and the difference score is sensitive to the nature of the outcome variable. The latter can be remedied with a ratio score. Contrasting previous meta-analyses, this meta-analysis covers all age groups and all Stroop test variants, and it excludes studies using the Golden quantification method. Mean effect sizes for interference in ADHD as quantified by difference scores relative to control scores were 0.24 across all studies but 1.11 for time-per-item studies; outcome variable was a significant moderator variable, reflecting the sensitivity of the difference score to this variable. Consistency analysis of ratio scores across 19 studies reveals more interference for the ADHD groups relative to the control groups. It is concluded that interference control is consistently compromised in individuals with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive inhibition and working memory in attention-deficit/hyperactivity disorder.

Studies of cognitive control in attention-deficit/hyperactivity disorder (ADHD) have emphasized the ability to suppress motor responses (i.e., behavioral inhibition) rather than the ability to actively suppress prepotent mental representations (i.e., cognitive inhibition). Further, working memory deficits are suspected in ADHD, yet their distinction from cognitive inhibition is unclear. Two hundred and eighty-eight adolescent and adult participants, 115 of whom met criteria for ADHD and 173 of whom were for non-ADHD comparison, completed a sentence processing task that required the suppression of an incorrect interpretation and a working memory task. The results failed to support cognitive inhibition problems in ADHD. Moreover, the ability to reanalyze sentences with a temporary misinterpretation was at least partially related to working memory performance. The results challenge a unitary inhibition problem in ADHD and suggest inhibition problems do not extend to cognitive suppression in this age range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experienced emotion and affect recognition in adult attention-deficit hyperactivity disorder.

[Correction Notice: An erratum for this article was reported in Vol 16(3) of Neuropsychology (see record 2007-17085-001). On Page 102, in the byline and in the author note, and on page 109 in the Rapport et al. (2001) reference, Sara Friedman's middle initial incorrectly reads "L." Her correct middle initial is "R."] Emotional competence and deficits that may disrupt interpersonal interactions were evaluated in 28 adults with attention-deficit hyperactivity disorder (ADHD) and 28 demographically equivalent controls. Participants completed tasks assessing affect recognition and experienced emotional intensity. Adults with ADHD performed worse in affect recognition than did adults without the disorder; however, the impairment was unrelated to gross perceptual processes, fundamental abilities in facial recognition, or attentional aspects of affect perception. Moreover, intensity of experienced emotion moderated affect recognition: Among controls, experienced emotion facilitated affect recognition. Among adults with ADHD, who reported significantly greater intensity, experienced emotion was inversely related to affect recognition. Results are consistent with theories of ADHD as a deficit in behavioral inhibition; yet, results may merely reflect a constellation of deficits associated with the disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting in mothers with and without attention-deficit/ hyperactivity disorder.

The authors examined the impact of maternal attention-deficit/hyperactivity disorder (ADHD) on parenting behaviors. Sixty mothers between the ages of 31 and 50 with (n = 30) and without (n = 30) ADHD and their 8- to 14-year-old children with ADHD completed self-report and laboratory measures of monitoring of child behavior, consistency in parenting, and parenting problem-solving abilities. These parenting behaviors were selected because of their established links to the development of child behavior problems. As predicted, mothers with ADHD were found to be poorer at monitoring child behavior and less consistent disciplinarians compared with mothers without ADHD. There was some evidence to support the prediction that mothers with ADHD were less effective at problem solving about childrearing issues than control mothers. The differences between the 2 groups of mothers persisted after child oppositional and conduct-disordered behavior were controlled. These results indicate that parenting is an area of functioning that requires more attention in adult ADHD research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the adult attention-deficit hyperactivity disorder endophenotype: Parametric measurement of attention.

Attention deficit hyperactivity disorder (ADHD) persists frequently into adulthood. The decomposition of endophenotypes by means of experimental neuro-cognitive assessment has the potential to improve diagnostic assessment, evaluation of treatment response, and disentanglement of genetic and environmental influences. We assessed four parameters of attentional capacity and selectivity derived from simple psychophysical tasks (verbal report of briefly presented letter displays) and based on a “theory of visual attention.” These parameters are mathematically independent, quantitative measures, and previous studies have shown that they are highly sensitive for subtle attention deficits. Potential reductions of attentional capacity, that is, of perceptual processing speed and working memory storage capacity, were assessed with a whole report paradigm. Furthermore, possible pathologies of attentional selectivity, that is, selection of task-relevant information and bias in the spatial distribution of attention, were measured with a partial report paradigm. A group of 30 unmedicated adult ADHD patients and a group of 30 demographically matched healthy controls were tested. ADHD patients showed significant reductions of working memory storage capacity of a moderate to large effect size. Perceptual processing speed, task-based, and spatial selection were unaffected. The results imply a working memory deficit as an important source of behavioral impairments. The theory of visual attention parameter working memory storage capacity might constitute a quantifiable and testable endophenotype of ADHD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Dosage effects of methylphenidate on the social behavior of adolescents diagnosed with attention-deficit hyperactivity disorder

Research participants were 46 adolescents (mean age = 13.8 years) who completed an intensive summer treatment program including a placebo-controlled, double-blind, crossover trial of 3 doses of methylphenidate (MPH) totaling 25, 50, or 75 mg per day. Dependent measures focused on social behavior and included observed behavior frequencies and ratings completed by counselors and parents, including side effects. Multiple data analytic methods were used with the goal of (a) describing the shape of the dose-response curves across multiple measures of social functioning, (b) determining the percentage of adolescents whose social behavior improved in response to MPH, and (c) assessing the incremental gains that result from increases in dose. The results show that (a) the shape of the dose-response curve is influenced by the measurement method, (b) the majority of adolescents exhibited improved social behavior when treated with MPH, (c) the bulk of the positive effects of MPH were achieved at the lowest dose, and (d) there appear to be diminishing positive effects and an increased risk of negative effects with successively higher doses.