Perceived family resources based on number of members with ADHD.

OBJECTIVE: This study examines how the number of family members with ADHD affects other family members' perceived resources. METHOD: A total of 40 adolescents diagnosed with ADHD and their mothers, fathers, and adolescent siblings living in the household participated. Hierarchical linear modeling was used to analyze family-level data from a total of 130 participants. RESULTS: Mothers reported more resources when only the target adolescent had ADHD and more nonsupportive factors when more than one member of the family had ADHD. Fathers reported more supportive factors when only one member of the family had ADHD. CONCLUSION: Parents reported greater resources and strengths when only one adolescent family member had ADHD; however, family members had varying viewpoints. The ADHD Family Scale examined issues specific to ADHD, compared with general family stress and resource scales, and may be a useful tool for examining the impact of ADHD on all members of a family.

The importance of ADHD subtype classification for educational applications of DSM-V.

OBJECTIVE: An examination of the academic achievement of children with ADHD by stimulant treatment status must consider this heterogeneity of the disorder. With the dissemination of the final wave of data, the Special Education Elementary Longitudinal Study presents an opportunity to examine the academic achievement of students with ADHD using a large, community-based, and nationally representative sample over 4 years. METHOD: In Study 1, the association between stimulant treatment and academic achievement is examined over 4 years. In Study 2, the association between stimulant treatment and academic achievement is examined acknowledging the influence of subtype symptoms of ADHD using growth mixture modeling. RESULTS: Results indicate significant differences in academic achievement according to long-term stimulant treatment status within each subtype symptom class. CONCLUSION: Research should acknowledge the influence of subtype symptoms when examining outcomes such as academic achievement. The upcoming DSM-V should consider the results as indicating the educational relevance of ADHD subtype classification.

An examination of the psychometric properties of the attention deficit scales for adults with outpatient substance abusers.

A growing body of research has established a high co-morbidity in the rates of attention deficit/hyperactivity disorder (ADHD) and substance abuse. The co-occurrence of these two conditions and the negative impact of untreated ADHD on the course and treatment of substance abuse highlights the need for ADHD assessment in individuals seeking substance abuse treatment. In this article, we investigated the clinical utility of the Attention Deficit Scales for Adults (ADSA) in a sample of substance abusers in an outpatient treatment program by assessing its sensitivity, specificity, positive and negative predictive values, and likelihood ratios at two potential cut-off levels (161 and 181) using a DSM-IV based ADHD diagnosis as the criterion. The ADSA had strong reliability (Cronbach's alpha .93; Guttman split-half .92) and correlated well with DSM-IV diagnostic criteria. Sensitivity and specificity of the device were relatively strong at both cut-off levels, as were the positive and negative predictive values.

The importance of perspective: evaluation of hospice care from multiple stakeholders.

The literature on hospice care and palliative medicine lacks a focus on the combined and concurrent assessment of services. This deficiency is problematic because research findings are then limited in their scope and applicability to particular stakeholder groups. The current study used the perspective of 72 participants and service delivery personnel of a home-based hospice program to address this perceived problem and limitation in the literature through a program evaluation of the multiple perspectives on a single hospice organization. Interviews were analyzed by stakeholder group and then across stakeholder groups to extract themes. Results include a description of the quality of service delivery and participant satisfaction, areas of current weakness, and ideas for potential growth and development for the program. Findings from this study are compared with previous research on hospice care and the implications of the results to the provision and continued development of hospice care are discussed.

There is no meaningful relationship between television exposure and symptoms of attention-deficit/hyperactivity disorder.

OBJECTIVE: The recent but methodologically limited longitudinal study of the adverse attentional effects of television viewing in early childhood suggests a possible association. The purpose of the present study was to extend this investigation to a more current sample of kindergarten students using structural equation modeling, which allows for the simultaneous evaluation of predictors. METHODS: Two samples were randomly selected from nationally representative data collected from the Early Childhood Longitudinal Study. A structural equation model was developed positing a relationship between kindergartners' television exposure and subsequent first-grade symptoms of attention-deficit/hyperactivity disorder (ADHD) while controlling for variables related to socioeconomic status and parent involvement. Variables were selected rather than developed and do not include an acceptable measure of ADHD, which limited the scope of the measures used. The model was tested by using the first sample and then cross-validated to the second sample. RESULTS: Although the adequate fit of the model to the data suggests that children's television exposure during kindergarten was related to symptoms of ADHD during the first grade, the amount of variance accounted for in the ADHD-symptoms variable revealed television exposure as a weak predictor of later ADHD symptoms. Effect sizes for the relationship between television exposure and symptoms of ADHD were close to zero and not statistically significant. CONCLUSIONS: Methodologic issues, including participant age, the measurement of ADHD symptoms, and evaluation of the importance of variables, may explain the differences between the present study and the results of others who have found television exposure to be related to attention problems. The measurement of ADHD symptoms through the use of longitudinal databases is an important limitation, because only a small number of items can be selected to represent symptoms. Future research is necessary to address these issues.

Factor Analysis of the Attention Deficit Scales for Adults (ADSA) with a clinical sample of outpatient substance abusers.

Individuals with adult symptoms of ADHD who are in treatment for substance abuse have been identified as being at greater risk of failure to complete treatment and relapse. The identification of such clients must thus become an important part of assessment and treatment planning. The Attention Deficit Scale for Adults (ADSA) is one device designed to assess ADHD symptomology in adults. This study investigated the application of the ADSA in a substance-abusing population by assessing its psychometric properties with a clinical sample of 268 adult patients (170 males, 92 females, gender missing for 6) in an outpatient substance abuse treatment program. The findings indicate that the ADSA is unidimensional with this population yet possess high reliability (alpha=.93 for entire sample:.89 for males,.94 for females) and correlate consistently with DSM-IV diagnostic criteria. The data tentatively support the use of the ADSA with substance-abusing populations as a reliable and valid assessment tool for clinical use and research.