"Dysregulated not deficit": A qualitative study on symptomatology of ADHD in young adults.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common condition that often persists into adulthood, although data suggest that the current diagnostic criteria may not represent how the condition presents in adults. We aimed to use qualitative methods to better understand ADHD symptomatology in young adults, especially regarding attentional and emotional dysregulation. METHODS: Nine focus groups involving young adults (aged 18-35 years; N = 43; 84% female; 86% US and Canada) with diagnoses of ADHD were conducted. Participants were asked about their perceptions of the current diagnostic criteria and how their symptoms have presented and changed over time. Data were analyzed using an interpretive phenomenological analysis framework. RESULTS: Most participants reported that the diagnostic criteria did not accurately capture their experiences with ADHD. They reported struggling with attention dysregulation, including hyperfocusing, and emotional dysregulation, including rejection-sensitive dysphoria. Many participants believed that their changing environments and behavioral adaptations influenced how their symptoms presented into adulthood. CONCLUSION: Current diagnostic criteria for ADHD may not capture the range of symptoms present in young adults. More research is needed to characterize attentional and emotional dysregulation in this population.

An exploratory study of problematic shopping and problematic video gaming in adolescents.

Problematic video gaming (PVG) and problematic shopping (PS) are addictive behaviors prevalent in adolescents, characterized by positive and negative reinforcement, and associated with psychosocial impairment. This study examined how PS and PVG relate in adolescents. It also examined how PS interacts with PVG in relation to health/functioning measures. Survey data from 3,657 Connecticut high-school students were evaluated. Chi-square analyses and logistic regression models were used to assess relationships between PS and measures of PVG. Interaction analyses measured effects of PS on relationships between PVG and health/functioning measures. Relative to adolescents without PS, those with PS had 8.79-fold higher odds of exhibiting PVG and were more likely to endorse gaming to relieve anxiety and impairment due to gaming. Interaction analyses revealed that in adolescents with PS, the relationships between PVG and aggressive behaviors, including fighting, serious fighting leading to physical injury, and weapon-carrying, were stronger than in adolescents without PS. PS strongly relates to PVG, and among youth reporting PS, there are stronger associations between PVG and aggressive behaviors. Prevention efforts for adolescents should consider the co-occurrence of PS and PVG. PS and PVG may be linked by negative reinforcement and propensities for aggressive and addictive behaviors, suggesting that further research should explore possible interventions targeting stress management and maladaptive coping.

Difficulties in impulse control in adolescents with problematic use of the internet and self-injurious behaviors.

Problematic use of the internet (PUI) and self-injurious behaviors (SIB) associate in adolescents and both relate to impulsivity. However, studies have not examined whether difficulties in impulse control are shared in adolescents with PUI and SIB, and how PUI relates to SIB frequency and impairment. Here, exploratory factor analysis was performed on a PUI questionnaire based on the Minnesota Impulse Disorder Interview, using survey data from 2,912 Connecticut high-school students. Regression analyses evaluated relationships between PUI factor scores and correlates of SIB. Moderation analyses examined impulsivity and sensation-seeking in relationship to PUI factors and SIB. Two PUI factors were extracted. The first PUI factor was associated with lifetime SIB, frequency, severity, urges, rising tension, and self-perceived problems with SIB. The second factor was associated with lifetime SIB and attempts to reduce SIB. Impulsivity and sensation-seeking associated with PUI factors and SIB, but did not moderate relationships between PUI and SIB. Findings suggest that PUI and SIB are related by difficulties in impulse control, and poor control over internet use is associated with more impairing SIB in adolescents who self-injure. Further research should investigate possible interventions targeting impulsivity and sensation-seeking to prevent PUI and SIB in youth.

The Potential of N-acetyl Cysteine in Behavioral Addictions and Related Compulsive and Impulsive Behaviors and Disorders: a Scoping Review.

Purpose of Review: Behavioral addictions (also termed disorders due to addictive behaviors) contain impulsive and compulsive features and have been shown to involve glutamate dysregulation. N-acetylcysteine (NAC), a well-tolerated cysteine pro-drug and antioxidant, may reduce addictive behaviors by restoring glutamate homeostasis. The current review details and discusses the use of NAC in behavioral addictions and related impulsive and compulsive behaviors, including gambling disorder, problematic use of the internet, problematic video gaming, compulsive sexual behavior, problematic shopping/buying, problematic stealing, repetitive self-injurious behavior, and binge eating disorder. Recent Findings: Preliminary results have indicated the usefulness of NAC in gambling disorder, self-injurious behaviors, and compulsive sexual behaviors. Preclinical studies indicate that NAC is effective in improving binge eating behavior, but clinical trials are limited to a small open-label trial and case report. Studies are lacking on the efficacy of NAC in problematic use of the internet, problematic video gaming, problematic stealing, and problematic shopping/buying. Summary: NAC demonstrates potential for use in behavioral addictions and compulsive behaviors, particularly in gambling disorder and self-injury. However, more studies are needed to assess the effectiveness of NAC in other behavioral addictions and the mechanisms by which NAC improves these conditions.

Problematic shopping and self-injurious behaviors in adolescents.

BACKGROUND AND AIMS: Self-injurious behaviors (SIBs) and problematic shopping (PS) are both prevalent in adolescents. These behaviors have been proposed as behavioral addictions and linked to impulsivity (Imp) and sensation-seeking (SS). They are also associated with negative mental health and psychosocial measures. This study examined relationships between PS and SIB in adolescents. It also examined how PS and SIB relate to Imp and SS, and interactions between PS and SIB in relation to health/functioning measures. METHODS: Survey data from 2,624 Connecticut high-school students were evaluated using chi-square analyses. Next, logistic regression models were used to assess relationships between PS and measures of SIB. T-tests compared Imp and SS in adolescents with and without PS and SIB. Interaction analyses assessed effects of PS on relationships between SIB and health/functioning measures. RESULTS: Adolescents with PS had 3.43-fold higher odds of endorsing lifetime SIB than those without PS, and were more likely to exhibit severe SIB and disruption due to SIB. PS and SIB were associated with elevated Imp and SS. Interaction analyses revealed that in adolescents with PS, the relationships between SIB and substance use was weaker than in adolescents without PS. This suggests PS accounts for variance in relationships between SIB and substance use. DISCUSSION AND CONCLUSIONS: PS is strongly related to SIB prevalence, severity, and impairment in adolescents, and weakens associations between SIB and substance use. PS should therefore be considered for prevention efforts for SIB. Further research should investigate mechanisms connecting PS and SIB and explore possible interventions targeting associated features like Imp and SS.

Accessing non-natural reactivity by irradiating nicotinamide-dependent enzymes with light.

Enzymes are ideal for use in asymmetric catalysis by the chemical industry, because their chemical compositions can be tailored to a specific substrate and selectivity pattern while providing efficiencies and selectivities that surpass those of classical synthetic methods. However, enzymes are limited to reactions that are found in nature and, as such, facilitate fewer types of transformation than do other forms of catalysis. Thus, a longstanding challenge in the field of biologically mediated catalysis has been to develop enzymes with new catalytic functions. Here we describe a method for achieving catalytic promiscuity that uses the photoexcited state of nicotinamide co-factors (molecules that assist enzyme-mediated catalysis). Under irradiation with visible light, the nicotinamide-dependent enzyme known as ketoreductase can be transformed from a carbonyl reductase into an initiator of radical species and a chiral source of hydrogen atoms. We demonstrate this new reactivity through a highly enantioselective radical dehalogenation of lactones-a challenging transformation for small-molecule catalysts. Mechanistic experiments support the theory that a radical species acts as an intermediate in this reaction, with NADH and NADPH (the reduced forms of nicotinamide adenine nucleotide and nicotinamide adenine dinucleotide phosphate, respectively) serving as both a photoreductant and the source of hydrogen atoms. To our knowledge, this method represents the first example of photo-induced enzyme promiscuity, and highlights the potential for accessing new reactivity from existing enzymes simply by using the excited states of common biological co-factors. This represents a departure from existing light-driven biocatalytic techniques, which are typically explored in the context of co-factor regeneration.

NKG2D-deficient mice are defective in tumor surveillance in models of spontaneous malignancy.

Ligands for the NKG2D stimulatory receptor are frequently upregulated on tumor lines, rendering them sensitive to natural killer (NK) cells, but the role of NKG2D in tumor surveillance has not been addressed in spontaneous cancer models. Here, we provided the first characterization of NKG2D-deficient mice, including evidence that NKG2D was not necessary for NK cell development but was critical for immunosurveillance of epithelial and lymphoid malignancies in two transgenic models of de novo tumorigenesis. In both models, we detected NKG2D ligands on the tumor cell surface ex vivo, providing needed evidence for ligand expression by primary tumors. In a prostate cancer model, aggressive tumors arising in NKG2D-deficient mice expressed higher amounts of NKG2D ligands than did similar tumors in wild-type mice, suggesting an NKG2D-dependent immunoediting of tumors in this model. These findings provide important genetic evidence for surveillance of primary tumors by an NK receptor.