Influence of maternal attention-deficit hyperactive disorder on child dental neglect - An analytical cross-sectional study.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario. AIM: The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children. METHODOLOGY: The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done. RESULTS: The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children. CONCLUSION: Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.

ADHD: prevalence and effect on opioid use disorder treatment outcome in a French sample of patients receiving medication for opioid use disorder-the influence of impulsivity as a mediating factor.

BACKGROUND: Opioid use disorder (OUD) poses a global health challenge, and despite medications for opioid use disorder (MOUD) and psychosocial interventions, relapse remains a significant concern. Comorbid psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), are one of the major factors associated with poor OUD treatment outcome. We aimed to estimate the frequency of probable ADHD (in childhood and in adulthood) in patients with OUD; to assess the factors associated with this comorbidity; and to explore the factors that mediate the relationship between ADHD and OUD treatment outcome. METHODS: We conducted an observational study using a sample of 229 patients aged 18 years and older who were diagnosed with OUD and had received MOUD for at least six months. Participants were assessed through a structured interview and self-report questionnaires. Multivariate logistic regressions and a mediation analysis were performed. RESULTS: Almost half of the participants reported probable ADHD in childhood, and ADHD persisted into adulthood among two-thirds of the patients. The factors associated with poor OUD treatment outcome included earlier onset of OUD, lower education, and greater impulsivity. There was no direct effect of probable ADHD in childhood on OUD treatment outcome, but there was an indirect effect through negative urgency, the tendency to respond impulsively to negatively connoted emotional experiences. CONCLUSIONS: The findings suggest that ADHD symptoms, particularly impulsivity, may contribute to vulnerability in opioid use and play a crucial role in treatment outcomes for this population. TRIAL REGISTRATION: ClinicalTrials identifier NCT01847729.

Sex differences in physiological correlates of affectively driven decision-making behavior in adult ADHD.

BACKGROUND: Sex differences in the symptomatology of adults with attention-deficit/hyperactivity disorder (ADHD) have often been overlooked when studying behavioral abnormalities. However, it is known that women exhibit considerably more stronger symptoms related to emotional competence than men. Since affective functions significantly influence the processing of risky decision-making and risk-engagement, we assume that risky behavior in ADHD is affected by sex differences. Therefore, we specifically investigated sex-specific effects on the interaction between emotionally induced changes in physiology and behavioral performance on a decision-making task. METHODS: Skin conductance responses of twenty-nine adults with ADHD (n = 16 male; n = 13 female) and thirty-three adults in the control group (n = 14 male; n = 19 female) were recorded during the performance in a modified version of the Balloon Analogue Risk Task (BART). Additional questionnaires were used to reveal insights in the self-assessment of emotional competence, risk perception, and feedback sensitivity. Emotional arousal and decision-making behavior were analyzed using linear mixed-effects models. RESULTS: Results showed different effects of sex on risk behaviors in controls and ADHD. In contrast to healthy controls, female adults with ADHD showed a significantly greater risk engagement in the BART compared to males with ADHD. This contrary sex relation was not observed in skin conductance responses and revealed a significantly different sex-dependent correlation of body response and behavioral task performance in ADHD. Comparisons with results from self-assessments furthermore indicate a reduced behavioral self-perception in women with ADHD, but not in men. CONCLUSION: In summary, we found an altered interaction between physiological activity and risky behavior in women with ADHD. Thus, the present study indicates a reduced sensitivity towards the own bodily responses in women with ADHD, which could consequently cause increased risky DM behavior in daily life. The current results suggest that more consideration needs to be given to sex-specific effects on physiological processes and behavior in adults with ADHD.

Formulation-based cognitive behavioral therapy compared to an active control and a waitlist in adult inmates with ADHD: study protocol for a randomized controlled trial.

BACKGROUND: Recent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD. METHODS: The study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups. DISCUSSION: This study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release. TRIAL REGISTRATION: ClinicalTrials.gov NCT06080373. Registered on October 12, 2023.

Cyclothymic affective temperament and low positive attitude coping strategies as predictors of comorbid depressive symptomatology in adult ADHD patients.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies. METHODS: A total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M). RESULTS: 64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI "positive attitude" subscale (B = -0.438, p = 0.024) (R = 0.496, R2 = 0.246, F(2,66) = 10.747, p < 0.001). LIMITATION: While considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed. CONCLUSION: Affective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.

Real-time cognitive performance metrics derived from a digital therapeutic for inattention predict ADHD-related clinical outcomes: Replication across three independent trials of AKL-T01.

AKL-T01 is a digital therapeutic (DTx) that targets attention by generating conflict at dynamically updated difficulty levels during a multitasking game. Clinical trials support AKL-T01's efficacy in attention-deficit/hyperactivity disorder (ADHD), but there is a need to understand how in-game data can be used to monitor patient changes in cognition. We aimed to derive a real-time measure of attention from AKL-T01 gameplay data and validate it against clinical outcomes. Trials of AKL-T01 included: STARS-ADHD-Adult (NCT05183919), a 6-week trial in adults 18 and older (n = 221; M age = 39.9; 70% female); STARS-ADHD-Adolescent (NCT04897074), a 4-week trial in adolescents ages 13-17 (n = 162; M age = 14.4; 41% female); and STARS-ADHD (NCT02674633), a 4-week trial in children ages 8-12 (n = 180; M age = 9.7; 31% female). A cognitive metric was derived from targeting response speed, targeting sensitivity (d-prime), and navigation skill level. Using multiple linear regression models, we analyzed relationships between cognitive metric change and changes in the Test of Variables of Attention (TOVA)-Attention Comparison Score (ACS), controlling for TOVA-ACS baseline, cognitive metric baseline, age, and sex. We explored associations with ADHD symptoms and quality of life. Increases in the cognitive metric significantly predicted increases in TOVA-ACS in the adult (ß = 0.16, p < 0.001), adolescent (ß = .09, p = 0.007), and pediatric (ß = 0.06, p = 0.014) trials. Cognitive metric changes additionally related to self-reported quality of life in adults and clinician-rated ADHD symptoms in adolescents. Findings support the clinical validity of a real-time measure of attention derived from AKL-T01 patient-device interactions.

Important aspects of experiences from patients and parents related to medications in Child and Adolescents Mental Health Services (CAMHS) - a qualitative study.

PURPOSE: Patient-reported experiences are a key source of information on quality in mental health care. Most patient experience surveys are limited to assessments from adults, including those conducted by parents or proxies on behalf of others. The aim of this study was to produce findings to inform development of modules on patient and parent experiences with medication in outpatient CAMHS in Norway, for use in previously validated instruments applied in national surveys. PATIENTS AND METHODS: We developed survey questions based on a systematic literature review, expert-group consultations, interviews with adolescents and parents, and pretesting of the modules in a pilot study. This study included adolescents aged 12-17 years and parents with experiences from outpatient CAMHS and we present findings from semi-structured interviews. RESULTS: Adolescents with ADHD emphasized the following aspects as important concerning medication use in CAMHS: positive effects of medication like better function and concentration in school and change of behaviour. They also stressed the importance of side effects such as eating problems, nausea, loss of appetite, insomnia, and changes in thoughts and feelings. In addition, adolescents highlighted the significance of aspects as support in daily routines for taking medications, while parents highlighted needs for a professional follow-up care. Parents emphasized aspects regarding their children's medication included both positive effects and change in behaviour, as well as their identification of negative side effects. CONCLUSION: Our findings from semi-structured interviews identified important aspects reported by both patients and parents on functions, side effects and follow-up care related to medication. The results indicated that both groups emphasized corresponding aspects of what was important regarding medication. However, when it came to follow-up care, the two groups highlighted distinct aspects, indicating differing priorities or concerns in this area.

Gender-specific motivational pathways in ADHD-related inattention and gaming disorder symptoms.

Comorbidity between attention-deficit/hyperactivity disorder (ADHD) and gaming disorder (GD) is widely recognized in the literature. Previous research has indicated gender-dependent underlying mechanisms in the development and maintenance of problematic gaming. Motivational research presents an opportunity to provide further insight regarding the nature of this association. Self-report data were collected from videogame players (N = 14,740) using an online survey in collaboration with a popular gaming magazine. The survey included items concerning symptoms of ADHD and GD, motives for gaming, and time spent playing videogames. Structural equation modeling was used to create two parallel mediation models (one for males, one for females), including motives to play games as mediators. This was done to potentially explain psychological drivers of the association between ADHD and GD. Results demonstrated a common pathway from inattention to GD symptom severity through the immersion/escapism motivation for both males (ß = 0.068; p < 0.001) and females (ß = 0.081; p < 0.05), while the paths from inattention to GD symptom severity through the habit/boredom motive (ß = 0.094; p < 0.001) and competition motive (ß = 0.021; p < 0.001) were only significant for males. Gamers experiencing symptoms of ADHD, especially inattentive symptoms, are at risk of the occurrence of GD symptoms through videogames becoming a source of maladaptive coping with daily psychological disturbances. Males experiencing inattentive symptoms tend to additionally develop problematic patterns of use through videogame playing, becoming a subjectively meaningless and boredom-reduction-oriented habitual activity or a platform of virtual competition. Unique differences suggest the necessity of different treatment approaches for males and females.

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories.

BACKGROUND: Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems. METHODS: This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle. RESULTS: Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: ß = 2.01, P < 0.001; high-deprivation: ß = 1.03, P < 0.001; high-unpredictability: ß = 0.83, P = 0.001; high-overall adversity: ß = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys. LIMITATIONS: The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data. CONCLUSIONS: This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

Psychosocial interventions for improving the physical health of young people and adults with attention deficit hyperactivity disorder: a scoping review.

BACKGROUND: Young people and adults with ADHD are at risk of a range of physical health problems. There is limited guidance on how to approach health problems in ADHD, and especially around 16-25 year olds who will be transitioning from paediatric to adult care. The aim of this scoping review was to identify psychosocial interventions that target physical health in young people and adults with ADHD. METHODS: We constructed searches in MEDLINE, PsycInfo, EMBASE of adolescents, young people and adults. Inclusion criteria were; studies of psychosocial interventions examining a component of physical health, applicable to people aged 16-25, with clinical or research diagnoses of ADHD. Data were extracted using a data extraction tool and tabulated, including study intervention framing/aims, population, intervention, and relevant outcomes (including specific statistics where relevant). RESULTS: Our search identified 22 unique papers covering, psychosocial interventions targeting at least one of sleep (n=7), smoking (n=3), substance/alcohol use (n=4), physical health/exercise (n=6) and general health (n=3). Studies examined psychotherapy/behaviour interventions (n=12), psychoeducation (n=4), digital (n=2) and social interventions (n=4). There was significant heterogeneity in intervention framing, outcome measures and population. CONCLUSION: Further work on the impact of targeted physical health interventions, with explicit reference to a conceptual framework of poor health in ADHD is required. Furthermore, future work standardising reporting of physical health outcomes in ADHD is crucial for the development of an evidence base in this field.

A randomized clinical trial to evaluate feasibility, tolerability, and preliminary target engagement for a novel executive working memory training in adolescents with ADHD.

OBJECTIVE: Working memory training for Attention-Deficit/Hyperactivity Disorder (ADHD) has focused on increasing working memory capacity, with inconclusive evidence for its effectiveness. Alternative training targets are executive working memory (EWM) processes that promote flexibility or bolster stability of working memory contents to guide behavior via selective attention. This randomized, placebo-controlled study was designed to assess feasibility, tolerability, and behavioral target engagement of a novel EWM training for ADHD. METHOD: 62 ADHD-diagnosed adolescents (12-18 years) were randomized to EWM training or placebo arms for 20 remotely coached sessions conducted over 4-5 weeks. Primary outcome measures were behavioral changes on EWM tasks. Secondary outcomes were intervention tolerability, trial retention, and responsiveness to adaptive training difficulty manipulations. RESULTS: Linear regression analyses found intervention participants showed medium effect size improvements, many of which were statistically significant, on Shifting and Filtering EWM task accuracy and Shifting and Updating reaction time measures. Intervention participants maintained strong self-rated motivation, mood, and engagement and progressed through the adaptive difficulty measures, which was further reflected in high trial retention. CONCLUSIONS: The results suggest that these EWM processes show promise as training targets for ADHD. The subsequent NIMH R33-funded extension clinical trial will seek to replicate and extend these findings.

Inter-subject gamma oscillation synchronization as a biomarker of abnormal processing of social interaction in ADHD.

Children with attention-deficit hyperactivity disorder (ADHD) have difficulties in social interactions. Studying brain activity during social interactions is difficult with conventional artificial stimuli. This pioneering study examined the neural correlates of social perception in children with ADHD and matched controls using naturalistic stimuli. We presented 20 children with ADHD and 20 age-and-sex-matched controls with tailored movies featuring high- or low-level social interactions while recording electroencephalographic signals. Both groups exhibited synchronized gamma-band oscillations, but controls demonstrated greater inter-subject correlations. Additionally, the difference in inter-subject correlations between high- and low-interaction movies was significantly larger in controls compared to ADHD patients. Between 55 and 75 Hz comparing viewing high interaction movies with low interaction moves, controls had a significantly larger weighting in the right parietal lobe, while ADHD patients had a significantly smaller weighting in the left occipital lobe. These findings reveal distinct spatiotemporal neural signatures in social interaction processing among children with ADHD and controls using naturalistic stimuli. These neural markers offer potential for group differentiation and assessing intervention efficacy, advancing our understanding ADHD-related social interaction mechanisms.

Deliberate self-harm in adolescents screening positive for attention-deficit / hyperactivity disorder: a population-based study.

BACKGROUND: Adolescents with attention-deficit / hyperactivity disorder (ADHD) have an increased risk of self-harm. The risk of self-harm among adolescents who display an elevated level of ADHD symptoms, but without a formal diagnosis, is not well-studied and understood. OBJECTIVE: To investigate the relationship between self-reported symptoms of ADHD and self-harm in a population-based sample of adolescents. METHODS: Adolescents in the population-based youth@hordaland study were invited to complete the Adult ADHD Self-Report Scale (ASRS) and the Short Mood and Feelings Questionnaire (SMFQ). They were asked whether they ever deliberately have taken an overdose or tried to harm themselves on purpose, once or multiple times, defined according to the code used in the Child and Adolescent Self-harm in Europe (CASE) Study. Adolescents reporting severe problems on ≥ four of six selected items on the ASRS-v 1.1 screener were defined as ADHD-screen positive (ADHD-SC+), and the remaining sample as ADHD-screen negative (ADHD-SC-). SMFQ score ≥ 12 was used to define a high level of depressive symptoms. RESULTS: A total of 9692 adolescents (mean age 17.4 years, 53.1% females) participated in the study, of which 2390 (24.7%) screened positive on the ASRS. ADHD-SC+ adolescents engaged in self-harm more often than the ADHD-SC- group (14.6% vs. 5.4%, OR = 3.02, 95%CI [2.57-3.24]). This remained significant after adjustment for demographic variables, SMFQ score ≥ 12, symptoms of conduct disorder and familial history of self-harm and suicide attempts (OR = 1.58, 95%CI [1.31-1.89]). They were also more likely to report an overdose as their method of self-harm (OR = 1.52, 95%CI [1.05-2.23]). Within the ADHD-SC+ group female sex, high levels of inattention and hyperactivity/impulsivity symptoms, SMFQ score ≥ 12, symptoms indicating conduct disorder and familial history of self-harm and suicide attempts increased the likelihood of engaging in deliberate self-harm. CONCLUSION: Adolescents who screened positive for ADHD had increased risk of engaging in self-harm. Clinicians should consider the increased risk of such engagement in adolescents who present with high level of ADHD symptoms, even in the absence of a clinical ADHD diagnosis.

Validation of the dispositional adult hyperfocus questionnaire (AHQ-D).

Hyperfocus (HF), or intense, deep concentration on a task, has gained significant research attention in recent years, particularly in regard to clinical populations such as Attention-Deficit/Hyperactivity Disorder (ADHD). The present work aims to provide validation of the 12-item dispositional adult hyperfocus questionnaire (AHQ-D) as a quantitative metric of HF in adults. We preregistered the study design and hypotheses. We administered the AHQ-D and several additional questionnaires to 347 adults (mean ± SD age: 33 ± 11 years; 47% female). Exploratory factor analysis revealed high factor loadings (0.57-0.81) on a single HF factor; item response theory analysis suggested that the questionnaire items had high discrimination and covered a wide range of responses; and we report strong internal consistency metrics (Cronbach's alpha 0.93, mean split-half reliability 0.93). Replicating our previous work, HF was positively correlated with Conners' Adult ADHD Rating Scale (CAARS) scores (r(345) = 0.53), suggesting that HF may be related to ADHD traits (though in this sample we did not specifically recruit individuals with ADHD). The AHQ-D demonstrated the hypothesized convergent validity; HF on the AHQ-D was positively correlated with HF measured using a different HF scale (r(344) = 0.69), as well as flow (r(345) = 0.12) and mind wandering (r(345) = 0.39) scores. AHQ-D HF scores showed a weak negative correlation with grit (r(345) = - 0.29). Though there was a weak negative correlation between HF and social desirability response tendency (r(345) = - 0.24), suggesting that those who care more about what others think may report less HF, there was no relationship between HF and extrasensory perception beliefs (r(345) = 0.01), suggesting that participants were not simply biased in their response tendencies. Taken together, we demonstrate strong scale metrics for the AHQ-D, the expected convergent validity, and a general lack of response bias, in addition to replicating our previous association of HF with ADHD traits. We suggest that the AHQ-D can be confidently used in future work as a valid way to measure HF in adults.

Wider health needs in attention deficit hyperactivity disorder from lived and professional experience: a qualitative framework analysis.

OBJECTIVES: This study aimed to explore the perspectives of people with attention deficit hyperactivity disorder (ADHD), their supporters and primary care professionals (PCPs), on the wider physical and mental health needs of people with ADHD and the support currently available. DESIGN: Qualitative semi-structured interviews, analysed using reflexive thematic analysis. SETTING: Five general practice surgeries across England. PARTICIPANTS: Participants with lived experience (people with ADHD and their supporters (n=11)) and PCPs (n=9) (eg, general practitioners and practice managers), recruited via clinical academic networks and previous work packages of this study. RESULTS: We generated three major themes in relation to ADHD, using reflexive thematic analysis: understanding health, barriers to health and addressing health. Within these, participants reflected on mental and physical health challenges, as well as wider social difficulties and variability in support offered/accessed. CONCLUSIONS: This study highlights that health problems in ADHD are complex and rooted both in individual factors (eg, mental health) and social factors (eg, support). This study also highlights the differences in expectations and fulfilment of healthcare.

Coping strategies and symptoms of Adjustment Disorder among adults with Attention Deficit Hyperactivity Disorder (ADHD) during the Covid-19 pandemic.

BACKGROUND: The current study examined whether coping strategies and symptoms of Adjustment Disorder in adults with ADHD differed from what was observed in the general adult population during the Covid-19 pandemic, and compared the extent to which coping strategies and symptom levels of Adjustment Disorder were related to ADHD. METHOD: This cross-sectional study was based on survey data collected during the spring of 2021 from 231 adult ADHD patients in specialist care and 1148 volunteers without ADHD in Sweden. The survey included questions about sociodemographic and clinical characteristics, along with the Brief-COPE and Adjustment Disorder-New Module 8 questionnaires. Regression models adjusting for sociodemographic and clinical characteristics were used for between-group comparisons of coping strategies and symptoms of Adjustment Disorder. RESULTS: There were some notable differences in the use of coping strategies between persons with and without ADHD; however, many of these differences were not observed in the adjusted models. The use of behavioral disengagement was more frequently observed among individuals with ADHD, whereas planning was more common among individuals without ADHD. Individuals with ADHD appeared to show higher symptom levels of Adjustment Disorder during the pandemic. Passive coping strategies, such as denial, self-blame, and behavioral disengagement, were associated with higher symptom levels of adjustment disorder in both individuals with and without ADHD. CONCLUSION: In conclusion, the results highlight that persons with ADHD may need more support to adjust to large societal changes than the general public. Potential targets for intervention towards members of this group include reducing resignation and maladaptive coping strategies.

Examining the effectiveness of a social-play-based programme to reduce symptoms of Attention-Deficit/Hyperactivity Disorder in Saudi elementary school children.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions in children, and can profoundly affect their social interactions, well-being, and relationships with parents, peers, and teachers. OBJECTIVE: This study investigated the effectiveness of a social-play-based intervention programme in reducing ADHD symptoms in a sample of 67 Saudi boys aged 8-10 diagnosed with ADHD. METHODS: The programme consisted of ten 60-minute sessions of play-based activities, delivered to the experimental group twice weekly for 5 weeks. The control group followed the usual school curriculum. Teachers and parents completed the Conners' Teacher Rating Scale-Revised: Short Form and Conners' Parent Rating Scale-Revised: Short Form for all participants at pre-test, post-test, and follow-up. RESULTS: The experimental group showed a significant reduction in ADHD-associated behavioural problems over time, with moderate to large effect sizes. No significant changes over time were found for the control group. The results were maintained at a 2-month follow-up. CONCLUSIONS: We recommend incorporating social-play-based activities and skill training into the school context. Reducing ADHD symptoms may improve children's academic performance and perspective on school.

Validation and assessment of the self-injurious behavior scale for tic disorders (SIBS-T).

Self-injurious behavior (SIB) is a well-known phenomenon in patients with chronic tic disorders (CTD). To investigate prospectively symptomatology of SIB in adults with CTD, we developed and validated the self-injurious behavior scale for tic disorders (SIBS-T). Patients completed the SIBS-T and a variety of assessments for tics and comorbidities. We investigated SIB frequency, internal consistency of the SIBS-T, and carried out an exploratory factor analysis (EFA). We enrolled n = 123 adult patients with CTD. SIB was reported by n = 103 patients (83.7%). The most frequently reported SIB were beating/pushing/throwing and were found in 79.6% of cases. Patients with SIB had significantly higher tic severity measured with the Adult Tic Questionnaire (ATQ) (p = 0.002) as well as higher severity of psychiatric comorbidities such as obsessive-compulsive symptoms (OCS) (p < 0.001,), attention deficit/hyperactivity disorder (ADHD) (p < 0.001,), and anxiety (p = 0.001). In addition, patients with SIB had significantly lower quality of life (p = 0.002). Pearson correlations demonstrated significant associations between SIB and severity of tics (p < 0.001), depression (p = 0.005), ADHD (p = 0.008), and borderline personality traits (p = 0.014). Consequently, higher SIBS-T also correlated with greater impairment of quality of life (p < 0.001). The internal consistency of the SIBS-T was good (α = 0.88). The EFA confirmed a single factor underlying the SIBS-T.

EFL Special Education Teachers' Perspectives: Evaluating Game-Based Learning for ADHD Behavioral Disorders.

OBJECTIVE: The purpose of this study was to examine the perspectives of English as a Foreign Language Special Education teachers (EFLSE) regarding game-based learning approaches for addressing behavioral disorders in ADHD patients. METHOD: The study involved a sample (n = 131) of EFLSE teachers who completed a questionnaire to determine how feasible, acceptable, and helpful they found game-based learning. RESULTS: The study revealed that EFLSE teachers perceive game-based learning to be a feasible and acceptable method for engaging ADHD students and helping to maintain their attention during game-based learning activities. Nevertheless, implementation and individualized approaches are cited as challenges. Additionally, EFLSE teachers emphasized the benefits of game-based learning, including improved problem-solving, assessment methods, collaboration, and the acquisition of academic skills. CONCLUSIONS: The study contributes insights for educators, policymakers, and researchers that can support the development of evidence-based interventions offering game-based learning for students with ADHD.

Feeling like an untapped resource. Experiences of working life among nurses with ADHD and/or autism: An interview study.

BACKGROUND: ADHD and autism are common and increasing neurodevelopmental disorders in the world and also occur among nurses. However, almost nothing is known about nurses with these diagnoses. To promote high-quality care provision and well-being in the nursing workforce, it is important to discover more about these nurses. Therefore, in the present study, we aimed to describe how nurses with ADHD and/or autism experience their working life. METHODS: The study was descriptive in design. Nurses were invited via Swedish Facebook groups targeting nurses. Semi-structured individual interviews were conducted with 17 nurses with ADHD and/or autism, online or by telephone. Data were analyzed using qualitative content analysis. RESULTS: One overarching theme and seven subthemes emerged from the analysis. The theme "feeling like an untapped resource" reflected the subthemes: 1) Being passionate about one's job, 2) having strengths and talents to use in working life, 3) a stressful and disturbing work environment inhibits personal strengths, 4) managers show goodwill but lack knowledge and resources, 5) feeling appreciated but socially different among colleagues, 6) using a variety of strategies to facilitate working life and 7) toward an uncertain future. CONCLUSION: Nurses with ADHD and/or autism experience having abilities and talents that are useful in the nursing profession. However, they feel that the physical and organizational working conditions and lack of managerial support entail challenges that prevent them from making optimal use of their strengths.