Advanced Test of Attention in Children with Attention-Deficit/Hyperactivity Disorder in Japan for Evaluation of Methylphenidate and Atomoxetine Effects.

OBJECTIVE: This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. METHODS: To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. RESULTS: Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. CONCLUSION: The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool.

Neuropsychological and behavioral profiles in attention-deficit hyperactivity disorder children of parents with a history of mood disorders: a pilot study.

OBJECTIVE: We aimed to investigate the neurocognitive and behavioral endophenotypes of premorbid mood disorder. We compared intelligence, neuropsychological functioning, and behavioral problems among three groups: 1) a high-risk group [attention-deficit hyperactivity disorder (ADHD) children of parents with a history of a mood disorder], 2) a low-risk group (ADHD children of parents without a history of a mood disorder), and 3) normal comparison subjects. METHODS: We used the Korean Educational Development Institute Wechsler Intelligence Scale for Children-Revised (KEDI-WISC-R), the Stroop Color Word Interference Test (Stroop), the Wisconsin Card Sorting Test (WCST), and the Rey-Osterrieth Complex Figure Test (RCFT) as neurocognitive measures, and we used the Child Behavior Checklist (CBCL) as a behavioral measure. Performance on these neuropsychological tests and score on the CBCL of 18 high-risk children were compared to those of 20 low-risk children and 24 healthy children. We also assessed the children's current mood state and familial functioning to control for the confounding effects of these variables. RESULTS: Compared to low-risk and healthy children, high-risk children were impaired on the Picture Completion and Stroop Word subtest and showed higher scores on the CBCL subscales representing internalizing symptoms. These significant group differences persisted even after adjustment for the children's current mood state and familial functioning. CONCLUSION: Neuropsychological deficits in the offspring of parents with a mood disorder may be associated with the current mood state rather than with innate characteristics, while their internalizing symptoms may partially stem from innate characteristics that are endophenotypes of a premorbid mood disorder.

The association between problematic internet use and depression, suicidal ideation and bipolar disorder symptoms in Korean adolescents.

OBJECTIVE: This study used a sample of Korean adolescents to evaluate: (a) associations between problematic internet use and depression, bipolar disorder symptoms and suicidal ideation; and (b) whether mood disorders mediate the relationship between problematic internet use and suicidal ideation. METHOD: A total of 795 middle and high school students were recruited (538 girls; mean age, 13.87 ± 1.51 years). The Internet Addiction Proneness Scale for Youth-Short Form (KS-scale) was used to evaluate the presence and severity of problematic internet use. The frequencies of depression, suicidal ideation and probable bipolar disorder were compared between adolescents with and without internet addiction. The associations between the severity of problematic internet use and the severity of depressive symptoms, bipolar symptoms and suicidal ideation were also analyzed. RESULTS: Seventy-five adolescents (9.4%) met the criteria for problematic internet use. The presence of problematic internet use was significantly associated with suicidal ideation (OR = 5.82, 95% CI = 3.30-10.26, p < 0.001) as well as depression (OR = 5.00, 95% CI = 2.88-8.66, p < 0.001). There was a marginally significant association between problematic internet use and probable bipolar disorder (OR = 3.05, 95% CI = 0.96-9.69, p = 0.059). In the path model, problematic internet use significantly predicted depressive symptoms (ß = 0.296, 95% CI = 0.214-0.367, p = 0.005), which predicted suicidal ideation (ß = 0.699, 95% CI = 0.631-0.751, p = 0.009). Problematic internet use also predicted suicidal ideation directly (ß = 0.115, 95% CI = 0.052-0.193, p = 0.006). Conversely, depressive symptoms (ß = 0.119, 95% CI = -0.005-0.219, p = 0.040) and suicidal ideation (ß = 0.215, 95% CI = 0.089-0.346, p = 0.005) predicted problematic internet use. CONCLUSIONS: There is a complex transactional relationship between problematic internet use, depressive symptoms, bipolar symptoms and suicidal ideation, so these conditions must be assessed together during the evaluation of adolescents. Prospective studies are warranted to elucidate the causal relationships between problematic internet use, mood symptoms and suicidal ideation.

The reliability and validity of the junior temperament and character inventory.

The purpose of this study was to evaluate the reliability and validity of the Junior Temperament and Character Inventory (Junior TCI), a child and adolescent version of the Adult Temperament and Character Inventory (TCI), which is based on Cloninger's biosocial model of personality. The Junior TCI was translated into Korean and administered to 663 Korean middle school students (male/female, 360/303; age, 13.3 +/- 1.0 years) and their parents (mother/father, 444/84). Internal consistency was calculated by Cronbach alpha. A test-retest study of the Junior TCI was conducted across a 3-month interval with 97 subjects. Factor analyses for the temperament and character dimensions were performed using principal component analysis, rotating factors by Promax. Cronbach alpha values of the Junior TCI scales ranged from.48 to.80 for the temperament scales and from.64 to.68 for the character scales. Test-retest correlations ranged from.62 to.85 for the temperament scales and from.76 to.79 for the character scales. Principal component factor analyses showed three factors out of four temperament scales (Harm Avoidance 1 to 4; Novelty Seeking 1 to 4; Persistence; and Reward Dependence 1, 3, 4) and three factors out of three character scales (Self-Directedness 1 to 5; Cooperativeness 1 to 5; and Self-Transcendence 1 to 3) that were similar to factor structures of adult versions of the TCI. Explorative factor analysis with a condition of eigenvalue greater than 1 produced six factors, as compared to seven factors extracted in Cloninger's original report of the adult TCI. In conclusion, this was the first study to tests and report detailed psychometric properties of the Junior TCI. The current study confirms that the Junior TCI has satisfactory psychometric properties for the use in child and adolescent populations and reflects Cloninger's biosocial model of personality.