Delay and reward choice in ADHD: an experimental test of the role of delay aversion.

Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.

Transcultural adaptation to Portuguese of the Mind Excessively Wandering Scale (MEWS) for evaluation of thought activity.

INTRODUCTION: The concept of mind wandering refers to periods during which attention and content of thoughts depart from the original idea or activity being performed. The phenomenon occurs commonly in the general population and the Mind Wandering Excessively Scale (MEWS) evaluates its frequency, intensity and related negative outcomes. OBJECTIVE: To describe the cross-cultural adaptation of the MEWS. METHODS: Cross-cultural adaptation of the original scale followed five consecutive steps: translation, backtranslation, appreciation of semantic equivalence and administration to a convenience sample to 20 adults with attention deficit hyperactivity disorder (ADHD) and 20 normal controls. RESULTS: Results indicated a satisfactory equivalence between the original and translated versions. A synthesis version for Brazilian Portuguese is presented. CONCLUSIONS: MEWS provides information on thought activity, which is particularly important in ADHD cases. The Brazilian Portuguese version would be welcome to address specific treatment responses and obtain new outcome measures.

Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology.

Attention deficit hyperactivity disorder (ADHD) is a common condition with a high societal burden. The present guidelines summarise current literature, generating expert consensus recommendations for the treatment of ADHD in children and adults. These guidelines also provide a review of recent research in the fields of neuroimaging, neuropsychology and genetics of ADHD. Novel discoveries in these areas have informed physiological models for the disease. Since the publication of the previous British Association for Psychopharmacology guidelines in 2008, new drugs have been licensed and further compounds are being investigated. The publication of randomised controlled trials of psychological interventions has contributed to the range of treatment options for ADHD. As the disorder has been diagnosed more frequently there has been greater focus on comorbid conditions and how they impact treatment. Services have continued to develop for the treatment of ADHD in adults and care agreements have been introduced to facilitate access to treatment.

Transcultural adaptation to Portuguese of the Mind Excessively Wandering Scale (MEWS) for evaluation of thought activity / Adaptação transcultural da Mind Excessively Wandering Scale para avaliação de atividade mental

Abstract Introduction: The concept of mind wandering refers to periods during which attention and content of thoughts depart from the original idea or activity being performed. The phenomenon occurs commonly in the general population and the Mind Wandering Excessively Scale (MEWS) evaluates its frequency, intensity and related negative outcomes. Objective: To describe the cross-cultural adaptation of the MEWS. Methods: Cross-cultural adaptation of the original scale followed five consecutive steps: translation, backtranslation, appreciation of semantic equivalence and administration to a convenience sample to 20 adults with attention deficit hyperactivity disorder (ADHD) and 20 normal controls. Results: Results indicated a satisfactory equivalence between the original and translated versions. A synthesis version for Brazilian Portuguese is presented. Conclusions: MEWS provides information on thought activity, which is particularly important in ADHD cases. The Brazilian Portuguese version would be welcome to address specific treatment responses and obtain new outcome measures

Resumo Introdução: O conceito de devaneio se refere a períodos nos quais a atenção e o conteúdo do pensamento de distanciam da ideia original ou da atividade que estava sendo realizada. O fenômeno ocorre na população em geral, e a Escala Mind Excessively Wandering Scale (MEWS) avalia sua frequência, intensidade e desfechos negativos associados. Objetivos: Descrever a adaptação transcultural da MEWS. Métodos: A adaptação transcultural envolveu cinco etapas: tradução, retrotradução, apreciação da equivalência semântica e administração em amostra de conveniência composta de 20 adultos com transtorno do déficit de atenção com hiperatividade (TDAH) e 20 controles normais. Resultados: Os resultados demonstraram equivalência satisfatória entre as versões original e traduzida. Uma versão síntese para o português brasileiro é apresentada. Conclusão: A MEWS fornece informações importantes sobre atividade mental, algo particularmente importante em casos de TDAH. A versão em português brasileiro deverá ser bem acolhida, permitindo investigar respostas específicas ao tratamento e obter novas medidas de desfechos.

Idiopathic generalized epilepsy with absences: syndrome classification.

In a cohort of 275 Caucasians with a broad IGE phenotype, patients with absences were classified. Criteria of the 1989 Commission on Classification of the International League Against Epilepsy for Childhood Absence Epilepsy (CAE 1989 criteria) were compared with the stricter criteria of the ILAE Task Force for Classification and Terminology (CAE 2005 criteria). Among the 129 patients with absences without significant myoclonus, 50 had juvenile absence epilepsy 44 had CAE according to the CAE 1989 criteria and only 30 had CAE according to the CAE 2005 criteria. We found a significantly better outcome in patients considered as CAE by the CAE 2005 criteria, compared with those excluded. Strict criteria for classification of absence syndromes leave many patients unclassified. However, diagnostic criteria used to classify CAE patients have prognostic significance. We propose that patients are classified as having benign CAE or as having CAE with the adverse prognostic factors indicated.