ABSTRACT
ABSTRACT Attention-Deficit Hyperactivity Disorder (ADHD) encompasses other symptoms besides inattention, hyperactivity, and impulsivity, such as language problems. ADHD can have a non-remitting course and is also found in older individuals, although there are no studies on language problems in elderly individuals with the disorder. Objective: To investigate the presence of language impairment in older adults with ADHD. Methods: Language impairment was investigated in three older ADHD adults, and compared with two matched control subjects using a narrative discourse task. The transcript discourses were evaluated based on the Trabasso Model for discourse analysis, and then processed by the Speech Graph Analysis software. Results: Compared to control subjects, ADHD patient discourse had more Plot components and their networks exhibited more Edges. The patients had higher scores on the Narrative Inefficiency, Density and Diameter Indexes as well as on the Average Clustering Coefficient. The networks of control subjects were sequential, with little or no recursiveness, whereas those of ADHD subjects were convoluted. Conclusion: Our results suggest that language deficits described in children, adolescents and young adults with ADHD may persist in older adults with the disorder.
RESUMO O Transtorno do Déficit de Atenção/Hiperatividade (TDAH) compreende diversos outros sintomas além de desatenção, hiperatividade e impulsividade, tais como problemas de linguagem. O TDAH pode cursar sem remissão, tendo sido demonstrado em indivíduos mais velhos, porém não há estudos investigando a linguagem em idosos com o transtorno. Objetivo: Investigar a presença de déficits de linguagem em adultos mais velhos portadores de TDAH. Métodos: Avaliou-se a presença de comprometimento de linguagem em três adultos mais velhos com TDAH, que foram comparados a dois indivíduos controles pareados, através de tarefa de discurso narrativo. A transcrição das narrativas foi avaliada com base no modelo de análise de narrativa de Trabasso, e então analisada com uso do programa Speech Graph Analysis. Resultados: Comparados aos indivíduos controles, adultos mais velhos com TDAH utilizaram mais componentes (Núcleos) da história em suas narrativas e suas redes mais Arestas. Eles apresentaram escores mais altos no Índice de Ineficiência, Diâmetro e Densidade e também no Coeficiente Médio de Grupamento. As redes dos indivíduos controles foram lineares e sequenciais, com pouca ou nenhuma recursividade, ao contrário das redes de adultos com TDAH. Conclusão: Estes resultados sugerem que problemas de linguagem já descritos em crianças, adolescentes e adultos com TDAH, podem persistir em adultos mais velhos com o transtorno.
Subject(s)
Humans , Attention Deficit Disorder with Hyperactivity/complications , Speech Disorders , Aged , Language DisordersABSTRACT
Objective: The marked increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students gives rise to questions about how best to diagnose in this setting. The aim of the present study was to calculate ADHD prevalence in a large non-clinical sample of medical students using a stepwise design and to determine whether ADHD diagnosis varies if interviewees use additional probing procedures to obtain examples of positive DSM items. Methods: A total of 726 students were screened with the Adult Self-Report Scale (ASRS) and invited for an interview with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) adapted for adults. Results: The ASRS was positive for 247 students (37%), although only 83 (7.9%) received an ADHD diagnosis. ASRS sensitivity and specificity rates were 0.97 and 0.40, respectively. Probing procedures were used with a subgroup of 226 students, which decreased the number of ADHD diagnoses to 12 (4.5%). Conclusion: Probing for an individual's real-life examples during the K-SADS interview almost halved ADHD prevalence rate based on the ASRS and K-SADS, which rendered the rate consistent with that typically reported for young adults. In reclassified cases, although examples of inattention did not match the corresponding DSM item, they often referred to another DSM inattention item.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Psychiatric Status Rating Scales/standards , Attention Deficit Disorder with Hyperactivity/epidemiology , Students, Medical/psychology , Diagnostic and Statistical Manual of Mental Disorders , Attention Deficit Disorder with Hyperactivity/diagnosis , Students, Medical/statistics & numerical data , Prevalence , Sensitivity and Specificity , Diagnosis, Differential , Self Report , Interview, Psychological/standardsABSTRACT
Background: Individuals with attention-deficit/hyperactivity disorder (ADHD) are reported to manifest visual problems (including ophthalmological and color perception, particularly for blue---yellow stimuli), but findings are inconsistent. Accordingly, this study investigated visual function and color perception in adolescents with ADHD using color Visual Evoked Potentials (cVEP), which provides an objective measure of color perception. Method: Thirty-one adolescents (aged 13---18), 16 with a confirmed diagnosis of ADHD, and 15 healthy peers, matched for age, gender, and IQ participated in the study. All underwent an ophthalmological exam, as well as electrophysiological testing color Visual Evoked Potentials (cVEP), which measured the latency and amplitude of the neural P1 response to chromatic (blue---yellow, red---green) and achromatic stimuli. Result: No intergroup differences were found in the ophthalmological exam. However, significantly larger P1 amplitude was found for blue and yellow stimuli, but not red/green or achromatic stimuli, in the ADHD group (particularly in the medicated group) compared to controls. Conclusion: Larger amplitude in the P1 component for blue---yellow in the ADHD group compared to controls may account for the lack of difference in color perception tasks. We speculate that the larger amplitude for blue---yellow stimuli in early sensory processing (P1) might reflect a compensatory strategy for underlying problems including compromised retinal input of s-cones due to hypo-dopaminergic tone (AU)
Antecedentes: Se ha reportado que las personas con trastorno de déficit de atención e hiperactividad (TDAH) manifiestan problemas visuales (incluyendo oftalmológicos y de color, particularmente para estímulos azul-amarillo), aunque los hallazgos son inconsistentes. El presente estudio investigó la función visual y la percepción del color en adolescentes con TDAH, utilizando potenciales evocados visuales (PEV), que aportan una medición objetiva de la percepción del color. Métodos: Participaron en el estudio treinta y un adolescentes (de edades comprendidas entre 13 y 18 años): 16 con diagnóstico confirmado de TDAH y 15 individuos sanos, equiparados por edad, sexo e IQ. Todos ellos fueron sometidos a examen oftalmológico y a pruebas electrofisiológicas de PEV, que midieron la latencia y amplitud de la respuesta neuronal P1 a los estímulos cromáticos (azul-amarillo, rojo-verde) y acromáticos. Resultados: No se hallaron diferencias entre los grupos en el examen oftalmológico. Sin embargo, se halló una amplitud significativamente mayor de P1 para los estímulos azul-amarillo, aunque no para los estímulos rojo/verde o acromáticos, en el grupo de TDAH (particularmente en el grupo medicado), en comparación a los controles. Conclusión: La mayor amplitud en el componente P1 para azul-amarillo del grupo TDAH, en comparación a los controles, podría explicar la falta de diferencia en las tareas de percepción del color. Suponemos que la mayor amplitud para los estímulos azul-amarillo en el proceso sensorial temprano (P1) podría reflejar una estrategia compensatoria para los problemas subyacentes, incluyendo el input retiniano comprometido de los conos S debido al tono hipo-dopaminérgico (AU)
Subject(s)
Adolescent , Female , Humans , Male , Visual Acuity , Color Perception , Attention Deficit Disorder with Hyperactivity/physiopathology , Perceptual Disorders/epidemiology , Evoked Potentials, Visual , Color Perception Tests/methodsABSTRACT
Este estudio examinó los errores y autocorrecciones en habilidades narrativas de los niños con déficit de atención e hiperactividad (TDAH) y TDAH más trastornos de lenguaje (TL). Cuarenta y cinco sujetos comprendidos en tres grupos de 15 (TDAH, TDAH + TL y un grupo de comparación [GC]) generaron una narración apoyada en un libro de imágenes sin palabras. El grupo con TDAH mostró menos producción verbal y tardó más en detectar los errores que los otros dos grupos. El grupo con TDAH tuvo menos errores que el grupo con TDAH+TL, que tenía una mayor tasa de errores gramaticales. El grupo con TDAH también tuvo menos expresiones asociadas a las imágenes que representan la narración central. Los resultados indican que las dificultades del grupo con TDAH+TL se limitan al lenguaje y son distintos de las del TDAH, en contra de la teoría de un doble déficit (AU)
This study examined the errors and self-corrections in narrative abilities of children with Attention Deficit Hyperactivity Disorder (ADHD) and ADHD plus Language Impairments (LI). Forty-five subjects comprising three groups of 15 (ADHD, ADHD +LI and Comparison Group [CG]) generated a narrative based on a wordless picture-book. The ADHD group showed a lower verbal output and detected errors later than the other two groups. The ADHD group had fewer errors than the ADHD+LI group, who had a higher rate of grammatical errors. The ADHD group also had fewer utterances associated with the pictures depicting the central narrative. Findings indicate that the ADHD+LI group's difficulties are confined to language and are distinct from those of ADHD, contrary to the theory of a double-deficit (AU)