COVID-19 Restrictions Resulted in Both Positive and Negative Effects on Digital Media Use, Mental Health, and Lifestyle Habits.

While studies have reported effects on digital media during the COVID-19 restrictions, few have included data prior to the pandemic, and most have only measured screen time. We therefore investigated changes in specific digital media activities, as well as mental health and lifestyle habits, in a longitudinal study of adolescents spanning from before the pandemic (T1) to one month into restrictions (T2) and one year later when schools had reopened (T3). Adolescents (16-19 years) rated smartphone use, problematic/addictive media use, negative experiences (e.g., victimization), mental health (i.e., irritability, stress, and closeness), and protective lifestyle habits (i.e., sleep and exercise). Results showed initial decreases in irritability and negative digital experiences, increases in sleep and exercise, as well as a decrease in closeness during remote learning (T2). However, these changes returned to, or superseded, their initial levels at follow-up (T3). There were also increases in digital media use and stress at T3. Conclusively, by investigating specific digital media activities and collecting data both prior to and during different phases of the pandemic, we were able to find both positive and negative effects.

The role of executive function deficits, delay aversion and emotion dysregulation in internet gaming disorder and social media disorder: Links to psychosocial outcomes.

Background and aims: It has been argued that it is important to consider underlying mechanisms of mental health problems. Previous studies have shown that executive deficits, delay aversion, and emotion dysregulation are related to Internet Gaming Disorder (IGD) and Social Media Disorder (SMD). However, the present study is the first to investigate whether these neuropsychological deficits show additive effects or if they interact. The present study also investigated whether these deficits mediate the association between IGD/SMD and psychosocial outcomes. Methods: The study involved 995 university students who completed a survey measuring IGD/SMD symptom severity, neuropsychological functions, and psychosocial outcomes. Both dimensional and categorical analyses were used to assess the associations between neuropsychological functions and IGD/SMD. Simple and multiple mediation analyses were conducted to examine if neuropsychological functioning mediates the association between IGD/SMD and psychosocial outcomes. Results: All neuropsychological functions were significantly associated with both IGD and SMD symptom severity. However, only inhibition and emotion regulation, as well as delay aversion for SMD, remained significant when controlling for the overlap between different functions. Associations were significantly stronger for men compared to women for IGD. In the categorical analyses, individuals with IGD/SMD were more likely to have neuropsychological deficits (odds ratios between 3.33 and 8.81). Finally, all neuropsychological functions, except inhibition, were significant mediators in the link between IGD/SMD and psychosocial outcomes. Discussion and conclusions: These results shed light on the neuropsychological underpinnings of IGD/SMD, which can be used to identify more homogenous subgroups and provide more individualized treatment options.

Group-based emotion regulation skills training for adults with ADHD: A feasibility study in an outpatient psychiatric setting.

The aim of this open non-controlled clinical trial was to investigate the feasibility and preliminary treatment effects of a new group-based skills training program for adult ADHD: Group Therapy for Improving Emotional Acceptance and Regulatory Skills in Adults with ADHD (GEARS). Out of the 226 allocated patients, 213 initiated the treatment and 170 (80%) were considered treatment completers (i.e., attending at least 9 out of 14 sessions). A total of 158 of the completers also completed pre- and post-treatment assessments, and 126 provided assessments at the 3-month follow-up. Treatment credibility received high ratings, as did treatment satisfaction. Preliminary treatment effects showed significant improvements in emotion regulation with large effect sizes. Significant effects were also found for all secondary outcome variables: ADHD symptom levels, depression, anxiety, and quality of life. All significant effects remained at the 3-month follow-up. In conclusion, GEARS should be considered a feasible treatment in an outpatient psychiatric setting. The results also indicate that GEARS could be an effective treatment for adults with ADHD who are also experiencing problems with emotion regulation. However, a randomized controlled trial is needed to further evaluate the effectiveness of this new treatment.

Screen time and addictive use of gaming and social media in relation to health outcomes.

Introduction: This study examined associations between screen time and addictive use (i.e., heavy involvement and negative consequences) of gaming and social media, and their independent effects on health outcomes. Methods: Survey data were collected from 2,265 participants (mean age = 21.57). Internet Gaming Disorder (IGD) and Social Media Disorder (SMD) were measured with the Gaming and Social Media Questionnaire (GSMQ-9), with separate measures for heavy involvement and negative consequences. Screen time was measured by weekly hours of gaming and social media. Assessed health outcomes were psychological problems, low self-concept, social problems, sleep problems, and sleep time. Results: Screen time and addictive use were significantly associated for both gaming and social media, with associations being stronger for symptoms of heavy involvement compared to symptoms of negative consequences. However, despite significant associations, a substantial proportion of the participants with a high screen time did not meet any or just one symptom of addiction. More importantly, it was primarily negative consequences that had independent effects on health outcomes, except for sleep. High levels of heavy involvement in gaming, were even related to lower, not higher, levels of psychological problems. Conclusion: The present findings study show that screen time is a poor indicator of addictive use of gaming and social media. Given that it was primarily negative consequences of gaming or social media that had effects on health outcomes, our study also emphasizes the need to distinguish between different types of addictive use and to further examine the diagnostic validity of the nine IGD symptom criteria.

Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review.

Previous reviews have often shown a link between digital media ADHD symptom levels. However, longitudinal studies are needed to find stronger evidence of a causal effect as well as to determine the direction of effects. The aim of the present review (PROSPERO CRD42021262695) was therefore to provide a systematic review of studies meeting the following inclusion criteria: (1) include longitudinal data investigating associations between digital media (i.e., gaming and social media) and later ADHD symptoms or vice versa, (2) be published within the past 10 years (i.e., 2011 until June 2021), (3) be published in a peer-reviewed journal in English, and (4) include children or adolescents (age 0-17 years). After a systematic search in the Web of Science and PsycInfo databases, we included 28 studies, all with adequate or high quality. Results showed support for reciprocal associations between digital media and ADHD symptoms, with associations being more consistent for problematic use of digital media than for screen time. Thus, children with ADHD symptoms appear more vulnerable to developing high or problematic use of digital media (i.e., selection effects), and digital media also have effects on later ADHD symptom levels, either because of specific characteristics of digital media or because of indirect effects on, for example, sleep and social relations (i.e., media effects). However, it should be emphasized that further studies investigating potential moderators and mediators are needed if we are to better understand the complex associations between digital media and ADHD symptom levels.

Distance learning during the COVID-19 pandemic for children with ADHD and/or ASD: a European multi-center study examining the role of executive function deficits and age.

BACKGROUND: One of the COVID-19 pandemic consequences that has affected families the most is school lockdowns. Some studies have shown that distance learning has been especially challenging for families with a child with neurodevelopmental disorders such as ADHD or ASD. However, previous studies have not taken the heterogeneity of these disorders into account. The aim of the present study was therefore to investigate differences between families with a child with ADHD, ASD, or both conditions, and to examine the role of underlying deficits in executive functioning (EF) in both children and parents in relation to negative and positive effects of distance learning. METHODS: Survey data assessing both negative and positive experiences of distance learning were collected from parents with a child aged 5-19 years in seven Western European countries: the UK, Germany, Spain, Sweden, the Netherlands, Italy, and Belgium. Altogether, the study included 1010 families with a child with ADHD and/or ASD and an equally large comparison group of families with a child without mental health problems. We included measures of three different types of negative effects (i.e., effects on the child, effects on the parent, and lack of support from school) and positive effects on the family. RESULTS: Results confirmed that families with a child with ADHD, ASD or a combination of ADHD and ASD showed higher levels of both negative and positive effects of distance learning than the comparison group. However, few differences were found between the clinical groups. Group differences were more pronounced for older compared to younger children. Regarding the role of both ADHD/ASD diagnosis and EF deficits, primarily children's EF deficits contributed to high levels of negative effects. Parent EF deficits did not contribute significantly beyond the influence of child EF deficits. Families of children with ADHD/ASD without EF deficits experienced the highest levels of positive effects. CONCLUSIONS: School closings during COVID-19 have a major impact on children with EF problems, including children with neurodevelopmental disorders. The present study emphasizes that schools should not focus primarily on whether a student has a neurodevelopmental disorder, but rather provide support based on the student's individual profile of underlying neuropsychological deficits.

Association of Perinatal and Childhood Ischemic Stroke With Attention-Deficit/Hyperactivity Disorder.

Importance: Early detection of attention-deficit/hyperactivity disorder (ADHD) plays a crucial role in reducing negative effects on everyday life, including academic failure and poor social functioning. Children who survive ischemic strokes risk major disabilities, but their risk of ADHD has not been studied in nationwide cohorts. Objective: To assess the risk of ADHD in children after pediatric ischemic stroke. Design, Setting, and Participants: Participants in this Swedish nationwide cohort study included 1320 children diagnosed with ischemic stroke recorded in linked Swedish national registers from January 1, 1969, to December 31, 2016, without prior ADHD diagnosis. Ten matched controls were identified for each index case, and first-degree relatives were identified for index individuals and controls. Analyses were stratified by perinatal and childhood strokes and presence of comorbid adverse motor outcomes and/or epilepsy. End of follow-up was the date of ADHD diagnosis, death, or December 31, 2016, whichever occurred first. Data analyses were performed August 1 to 28, 2021. Exposures: Pediatric ischemic stroke. Main Outcomes and Measures: Attention-deficit/hyperactivity disorder identified using codes from the International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, and/or prescribed ADHD medication recorded in the Medical Birth Register, National Patient Register, or Prescribed Drug Register after stroke. Cox proportional hazards regression was used to assess adjusted hazard ratios (aHRs) for ADHD after pediatric stroke, adjusting for parental age and ADHD in first-degree relatives. Results: Of 1320 children with stroke included in the analysis (701 boys [53.1%]), 75 (45 boys [60.0%]) were diagnosed with ADHD after stroke compared with 376 (252 boys [67.0%]) among the controls (aHR, 2.00 [95% CI, 1.54-2.60]). The risk was increased after both perinatal (aHR, 2.75 [95% CI ,1.65-4.60]) and childhood (aHR, 1.82 [95% CI, 1.34-2.48]) strokes and were similar if children born preterm or small for gestational age were excluded. Compared with controls, risks of ADHD were higher among children with perinatal stroke and adverse motor outcomes and/or epilepsy (aHR, 6.17 [95% CI, 2.80-13.62]) than among those without these comorbidities (aHR, 1.65 [95% CI, 0.80-3.42]). However, findings were similar in childhood stroke for children with adverse motor outcomes and/or epilepsy (aHR, 1.80 [95% CI, 1.12-2.89]) and among those without these comorbidities (aHR, 1.92 [95% CI, 1.28-2.90]). Conclusions and Relevance: This cohort study of 1320 children with pediatric ischemic stroke suggests that there is an increased risk of ADHD, particularly in children with adverse motor outcomes and/or epilepsy, compared with controls. The risk increases after childhood strokes regardless of comorbidities.

Validation of the Spanish version of the Childhood Executive Functioning Inventory (CHEXI) in 4-5 year-old children

Contexto:El Childhood Executive Functioning Inventory (CHEXI) se diseñó para detectar déficit de Funciones Ejecutivas (FE) en contextos de la vida diaria.El propósito del presente estudio era validar la versión española del CHEXI para niños de 4 y 5 años. Método:Se obtuvie-ron las valoraciones de los padres y las puntuaciones en test de laboratorio en una muestra de 445 niños de 4 años (196 niñas, 249niños) yotra de 459 niños de 5 años (208 niñas, 251 niños). Un año más tarde se volvieron a re-coger las valoraciones de los padres en CHEXI. Resultados:Se replicó la es-tructura de dos factores de CHEXI(Memoria de Trabajo e Inhibición), ob-teniendo una alta consistencia interna y estabilidad temporal. Los niños de 4 años eran valorados con mayor déficit en FE que los niños de 5 años. Los niños alcanzaban puntuaciones más elevadas de déficit de FE. Sin em-bargo, no aparecieron diferencias significativas de géneroen las pruebas conductuales. Finalmente, se encontró una baja asociación entre las valora-ciones de CHEXI y las puntuaciones de las pruebas conductuales. Este re-sultado sugiere que los inventarios y las medidas conductuales evalúan dife-rentes aspectos de las FE.Conclusiones:La versión española de CHEXI ofrece un instrumento válido para evaluar las FE en niños de 4 y 5 años.(AU)

Background:The Childhood Executive Functioning Inventory (CHEXI) was designed to identify EF deficits in daily life contexts.The aim of the present study was to validate the Spanish version of the CHEXI in 4-5-year-old children.Method: Parents’ ratings of the CHEXI and labora-tory tests of EF were investigated in two large samples of 445 children aged 4 years (196 girls, 249 boys)and 459 children aged 5 years (208 girls, 251 boys). CHEXI ratings were collected again after one-year. Results:The two-factor structure of the CHEXI (i.e., Working Memory and Inhibition) was replicated, showing high internal consistency and temporal stability. The 4-year-olds were reported to have higher EF deficits than 5-year-olds have. Boys were rated as having higher EF deficits than girls were. Howev-er, gender differences were not significant contrasting performance on EF tasks. Finally, associations between CHEXI ratings and EF tests were weak, suggesting that EF tests and EF ratings capture different aspects of EF. Conclusions:The Spanish CHEXI provides a suitable instrument to as-sess EF in 4-5-year-old children.(AU)

Neuropsychological deficits in relation to ADHD symptoms, quality of life, and daily life functioning in young adulthood.

Attention-deficit/hyperactivity disorder (ADHD) is related to multiple neuropsychological deficits. However, most previous studies, especially studies of adult samples, have not taken the overlap between different neuropsychological deficits into account. In addition, the link between neuropsychological deficits and daily life functioning and quality of life needs to be further investigated. The aim was therefore to investigate the independent effects of executive deficits, delay-related behaviors and emotion dysregulation on ADHD symptom levels, daily life functioning, and quality of life in a non-clinical sample of younger adults. Results showed independent effects of all three neuropsychological deficits on the two ADHD symptom domains. With regard to daily life functioning and quality of life, bivariate relations were found to all three neuropsychological deficits. However, it was primarily the associations to executive deficits that remained significant when studying independent effects. Executive deficits were related to daily life functioning and quality of life also when controlling for ADHD symptom levels. Conclusively, this study shows that ADHD is related to multiple neuropsychological deficits, even in adulthood. Previous studies may have overestimated the importance of delay-related behaviors and emotion dysregulation for daily life functioning, as they have failed to control for the effects of executive deficits.

Parental experiences of homeschooling during the COVID-19 pandemic: differences between seven European countries and between children with and without mental health conditions.

The aim of the present study was to examine parental experiences of homeschooling during the COVID-19 pandemic in families with or without a child with a mental health condition across Europe. The study included 6720 parents recruited through schools, patient organizations and social media platforms (2002 parents with a child with a mental health condition and 4718 without) from seven European countries: the UK (n = 508), Sweden (n = 1436), Spain (n = 1491), Belgium (n = 508), the Netherlands (n = 324), Germany (n = 1662) and Italy (n = 794). Many parents reported negative effects of homeschooling for themselves and their child, and many found homeschooling to be of poor quality, with insufficient support from schools. In most countries, contact with teachers was limited, leaving parents with primary responsibility for managing homeschooling. Parents also reported increased levels of stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol/drug use. Some differences were found between countries and some negative experiences were more common in families with a child with a mental health condition. However, differences between countries and between families with and without a mental health condition were generally small, indicating that many parents across countries reported negative experiences. Some parents also reported positive experiences of homeschooling. The adverse effects of homeschooling will likely have a long-term impact and contribute to increased inequalities. Given that school closures may be less effective than other interventions, policymakers need to carefully consider the negative consequences of homeschooling during additional waves of the COVID-19 pandemic and future pandemics.

Partner responsiveness moderates the relation between COVID-19-related stressors and changes in mood during the pandemic.

The COVID-19 pandemic has created an unusually stressful situation for many people around the world. Due to the restrictions, many have been isolated in their homes, and having a responsive partner may have become even more important. The present study aimed to investigate (1) whether there were any differences in social and work-related stressors and changes in negative mood during the COVID-19 pandemic as a function of marital status, and (2) whether perceived partner responsiveness can attenuate the associations between COVID-19-related stressors and changes in negative mood. The participants were 2,400 Brazilian adults recruited via the Internet, using a virtual sampling strategy. They were assigned to three distinct groups based on their relationship status. The results showed that a relatively large proportion of the sample reported increased levels of negative mood, and that married/cohabitating couples reported low levels of negative change in mood compared to single participants. We also found that partner responsiveness attenuated the association between stress and mental health, but only for people who were dating. Our study contributes new insights by showing that effects on mental health during the COVID-19 pandemic are dependent on relationship type and perceived partner responsiveness.

Gaming and Social Media Addiction in University Students: Sex Differences, Suitability of Symptoms, and Association With Psychosocial Difficulties.

Background: Previous research has shown that addictions to digital media can have negative impact on psychosocial health. Although Internet Gaming Disorder (IGD) has received most scholarly recognition, the potential negative consequences of Social Media Disorder (SMD) have also been found. However, few studies have assessed the symptoms of these two digital media addictions in the same way, making comparisons difficult. The present study aims to fill this gap by investigating differences and similarities regarding how common the symptoms are, sex differences, the suitability of the symptoms, and their association with psychosocial difficulties. Method: A total of 688 university students (63.2% women, Mean age = 25.98) completed a questionnaire measuring symptoms of IGD and SMD, as well as psychosocial difficulties (i.e., psychosomatic symptoms, low self-concept, and social problems). Results: Results showed that 1.2% of the men and 0.9% of the women met the symptom criteria for IGD (non-significant difference), whereas 3.2% men and 2.8% women met the symptom criteria for SMD (non-significant difference). Dimensional analyses indicated that men had higher IGD scores compared to women, whereas the opposite was found for SMD. Symptoms of heavy involvement in digital media (i.e., Preoccupation, Tolerance, Withdrawal, Unsuccessful attempts to control, and Escape) had high sensitivity, but low positive predictive value (PPV). However, symptoms associated with negative consequences of digital media use (i.e., Loss of interest, Continued excessive use, Deception, and Jeopardizing career/relationships) had low sensitivity, but high PPV. These symptom patterns were similar for IGD and SMD. Meeting the criteria for IGD or SMD as well as being at risk of these disorders were significantly associated with psychosocial difficulties. Symptoms of SMD generally had stronger associations with psychosomatic symptoms compared to symptoms of IGD. Conclusions: We conclude that heavy involvement in digital media seems common among individuals with IGD or SMD, but also among those not meeting the symptom criteria, whereas negative consequences are less common but highly predictive of digital media addictions once present. Further attention to SMD is warranted, as it seems more common than IGD and also seems to be equally or more strongly associated with psychosocial difficulties.

The Executive Checklist (EC-10) - a new rating instrument for clinicians assessing dysexecutive behavior.

Assessment of executive functions (EF) is often criticized for its lack of ecological validity. As a consequence, several self- and partner rating scales for EF have been developed, while rating scales designed for clinicians are lacking. We therefore developed the Executive Checklist (EC-10), a new rating scale for clinicians assessing dysexecutive behavior during neuropsychological assessment and examined its psychometric properties. Consecutive referrals from a memory clinic with subjective cognitive impairment (SCI; n = 27), mild cognitive impairment (MCI; n = 29), dementia (DEM; n = 16), as well as 11 healthy controls were assessed with the EC-10 while performing common neuropsychological tests. Results showed that the EC-10 had excellent inter-rater reliability, good internal consistency and modest relations to cognitive laboratory measures. The EC-10 increased the classification rate above and beyond the influence of neuropsychological tests when comparing patients with SCI and MCI or between cognitively impaired and non-impaired patients. Conclusively, the present study demonstrates that clinical observations can be quantified using the EC-10 and that this rating provides valuable information. As executive deficits are common in many neurological and neuropsychiatric disorders, validating the EC-10 in broader patient groups should be an important avenue for future research.

Distance Learning Effects Among Italian Children and Parents During COVID-19 Related School Lockdown.

Background: During the COVID-19 pandemic, both children and their parents experienced consequences related to distance learning (DL). However, positive and negative effects have varied greatly among families, and the specific factors explaining these differences in experiences are still underexplored. In this study, we examined children's executive functions (EF) and parents' psychological well-being in relation to negative and positive effects of DL on both children and their parents. Method: Participants were 637 Italian parents (92% mothers) with a child (48% male) aged between 6 and 19 years involved in DL due to school closures during the first wave of the COVID-19 pandemic. Data were collected using an online survey. We performed three fixed-order hierarchical multiple regression analyses with child age and sex, children's EF deficits, and parents' psychological well-being as independent variables, and DL-related negative effects (on the child and on the parent) and DL-related positive effects as dependent variables. Results: The results of the regression analyses showed that for negative effects of DL, younger age and greater EF deficits explained most part of the variance. Specifically, regarding negative effects on children, the most important factor was EF deficits, whereas regarding negative effects on parents, child age was the most important factor. For positive effects of DL, all variables explained only a small part of the variance. Child age was the most important factor, but EF deficits and parents' psychological well-being also had a significant impact. Conclusions: The effects of DL during school closures vary widely across families. Our findings indicate that intervention efforts need to consider background variables, child factors, as well as parent factors when supporting families with homeschooling in times of pandemic.

Emotion dysregulation in adult ADHD: Introducing the Comprehensive Emotion Regulation Inventory (CERI).

INTRODUCTION: Previous research has shown that Attention-Deficit Hyperactivity Disorder (ADHD) is linked to emotion dysregulation, but we still do not know enough about the specific nature of this deficit. The aim of the present study was therefore to study emotion dysregulation in adult ADHD using a new self-rating instrument, the Comprehensive Emotion Regulation Inventory (CERI). METHODS: The study included 390 participants, both adults diagnosed with ADHD and a comparison group. The CERI was created based on Gross' process model of emotion. Unlike instruments already available, the CERI enables a detailed analysis of different strategies for regulating both positive and negative emotions and of the impact emotion dysregulation has on daily life. RESULTS: Results showed that the CERI has good psychometric properties, and a 5-factor solution was identified. Adults with ADHD differed from the comparison group with regard to how often they use different strategies, although effect sizes were small to medium. However, large effect sizes were found between ADHD and the comparison group with regard to problems implementing the use of various regulatory strategies and the negative impact on daily life functioning with regard to friendships, work/studies, or romantic relations. Within-group differences showed that adults with ADHD use the less advanced strategy suppression significantly more often compared to the more advanced strategies attentional deployment and reappraisal. CONCLUSIONS: The CERI appears to be a valuable instrument for gaining more in-depth insights into emotion dysregulation in adults with mental disorders. Future research needs to examine what aspects of emotion dysregulation are shared between different mental disorders and what aspects might be specifically related to ADHD.

Objective measurement of attention deficit hyperactivity disorder symptoms outside the clinic using the QbCheck: Reliability and validity.

Objective measurements of ADHD symptom levels can be a highly valuable complement to ratings. However, sometimes it is not feasible to bring patients into the clinic/lab for assessment. The aim of the present study was therefore to evaluate the psychometric properties of the QbCheck, an online computerized test that measures errors and reaction time as well as activity during testing using the computer's built-in web camera. Study I (n = 27 adolescents/adults) investigated test-retest reliability and concurrent validity of the QbCheck. Study II included 142 adolescents/adults (69 with ADHD/73 controls) and investigated convergent and diagnostic validity, as well as usability, of the QbCheck. In Study I, the QbCheck showed high test-retest reliability and high concurrent validity. In Study II, high convergent validity was observed when studying associations between the QbCheck performed in the home and the QbTest performed at the clinic. In addition, the QbCheck discriminated well between patients with ADHD and controls, with a sensitivity of 82.6 and a specificity of 79.5. The QbCheck appears to be a valuable test with good psychometric properties and will thereby enable assessment of ADHD symptom levels in adolescents and adults outside the clinic in the home setting.

Psychometric properties of the Teenage Executive Functioning Inventory (TEXI): A freely available questionnaire for assessing deficits in working memory and inhibition among adolescents.

The Childhood Executive Functioning Inventory (CHEXI) and the Adult Executive Functioning Inventory (ADEXI) are reliable and valid rating instruments for assessing working memory and inhibitory control. However, a teenage version of this instrument has not been available, and the aim of the present study was therefore to investigate the psychometric properties of the Teenage Executive Functioning Inventory (TEXI). After interviewing both researchers/clinicians and adolescents themselves, a questionnaire with 20 items was created. Data from adolescents age 13-19 years (n = 302) and their parents were thereafter collected. Factor analysis showed that the TEXI has two clear factors: working memory and inhibition. Further, the TEXI was shown to have high reliability in terms of internal consistency (≥ .85), split-half reliability (≥ .81) and inter-rater reliability between self-ratings and parent ratings (.82). In sum, the TEXI is a reliable questionnaire for measuring working memory and inhibition in adolescents. The two versions of the TEXI are presented in the appendices of this paper and they will be freely available on the Internet.

Functional impairments among adults with ADHD: A comparison with adults with other psychiatric disorders and links to executive deficits.

The aim of the present study was to investigate daily life functioning in adults with ADHD and adults with other psychiatric disorders and to compare ADHD subgroups with or without executive deficits. Daily life functioning was assessed using self-ratings covering the following domains: academic/occupational functioning, social relations, daily life problems, and criminality. Executive deficits were assessed using self-ratings and laboratory tests of working memory, inhibition, and shifting. The results showed that adults with ADHD were more impaired with regard to academic functioning, current occupational status, daily life functioning, criminality, and some aspects of social functioning. The ADHD subgroup with executive deficits had more impairments than the subgroup without executive deficits with regard to academic functioning, current occupational status, and criminality. Conclusively, ADHD in adulthood is related to significant impairment in many areas of daily functioning, also compared to patients with other psychiatric disorders. Executive functioning deficits appear to at least partly explain these impairments.

No effects of a long-term physical activity intervention on executive functioning among adolescents.

OBJECTIVES: We investigated whether a school-based physical activity intervention would lead to improvements in working memory, inhibition and cognitive flexibility in adolescents aged 13-15 years. METHODS: The adolescents at the active school (n = 108) participated in an intervention that included increased physical activity for 20 min/day, focused on aerobic activity with low cognitive demands for an entire school year. The adolescents at the control school (n = 59) received no extra physical activity. At the beginning (baseline) and end (follow-up) of the school year, the participants performed tests of executive function (working memory, inhibition and cognitive flexibility) and performed tests of physical fitness and health. RESULTS: There was no change in executive functioning at follow-up when comparing the schools. However, only 46% complied with the intervention. When non-compliers were excluded from the analyses, the results remained the same, except for a small but significant increase in working memory for the active school as compared to the control school. CONCLUSION: These results indicate that compliance with the intervention was low and that aerobic exercise with low cognitive load does not produce improvements in executive functioning.