Multi-informant evaluation of Cognitive Disengagement Syndrome (formerly Slow Cognitive Tempo). Children's self-reported measures in relation to parents / Evaluación multi-informante del Síndrome de Desconexión Cognitiva (anteriormente Tempo Cognitivo Lento). Medidas autoinformadas de los niños con relación a padres

El objetivo fue examinar, desde una aproximación multi-informante, las medidas del Síndrome de Desconexión Cognitiva (SDC) de padres/madres e hijos/as y su relación con síntomas internalizantes y externalizantes. 279 niños/as (9-13 años), y sus padres/madres completaron las evaluaciones sobre SDC, la inatención del trastorno por déficit de atención e hiperactividad (TDAH) y otras medidas internalizadas y externalizadas. Los ítems de las tres medidas de SDC convergieron razonablemente bien en el factor SDC. Se aportaron pruebas discriminantes de la validez de las relaciones entre las puntuaciones de las pruebas y las medidas de los tres constructos diferentes (SDC, soledad y preferencia por la soledad). La asociación más estrecha estuvo entre la evaluación parental de las medidas de SDC con ansiedad y depresión, y entre inatención con hiperactividad/impulsividad y trastorno negativista desafiante. Se observó capacidad predictiva de la medida de SDC sobre la soledad y preferencia por estar solo autoinformadas. Se encontró una posible asociación entre la medida del SDC evaluado por padres/madres y sexo y edad de los niños. En conclusión, los datos apoyan la inclusión de medidas autoinformadas en la evaluación del SDC. Las medidas del SDC en niños se vinculan con medidas internalizantes y, la inatención con las externalizantes.(AU)

Air pollution and children's mental health in rural areas: compositional spatio-temporal model.

Air pollution stands as an environmental risk to child mental health, with proven relationships hitherto observed only in urban areas. Understanding the impact of pollution in rural settings is equally crucial. The novelty of this article lies in the study of the relationship between air pollution and behavioural and developmental disorders, attention deficit hyperactivity disorder (ADHD), anxiety, and eating disorders in children below 15 living in a rural area. The methodology combines spatio-temporal models, Bayesian inference and Compositional Data (CoDa), that make it possible to study areas with few pollution monitoring stations. Exposure to nitrogen dioxide (NO2), ozone (O3), and sulphur dioxide (SO2) is related to behavioural and development disorders, anxiety is related to particulate matter (PM10), O3 and SO2, and overall pollution is associated to ADHD and eating disorders. To sum up, like their urban counterparts, rural children are also subject to mental health risks related to air pollution, and the combination of spatio-temporal models, Bayesian inference and CoDa make it possible to relate mental health problems to pollutant concentrations in rural settings with few monitoring stations. Certain limitations persist related to misclassification of exposure to air pollutants and to the covariables available in the data sources used.

Quantification of ADHD medication in biological fluids of pregnant and breastfeeding women with liquid chromatography: a comprehensive review.

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that has long been considered a concern only in the pediatric population. However, symptoms often sustain into adulthood and may require medication. For women with ADHD, this also means dealing with the disorder during the reproductive period. Medication safety during pregnancy and breastfeeding is a critical concern, and the potential transfer of ADHD medication to infants remains a topic of scientific interest. The quantification of ADHD medications in both maternal blood and breast milk are vital for understanding their pharmacokinetics and potential exposure risks for (nursing) infants. This review aims (1) to compile and critically assess existing research on the transfer of ADHD medications into breast milk and the potential implications for nursing infants and (2) to provide a comprehensive overview and discussion of the literature regarding the quantification of methylphenidate, amphetamine, atomoxetine, viloxazine, guanfacine, clonidine and bupropion in the blood, urine, oral fluid, and breast milk with liquid chromatography. A literature search was conducted using PubMed, Scopus, and Web of Science, to identify relevant articles published from January 2014 up to December 2023. We illustrate the lack of methods to simultaneously monitor multiple ADHD medications as well as the lack of developed methods for breast milk. Finally, we highlight the need for continued research to refine our understanding of medication transfer into breast milk and potential risks, and to develop clinical guidelines to support mothers with ADHD in making informed choices regarding medication use during pregnancy and lactation.

Attention-Deficit/Hyperactivity Disorder in Adults.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder involving functionally disruptive inattentive and/or hyperactive/impulsive behaviors, such as being easily distracted, regularly failing to follow through on tasks, being restless, or often interrupting others. ADHD diagnosed in childhood often persists into adulthood, with 14.6% of U.S. adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria for ADHD. When evaluating for adult ADHD, other mental disorders should be included in the differential diagnosis due to the substantial overlap of symptoms and ADHD concurrence with anxiety/stress, mood, personality, impulse control, and substance use disorders. An ADHD diagnosis requires a comprehensive clinical history and evaluation, patient symptom and function assessment (e.g., Adult ADHD Self-Report Scale, Conners Adult ADHD Rating Scales), and gathering of collateral information. Clinical guidelines recommend a subset of amphetamine and methylphenidate stimulants as first-line pharmacotherapy, which may be more effective when combined with psychotherapy. For adults unable to take stimulants or with concurrent anxiety/depression, options include atomoxetine, viloxazine, and bupropion. To monitor for patient misuse or diversion of stimulants, physicians should consider employing controlled substance agreements and prescription drug monitoring programs.

The impact of paediatric epilepsy and co-occurring neurodevelopmental disorders on functional brain networks in wake and sleep.

Epilepsy is one of the most common neurological disorders in children. Diagnosing epilepsy in children can be very challenging, especially as it often coexists with neurodevelopmental conditions like autism and ADHD. Functional brain networks obtained from neuroimaging and electrophysiological data in wakefulness and sleep have been shown to contain signatures of neurological disorders, and can potentially support the diagnosis and management of co-occurring neurodevelopmental conditions. In this work, we use electroencephalography (EEG) recordings from children, in restful wakefulness and sleep, to extract functional connectivity networks in different frequency bands. We explore the relationship of these networks with epilepsy diagnosis and with measures of neurodevelopmental traits, obtained from questionnaires used as screening tools for autism and ADHD. We explore differences in network markers between children with and without epilepsy in wake and sleep, and quantify the correlation between such markers and measures of neurodevelopmental traits. Our findings highlight the importance of considering the interplay between epilepsy and neurodevelopmental traits when exploring network markers of epilepsy.

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.

From neurons to brain networks, pharmacodynamics of stimulant medication for ADHD.

Stimulants represent the first line pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) and are among the most prescribed psychopharmacological treatments. Their mechanism of action at synaptic level has been extensively studied. However, it is less clear how their mechanism of action determines clinically observed benefits. To help bridge this gap, we provide a comprehensive review of stimulant effects, with an emphasis on nuclear medicine and magnetic resonance imaging (MRI) findings. There is evidence that stimulant-induced modulation of dopamine and norepinephrine neurotransmission optimizes engagement of task-related brain networks, increases perceived saliency, and reduces interference from the default mode network. An acute administration of stimulants may reduce brain alterations observed in untreated individuals in fronto-striato-parieto-cerebellar networks during tasks or at rest. Potential effects of prolonged treatment remain controversial. Overall, neuroimaging has fostered understanding on stimulant mechanism of action. However, studies are often limited by small samples, short or no follow-up, and methodological heterogeneity. Future studies should address age-related and longer-term effects, potential differences among stimulants, and predictors of treatment response.

Acetaminophen use during pregnancy was not linked to autism, ADHD, or intellectual disability in offspring.

SOURCE CITATION: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331:1205-1214. 38592388.

Dopamine reuptake and inhibitory mechanisms in human dopamine transporter.

The dopamine transporter has a crucial role in regulation of dopaminergic neurotransmission by uptake of dopamine into neurons and contributes to the abuse potential of psychomotor stimulants1-3. Despite decades of study, the structure, substrate binding, conformational transitions and drug-binding poses of human dopamine transporter remain unknown. Here we report structures of the human dopamine transporter in its apo state, and in complex with the substrate dopamine, the attention deficit hyperactivity disorder drug methylphenidate, and the dopamine-uptake inhibitors GBR12909 and benztropine. The dopamine-bound structure in the occluded state precisely illustrates the binding position of dopamine and associated ions. The structures bound to drugs are captured in outward-facing or inward-facing states, illuminating distinct binding modes and conformational transitions during substrate transport. Unlike the outward-facing state, which is stabilized by cocaine, GBR12909 and benztropine stabilize the dopamine transporter in the inward-facing state, revealing previously unseen drug-binding poses and providing insights into how they counteract the effects of cocaine. This study establishes a framework for understanding the functioning of the human dopamine transporter and developing therapeutic interventions for dopamine transporter-related disorders and cocaine addiction.

Interference of default mode on attention networks in adults with attention-deficit/hyperactivity disorder and its association with genetic variants and treatment outcomes.

AIMS: Altered brain functional connectivity has been proposed as the neurobiological underpinnings of attention-deficit/hyperactivity disorder (ADHD), and the default mode interference hypothesis is one of the most popular neuropsychological models. Here, we explored whether this hypothesis is supported in adults with ADHD and the association with high-risk genetic variants and treatment outcomes. METHODS: Voxel-based whole-brain connectome analysis was conducted on resting-state functional MRI data from 84 adults with ADHD and 89 healthy controls to identify functional connectivity substrates corresponding to ADHD-related alterations. The candidate genetic variants and 12-week cognitive behavioral therapy data were leveraged from the same population to assess these associations. RESULTS: We detected breakdowns of functional connectivity in the precuneus and left middle temporal gyrus in adults with ADHD, with exact contributions from decreased connectivity within the default mode, dorsal and ventral attention networks, as well as increased connectivity among them with the middle temporal gyrus serving as a crucial 'bridge'. Additionally, significant associations between the altered functional connectivity and genetic variants in both MAOA and MAOB were detected. Treatment restored brain function, with the amelioration of connectivity of the middle temporal gyrus, accompanied by improvements in ADHD core symptoms. CONCLUSIONS: These findings support the interference of default mode on attention in adults with ADHD and its association with genetic risk variants and clinical management, providing insights into the underlying pathogenesis of ADHD and potential biomarkers for treatment evaluation.

Evaluation of potential alterations related to ADHD in the effective connectivity between the default mode network and cerebellum, hippocampus, thalamus, and primary visual cortex.

Hyperactivity in children with attention-deficit/hyperactivity disorder (ADHD) leads to restlessness and impulse-control impairments. Nevertheless, the relation between ADHD symptoms and brain regions interactions remains unclear. We focused on dynamic causal modeling to study the effective connectivity in a fully connected network comprised of four regions of the default mode network (DMN) (linked to response control behaviors) and four other regions with previously-reported structural alterations due to ADHD. Then, via the parametric empirical Bayes analysis, the most significant connections, with the highest correlation to the covariates ADHD/control, age, and sex were extracted. Our results demonstrated a positive correlation between ADHD and effective connectivity between the right cerebellum and three DMN nodes (intrinsically inhibitory connections). Therefore, an increase in the effective connectivity leads to more inhibition imposition from the right cerebellum to DMN that reduces this network activation. The lower DMN activity makes leaving the resting-state easier, which may be involved in the restlessness symptom. Furthermore, our results indicated a negative correlation between age and these connections. We showed that the difference between the average of effective connectivities of ADHD and control groups in the age-range of 7-11 years disappeared after 14 years-old. Therefore, aging tends to alleviate ADHD-specific symptoms.

Exploring the link between toxic metal exposure and ADHD: a systematic review of pb and hg.

INTRODUCTION: Attention-Deficit/Hyperactivity Disorder (ADHD) is a recognized neurodevelopmental disorder with a complex, multifactorial origin. Lead (Pb) and mercury (Hg) are highly toxic substances that can potentially impair brain development and have been implicated in the development of ADHD. This systematic review aims to analyze the epidemiological literature regarding the association between Pb and Hg exposure and the diagnosis of ADHD. METHODS: From November 1983 to June 2, 2023, a comprehensive search was conducted in multiple databases and search engines, including PubMed, Web of Science, Scopus, and Google Scholar. Observational studies (case-control, cohort, and cross-sectional) measuring Pb and Hg levels in various biological samples (blood, hair, urine, nail, saliva, teeth, and bone) of children with ADHD or their parents and their association with ADHD symptoms were included. RESULTS: Out of 2059 studies, 87 met the inclusion criteria and were included in this systematic review. Approximately two-thirds of the 74 studies investigating Pb levels in different biological samples reported associations with at least one subtype of ADHD. However, most studies examining Hg levels in various biological samples found no significant association with any ADHD subtype, although there were variations in exposure periods and diagnostic criteria. CONCLUSION: The evidence gathered from the included studies supports an association between Pb exposure and the diagnosis of ADHD, while no significant association was found with Hg exposure. Importantly, even low levels of Pb were found to elevate the risk of ADHD. Further research is needed to explore the comprehensive range of risk factors for ADHD in children, considering its significance as a neurodevelopmental disorder.

Paediatric traumatic brain injury and attention-deficit/hyperactivity disorder medication in Finland: a nationwide register-based cohort study.

BACKGROUND: The association between paediatric traumatic brain injury (pTBI) and post-traumatic attention-deficit/hyperactivity disorder (ADHD) medication usage remains understudied subject. OBJECTIVE: We aimed to evaluate the association between pTBI and subsequent ADHD medication. METHODS: A nationwide retrospective cohort study in Finland from 1998 to 2018 included 66 594 patients with pTBI and 61 412 references with distal extremity fractures. ADHD medication data were obtained from the Finnish Social Insurance Institution. The primary outcome was post-traumatic pediatric ADHD medication. A 1-year washout period was applied, and follow-up started 1 year post-pTBI. FINDINGS: Kaplan-Meier analyses showed higher ADHD medication usage in patients with pTBI, especially post-operatively. Both sex groups exhibited elevated rates compared with the reference group. Over 10 years, cumulative incidence rates were 3.89% (pTBI) vs 1.90% (reference). HR for pTBI was 1.89 (95% CI 1.70 to 2.10) after 4 years and 6.31 (95% CI 2.80 to 14.20) for the operative group after the initial follow-up year. After 10 years, cumulative incidence in females increased to 2.14% (pTBI) vs 1.07% (reference), and in males, to 5.02% (pTBI) vs 2.35% (reference). HR for pTBI was 2.01 (95% CI 1.72 to 2.35) in females and 2.23 (95% CI 2.04 to 2.45) in males over 1-20 years. CONCLUSIONS: A substantial association between pTBI and post-traumatic ADHD medication was evidenced over a 20-year follow-up period. CLINICAL IMPLICATIONS: These results stress the need for preventive measures for pTBI and highlight the potential impact of long-term post-traumatic monitoring and psychoeducation.

Machine learning-enabled detection of attention-deficit/hyperactivity disorder with multimodal physiological data: a case-control study.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a multifaceted neurodevelopmental psychiatric condition that typically emerges during childhood but often persists into adulthood, significantly impacting individuals' functioning, relationships, productivity, and overall quality of life. However, the current diagnostic process exhibits limitations that can significantly affect its overall effectiveness. Notably, its face-to-face and time-consuming nature, coupled with the reliance on subjective recall of historical information and clinician subjectivity, stand out as key challenges. To address these limitations, objective measures such as neuropsychological evaluations, imaging techniques and physiological monitoring of the Autonomic Nervous System functioning, have been explored. METHODS: The main aim of this study was to investigate whether physiological data (i.e., Electrodermal Activity, Heart Rate Variability, and Skin Temperature) can serve as meaningful indicators of ADHD, evaluating its utility in distinguishing adult ADHD patients. This observational, case-control study included a total of 76 adult participants (32 ADHD patients and 44 healthy controls) who underwent a series of Stroop tests, while their physiological data was passively collected using a multi-sensor wearable device. Univariate feature analysis was employed to identify the tests that triggered significant signal responses, while the Informative k-Nearest Neighbors (KNN) algorithm was used to filter out less informative data points. Finally, a machine-learning decision pipeline incorporating various classification algorithms, including Logistic Regression, KNN, Random Forests, and Support Vector Machines (SVM), was utilized for ADHD patient detection. RESULTS: Results indicate that the SVM-based model yielded the optimal performance, achieving 81.6% accuracy, maintaining a balance between the experimental and control groups, with sensitivity and specificity of 81.4% and 81.9%, respectively. Additionally, integration of data from all physiological signals yielded the best results, suggesting that each modality captures unique aspects of ADHD. CONCLUSIONS: This study underscores the potential of physiological signals as valuable diagnostic indicators of adult ADHD. For the first time, to the best of our knowledge, our findings demonstrate that multimodal physiological data collected via wearable devices can complement traditional diagnostic approaches. Further research is warranted to explore the clinical applications and long-term implications of utilizing physiological markers in ADHD diagnosis and management.

Involvement of posterior hypothalamic CaMKII-positive neurons in ADHD-like behaviors in mice.

This study explores the behavioral effects of modulating CaMKII-positive (CaMKII+) neurons in the posterior hypothalamus (PH). Utilizing a chemogenetic approach in mice, we discovered that the activation of CaMKII + neurons within the PH is associated with heightened locomotor activity, reduced social interaction, and impulsive behavior unrelated to anxiety or avoidance. These observed behaviors share a significant resemblance with characteristics commonly found in attention deficit and hyperactivity disorder (ADHD). Notably, treatment with clonidine, which is frequently prescribed for ADHD, effectively reduced impulsive behaviors in our mouse model. Our findings uncover the role of the PH that has not been previously explored and suggest a possible involvement of the PH in the manifestation of ADHD-like behaviors.

[Anxiety disorders as comorbid conditions in neuropsychiatric diseases in children]. / Trevozhnye rasstroistva kak komorbidnye sostoyaniya pri psikhonevrologicheskikh zabolevaniyakh u detei.

The variants of heterotypic comorbidity of anxiety disorders (AD) with attention deficit hyperactivity disorder, autism spectrum disorders, speech and language development disorders, specific learning disabilities (dyslexia, dysgraphia, dyscalculia), migraine, tension type headache in children and adolescents are discussed. In cases of heterotypic comorbidity the patients with AD referrals to specialists may be primarily associated with their emotional problems. Meanwhile, the comorbidity of AD with these diseases leads to a deterioration of their clinical manifestations and a worsening of the prognosis, and anxiety symptoms often not only persist, but also increase with age. It should be borne in mind that AD in children with neurodevelopmental disorders contribute to a decrease in the quality of life, academic failure, have a negative impact on peer relationships and the family environment, and in young adulthood, patients have an increased risk of depression and substance abuse. Therefore, early intervention and a comprehensive therapeutic approach with a dynamic assessment of the patient's condition are becoming important. When choosing pharmacotherapy, it is advisable to choose medictions that have a complex effect on the pathogenetic mechanisms of the underlying disease and concomitant AD, which include Tenoten for children.

Estimation of Attributable Risk and Direct Medical and Non-Medical Costs of Major Mental Disorders Associated With Air Pollution Exposures Among Children and Adolescents in the Republic of Korea, 2011-2019.

BACKGROUND: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. METHODS: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011-2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. RESULTS: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 µm [PM10]), 3.7% (PM2.5), and 2.2% (sulfur dioxide [SO2]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period. CONCLUSION: This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5, and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

Dietary Patterns in Children with Neurodevelopmental Disorders.

Neurodevelopmental disorders (NDDs), of which Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two of the most common, are described as a group of conditions that begin in the developmental period and lead to deficits that impair functioning [...].

Iron Deficiency and Sleep/Wake Behaviors: A Scoping Review of Clinical Practice Guidelines-How to Overcome the Current Conundrum?

Current evidence suggests that iron deficiency (ID) plays a key role in the pathogenesis of conditions presenting with restlessness such as attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS). In clinical practice, ID and iron supplementation are not routinely considered in the diagnostic work-up and/or as a treatment option in such conditions. Therefore, we conducted a scoping literature review of ID guidelines. Of the 58 guidelines included, only 9 included RLS, and 3 included ADHD. Ferritin was the most frequently cited biomarker, though cutoff values varied between guidelines and depending on additional factors such as age, sex, and comorbidities. Recommendations surrounding measurable iron biomarkers and cutoff values varied between guidelines; moreover, despite capturing the role of inflammation as a concept, most guidelines often did not include recommendations for how to assess this. This lack of harmonization on the interpretation of iron and inflammation biomarkers raises questions about the applicability of current guidelines in clinical practice. Further, the majority of ID guidelines in this review did not include the ID-associated disorders, ADHD and RLS. As ID can be associated with altered movement patterns, a novel consensus is needed for investigating and interpreting iron status in the context of different clinical phenotypes.

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.