The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients.

Many children with attention deficit hyperactive disorder (ADHD) are known to have executive dysfunction, which weakens their abilities to learn and behave in daily living. This protocol describes the methodology that is required for the intervention (psychotherapy) based on planning, attention, successive, and simultaneous (PASS theory) cognitive processing and fear emotional processing. It provides guiding principles and practical recommendations. A disproportionately high level of fear (dysregulation) increases the vulnerability for dysfunction in learning and behavior. We explain the interplay between emotion and cognition at the neurological level. A go/no go task (The Adventures of Fundi), which involves decision making, is administered in a PC- mode to a sample of 66 ADHD subjects. The Adventures of Fundi, a computer program, was constructed to induce successive or simultaneous processing when involving the training of planning and selective attention. It aims to improve the executive function with planning and selective attention. If executive function improves, learning improves, and behavior ameliorates. After intervention over 6 months, remission was achieved in 70% of subjects. The instructor encourages the use of appropriate strategies and points out the ways in which the strategies can be useful in finding the solution to the problem (go/no go). The emphasis is not on rehearsing and adult instructed verbal sequence. The verbalization may reveal the conscious verbalized strategy to solve a task that is not really the strategy being unconsciously used in that case. A self-verbal report is unreliable. This is an inductive learning rather than deductive rule-learning approach central to cognitive PASS training. This inductive training has proved to produce not only near transfer but also far transfer. Noncognitive factors (emotional factors) must be considered to maximize the benefit of cognitive training. Indirect and metaphorical communication considers the emotional factor.

Clinical usefulness of hemoencephalography beyond the neurofeedback.

AIM: Hemoencephalography (HEG) is an emerging procedure for clinical application in attention-deficit hyperactivity disorder and other disorders, regardless of age. It is available to any research group for its relative simplicity and low cost and is a useful tool for assessing prefrontal-dependent functions. Older teenagers pose peculiarities in the prefrontal maturation, and we aim to establish HEG patterns that might have clinical applicability. METHODS: The HEG patterns of 70 university students (56 women and 14 men, 21-48 years old, mean 31.84, SD 10.65, standard error of mean 0.31) were compared with those of 59 adolescents - 13-14-year-old secondary education students, 28 females and 31 males. The HEG patterns were obtained in response to the observation of shocking, unpleasant, and pleasant pictures. We use one-way and two-way analysis of variance to disentangle the differences between groups. All effects were analyzed with F-tests. RESULTS: In all cases, university students and adolescents showed a decrease in prefrontal activity, indicative of differences in the emotional inner networks between groups, which are responsible for security-insecurity processing. Compared with university students, adolescents showed statistically significant differences in decreased activity in very unpleasant (shocking) tests that demand increased security-insecurity processing. Adolescents showed lower decrease. In addition, adolescents, compared with university subjects, did not show statistically significantly decreased HEG activity compared with the baseline in very unpleasant tests. CONCLUSION: Teens showed distinguishable patterns of HEG, which were consistent with the cognitive emotional dysregulation in cognition and emotion interaction, that is, exterior network versus internal network interactions. Disability in regulation (modulation) of emotional response to negative emotional stimuli (fear of insecurity) in adolescence is an indicator of possible future clinical and psychiatric disorders such as depression and anxiety with high incidence of onset at this critical age and frequent comorbidity in attention-deficit hyperactivity disorder. HEG pattern might be a useful marker to define maturation and future possible mental dysfunctions.