Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms in Children Adopted from Poland and their Atypical Association Patterns: a Bayesian Approach

Although high rates of attention-deficit hyperactivity disorder (ADHD) symptoms have been observed among internationally adopted children, research on these symptoms in Polish adoptees is lacking. Therefore, we examined ADHD symptoms in Polish adoptees and their relationship to pre-adoptive risk factors, that is, time in institutional care, early deprivation, and prenatal alcohol exposure. We further compared the association patterns and gender distribution of ADHD symptoms in children adopted from Poland to those reported in the literature for ADHD symptoms in non-adopted children. Dutch adoptive parents of 121 Polish adoptees (52% boys; M _age = 10.9 years, range 6.2–15.6; M _ageadoption = 3.0 years, range 0.8–6.9) completed questionnaires regarding ADHD symptoms, pre-adoptive risk factors, attachment problems, conduct problems, and executive functioning deficits. Bayesian evaluation of informative hypotheses showed that Polish adoptees had increased levels of ADHD symptoms, compared to Dutch children in the general population. Time in institutional care, early deprivation, and prenatal alcohol exposure were not associated with ADHD symptoms. ADHD symptoms in Polish adoptees were more strongly associated with attachment problems and executive functioning deficits, but less strongly with conduct problems, compared to ADHD symptoms in non-adoptees. Furthermore, ADHD symptoms were more equally distributed among boys and girls than they are in non-adopted children. The findings indicate that Polish adoptees and their adoptive parents need special attention and support. The dissimilarities between ADHD symptoms in Polish adoptees and non-adoptees might indicate a different underlying causal mechanism, which may have important implications for clinical practice.     

Examination of Spatial Working Memory Performance in Children and Adolescents with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT) and Anxiety

Spatial working memory (SWM) is known to be impaired in children with ADHD-CT, whether anxiety is present or not. Yet, it remains unclear whether anxiety disorders add to the SWM impairments evident in ADHD-CT and whether these findings extend into adolescents with ADHD-CT and anxiety. Further, it is not yet known whether children and adolescents with carefully defined anxiety disorders alone, demonstrate SWM deficits. This study explored the association of SWM and its strategy and spatial span components in carefully defined children and adolescents (age 6–16 years) with ADHD-CT alone (N?=?163; 14 % female), ADHD-CT and anxiety (N?=?243; 23 % female), anxiety disorders alone (N?=?69; 25 % female) compared to age- and gender-matched healthy control participants (N?=?116; 19 % female). The relationship between SWM and its strategy and span components and core ADHD-CT symptoms and anxiety symptoms were also examined. There was no evidence of an additive effect of ADHD and anxiety on SWM, strategy and spatial span deficits. But, anxiety disorders alone were associated with impaired SWM and span performance compared to healthy control participants. In contrast, strategy did not differ between children and adolescents with anxiety disorders alone and healthy control participants, suggesting that with anxiety span is the most affected component. Further, these findings were age-independent. This study concurs with and extends current influential models about the cognitive effects of anxiety on performance in the setting of ADHD-CT. Clinical implications and future research directions are discussed.     

Integrating Impairments in Reaction Time and Executive Function Using a Diffusion Model Framework

Using Ratcliff’s diffusion model and ex-Gaussian decomposition, we directly evaluate the role individual differences in reaction time (RT) distribution components play in the prediction of inhibitory control and working memory (WM) capacity in children with and without ADHD. Children with (n?=?91, $ \overline{\mathrm{x}} $ age?=?10.2 years, 67 % male) and without ADHD (n?=?62, $ \overline{\mathrm{x}} $ age?=?10.6 years, 46 % male) completed four tasks of WM and a stop signal reaction time (SSRT) task. Children with ADHD had smaller WM capacities and less efficient inhibitory control. Diffusion model analyses revealed that children with ADHD had slower drift rates (v) and faster non-decision times (Ter), but there were no group differences in boundary separations (a). Similarly, using an ex-Gaussian approach, children with ADHD had larger τ values than non-ADHD controls, but did not differ in μ or σ distribution components. Drift rate mediated the association between ADHD status and performance on both inhibitory control and WM capacity. τ also mediated the ADHD-executive function impairment associations; however, models were a poorer fit to the data. Impaired performance on RT and executive functioning tasks has long been associated with childhood ADHD. Both are believed to be important cognitive mechanisms to the disorder. We demonstrate here that drift rate, or the speed at which information accumulates towards a decision, is able to explain both.     

Executive Functioning and Non-Verbal Intelligence as Predictors of Bullying in Early Elementary School

Executive function and intelligence are negatively associated with aggression, yet the role of executive function has rarely been examined in the context of school bullying. We studied whether different domains of executive function and non-verbal intelligence are associated with bullying involvement in early elementary school. The association was examined in a population-based sample of 1,377 children. At age 4 years we assessed problems in inhibition, shifting, emotional control, working memory and planning/organization, using a validated parental questionnaire (the BRIEF-P). Additionally, we determined child non-verbal IQ at age 6 years. Bullying involvement as a bully, victim or a bully-victim in grades 1–2 of elementary school (mean age 7.7 years) was measured using a peer-nomination procedure. Individual bullying scores were based on the ratings by multiple peers (on average 20 classmates). Analyses were adjusted for various child and maternal socio-demographic and psychosocial covariates. Child score for inhibition problems was associated with the risk of being a bully (OR per SD?=?1.35, 95%CI: 1.09–1.66), victim (OR per SD?=?1.21, 95%CI: 1.00–1.45) and a bully-victim (OR per SD?=?1.55, 95%CI: 1.10–2.17). Children with higher non-verbal IQ were less likely to be victims (OR?=?0.99, 95%CI: 0.98–1.00) and bully-victims (OR?=?95%CI: 0.93–0.98, respectively). In conclusion, our study showed that peer interactions may be to some extent influenced by children’s executive function and non-verbal intelligence. Future studies should examine whether training executive function skills can reduce bullying involvement and improve the quality of peer relationships.     

Working memory in very-low-birthweight children at the age of 11 years

The aim of this study is to investigate the working memory (WM) of very-low-birthweight (VLBW, ≤ 1500 g) children at the age of 11 years using Baddeley’s WM model. A regional cohort of 95 VLBW children was assessed for the domains of the WM model (central executive [CE], visuospatial sketchpad [VS], and phonological loop [PL]) using subtests from the Working Memory Test Battery for Children (WMTB-C) and the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV). VLBW children were categorized into three groups according to their degree of brain pathology (normal, minor, or major) in neonatal brain magnetic resonance imaging at the term age, and the WM performance was compared between groups to test norms. The structure of the WM model was studied by analyzing correlations among domains. Even VLBW children with normal cognitive development (general ability index ≥ 85) performed worse compared to the test norms (M = 100, SD = 15) on CE (M = 87.64, SD = 20.54, p < .001) and VS (M = 91.65, SD = 11.03, p < .001), but their performance on PL was above the norm (M = 110.79, SD = 13.79, p < .001). VLBW children with major brain pathology performed significantly worse on VS and PL compared to the other groups. The correlations among the WM domains of the VLBW children differ from earlier findings in normative populations. To conclude, the WM of the VLBW children in the study differ—especially in the CE and VS subtest scores—from the normative population irrespective of the degree of brain pathology and level of cognitive development.     

Advancing an Understanding of the Anxiety Control Questionnaire for Children (ACQ-C) in Clinically Anxious and Non-Anxious Youth: Psychometric Properties,Incremental Prediction and Developmental Differences

A lack of perceived control over anxiety-related situations is theorized to be characteristic of anxiety disorders in children and adolescents. In the current study we tested several theoretical predictions and developmental variation with the Dutch translation of the Anxiety Control Questionnaire for Children (ACQ-C). The theoretical factor structure of anxiety control was tested using Confirmatory Factor Analysis (CFA) in 548 non-referred children (8–18 years old, M?=?12.5 years; 50.7 % girls). The incremental predictive validity of perceived control for anxiety status was assessed using logistic regression in 141 clinically anxious children (age M?=?12.6 years; 56.7 % girls) and 298 non-referred non-anxious children (age M?=?12.6 years; 52.7 % girls). CFA showed that both a one-factor model and two-factor model (perceived control over internal reactions and external events) fit well. The one-factor model proved invariant across age and gender. Internal consistency was excellent (Cronbach’s α?=?.93). Two-month test-retest reliability was adequate. The ACQ-C was able to incrementally predict diagnostic status, even after controlling for age, gender and self-reported anxiety symptoms. Finally, both younger children and girls reported less perceived control, independent of anxiety level. Findings advance the understanding of the psychometric properties of the ACQ-C, the role of control in childhood anxiety and point to the potential utility of the ACQ-C in both clinical and community samples. The Dutch translation of the ACQ-C demonstrated sound psychometric properties.     

Pre-adoptive risk factors and behavioural problems in children adopted from Poland

Behavioural problems in adoptees have been related to adverse circumstances prior to adoption. We examined pre-adoptive risk factors and post-adoptive behavioural problems in children adopted from Poland. Dutch adoptive parents of 133 Polish adoptees (M_age = 8.7 years, range 2.8–15.2; M_ageadoption = 3.0 years, range .4–6.9) answered the Child Behaviour Checklist and questions regarding pre-adoptive risk factors, such as institutionalization, neglect and abuse. Polish adoptees in our sample were four times more likely to have clinical behavioural problems than non-adopted children. Compared with a group of children adopted from various countries, predominantly from Asia, Polish adoptees had higher levels of behavioural problems as well. Multiple pre-adoptive risk factors were present. Only a history of abuse was found to be associated with behavioural problems after adoption. Special attention and support after adoption are needed for these children and their adoptive parents, especially when a pre-adoptive history of abuse is known.     

When Trust Fails: The Relation Between Children’s Trust Beliefs in Peers and their Peer Interactions in a Natural Setting

One hundred and forty-nine 8–11 year-old children (86 males; M?=?9 years - 4 months and SD?=?7 months) from the UK were administered the Trust Beliefs in Peers scale and were observed in the playground over one school year. Quadratic relations were found between trust beliefs in peers and peer interaction, which varied by gender. Compared to girls with the middle range of trust beliefs, girls with very low beliefs and those with very high beliefs (a) were less accepted/more rejected by the peer group (i.e., lower group interaction, and greater negatively received bids), (b) showed greater indirect aggression (engaged in and received), (c) showed greater non-engagement (i.e., being alone), and (d) showed greater concomitant distress. Compared to children with the middle range of trust beliefs, children with those extreme trust beliefs in peers demonstrated greater direct aggression (engaged in and received) and showed passive behavior (for boys only). The findings supported the conclusion that children, primarily girls, who trust peers too little and those who trust too much are at risk for psychosocial maladjustment.     

Children's and adolescents' narratives of guilt: Antecedents and mentalization

In this study, situational antecedents and mentalization of guilt were examined by asking children and adolescents for written narratives. The sample of 240 participants, aged between 9 years and 15 years 6 months, was divided into two groups of 120 children (M = 9 years and 7 months; SD = 0.4) and 120 adolescents (M = 14 years and 7 months; SD = 0.4). Participants displayed typical development, were recruited at schools in Milan city, and came from middle-class backgrounds. There was an equal number of males and females in each of the two age groups. Both content analysis for antecedents and mental states language analysis for mentalization were applied to the texts. We found that the distribution of guilt antecedents varied as a function of age, and only in the adolescent group as a function of gender. We also found that the use of mental states language varied very significantly with age, but not with gender. The results support the idea that in the transition from childhood to adolescence antecedents shift their focus from externalizing behaviours to internal thoughts and intentions; in addition, a more advanced ability to represent and reflect on the experience of feeling guilty is acquired.     

A longitudinal investigation of children internationally adopted at school age

Most existing research on children adopted internationally has focused on those adopted as infants and toddlers. The current study longitudinally tracked several outcomes, including cognitive, behavioral, emotional, attachment, and family functioning, in 25 children who had been internationally adopted at school age (M = 7.7 years old at adoption, SD = 3.4, range = 4–15 years). We examined the incidence of clinically significant impairments, significant change in outcomes over the three study points, and variables that predicted outcomes over time. Clinically significant impairments in sustained attention, full-scale intelligence, reading, language, executive functioning, externalizing problems, and parenting stress were common, with language and executive functioning impairments present at higher levels in the current study compared with past research focusing on children adopted as infants and toddlers. Over the three study points, significant improvements across most cognitive areas and attachment functioning were observed, though significant worsening in executive functioning and internalizing problems was present. Adoptive family-specific variables, such as greater maternal education, smaller family size, a parenting approach that encouraged age-expected behaviors, home schooling, and being the sole adopted child in the family were associated with greater improvement across several cognitive outcomes. In contrast, decreased parenting stress was predicted by having multiple adopted children and smaller family sizes were associated with greater difficulties with executive functioning. Child-specific variables were also linked to outcomes, with girls displaying worse attachment and poorer cognitive performance and with less time in orphanage care resulting in greater adoption success. Implications for future research and clinical applications are discussed.     

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5–5 years post‐adoption

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non‐adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co‐occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5–5 years post‐adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent‐ and experimenter‐reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non‐adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29–64 months post‐adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post‐adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non‐adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = −0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = −.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post‐adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c     

Theory of Mind Understanding and Conversational Patterns in Middle Childhood

The author investigated the longitudinal relations between theory of mind (ToM) understanding and perceptions of self and social conversations in 17 school-aged children (12 girls, 5 boys, age 8–12 years). ToM was assessed at Time 1 (T1; M age = 8 years 5 months, SD = 8.7 months, and perceptions of self and conversational experiences assessed two years later at Time 2 (T2; M age = 10 years 4 months, SD = 7.9 months. Most importantly, longitudinal findings showed that children who scored relatively high on ToM at T1 reported relatively lower perceptions of self-worth and higher number of mental states verbs in their perceptions of peer and family conversations at T2. Significant negative longitudinal associations were found between children's number of siblings and their perceptions of self-worth (T1) and number of cognitive terms in their perceptions of peer and family conversations (T2). Frequency analysis suggested that girls’ perceptions of conversations referred to more social and psychological aspects of self and relationships, whereas boys focused mainly on physical activities. Most children were more likely to prefer listening to talking during social conversations. The majority of children reported feelings of mixed or ambiguous emotions during experiences of silence. Implications for socioemotional and cognitive development in early adolescents are discussed.     

Emotional prosody effects on verbal memory in older and younger adults

Prosody, or the way things are said, can modify the meaning of utterances making qualitatively different affective prosodies useful for understanding how auditory affective information is processed and remembered. In this study, we collected behavioral data from 225 younger (M age = 20.8 years, SD = 2.5 years; 119 males) and 225 older adults (M age = 71.6 years, SD = 6.5 years; 119 males) in order to examine age differences in emotional prosody effects on verbal memory. Participants were randomly divided into three subgroups according to different prosody listening conditions (positive, negative, and neutral) and prosody effects on a yes–no recognition memory task were investigated. The results showed how older adults who listened to the story read with a neutral prosody remembered more words than those who listened to the same story with a positive or negative prosody. Younger adults showed no valence effects. Our findings highlighted an age and affective prosody interaction that affects remembering in older adults alone.     

Empathic accuracy: age differences from adolescence into middle adulthood

ABSTRACT

This study investigated age differences in empathic accuracy, the ability to correctly perceive others’ emotions, in a sample of 151 boys and men from three age groups: adolescents (M_age?=?16 years, SD?=?1.04), young adults (M_age?=?29 years, SD?=?2.78), and middle-aged adults (M_age?=?50 years, SD?=?3.07). All participants viewed nine newly developed film clips, each depicting a boy or a man reliving one of three emotions (anger, sadness, or happiness), while talking about an autobiographical memory. Adolescents and middle-aged men were less accurate than young men, and these age differences were associated with parallel age differences in fluid-mechanical abilities. In addition, age differences in vocabulary, one indicator of crystallized-pragmatic intelligence, were associated with age differences in empathic accuracy in adolescent and young, but not middle-aged, men. Within the limitations of cross-sectional data, this study provides evidence for the idea that empathic accuracy is an effortful task that requires cognitive resources and, thus, may show a normative increase until young adulthood followed by periods of stability and decline in subsequent decades.     

Behavioral Inhibition and Risk for Posttraumatic Stress Symptoms in Latino Children Exposed to Violence

Latino children in urban contexts marked by poverty are at high risk of being exposed to violence and developing posttraumatic stress disorder (PTSD). Nonetheless, there is great variability in individual responses to violence exposure. This study examines risk for developing re-experiencing, avoidance, and arousal symptoms of PTSD as a function of individual differences in behavioral inhibition and exposure to community violence. Participants were 148 Latino students (M age =11.43 years, SD?=?0.69; 55 % girls) living in an area marked by poverty and crime. Children completed self-report measures of behavioral inhibition and posttraumatic stress symptoms during a baseline assessment. During a follow-up interview 6 months later, children completed self-report measures of exposure to community violence since the baseline assessment and posttraumatic stress symptoms. Structural equation models revealed that behavioral inhibition at baseline was positively associated with PTSD avoidance and arousal symptoms at follow-up, after controlling for symptoms at baseline. Furthermore, behavioral inhibition moderated the association between violence exposure and symptoms such that violence was more strongly associated with the development of PTSD avoidance symptoms as behavioral inhibition increased. Results suggest that individual differences in behavioral inhibition contribute to risk for specific PTSD symptoms and are important for understanding variation in responses to trauma exposure. By examining diathesis-­stress models within a disorder, we may be better able to elucidate the etiology of a disorder and translate this improved understanding into personalized intervention approaches that maximize effectiveness.     

A comparison of visual working memory and episodic memory performance in younger and older adults

Working memory and episodic memory decline with age. However, as they are typically studied separately, it is largely unknown whether age-associated differences are similar. A task design was developed in which visual working memory and episodic memory performances were measured using the same stimuli, with both tasks involving context binding. A 2-back working memory task was followed by a surprise subsequent recognition memory task that assessed incidental encoding of object locations of the 2-back task. The study compared performance of younger (N=30; M_age=23.5, SD_age=2.9, range=20-29) and older adults (N=29; M_age=72.1, SD_age=6.8, range=62-90). Older adults performed worse than younger adults, without an interaction effect. In younger, but not in older adults, performance on the two tasks was related. We conclude that although age differences (Young>Older) are similar in the working memory and incidental associative memory tasks, the relationship between the two memory systems differs as a function of age group.     

ADHD Symptoms in Post-Institutionalized Children Are Partially Mediated by Altered Frontal EEG Asymmetry

Individual differences in the propensity for left versus right frontal electroencephalogram (EEG) asymmetry may underlie differences in approach/withdrawal tendencies and mental health deficits. Growing evidence suggests that early life adversity may shape brain development and contribute to the emergence of mental health problems. The present study examined frontal EEG asymmetry (FEA) following the transition to family care in children adopted internationally from institutional care settings between 15 and 36 months of age (N = 82; 46 female, 36 male). Two comparison groups were included: an international adoption control consisting of children adopted from foster care with little to no institutional deprivation (N = 45; 17 female, 28 male) and a post-adoption condition control consisting of children reared in birth families of the same education and income as the adoptive families (N = 48; 23 female, 25 male). Consistent with evidence of greater approach and impulsivity-related behavior problems in post-institutionalized (PI) children, PI status was associated with greater left FEA than found in the other two groups. In addition, left FEA served as a mediator between institutionalization and age 5 ADHD symptoms for girls. Age at adoption and other preadoption factors were examined with results suggesting that earlier adoption into a supportive family resulted in a more typical pattern of brain functioning. Findings support the idea that the capacity of brain activity to evidence typical functioning following perturbation may differ in relation to the timing of intervention and suggest that the earlier the intervention of adoption, the better.     

Depressive Symptoms Following Coping with Peer Aggression: The Moderating Role of Negative Emotionality

The way in which children cope with peer aggression may determine their subsequent adjustment, but different forms of coping may be more or less effective for particular children. This research examined whether the contribution of children’s coping to subsequent depressive symptoms was contingent on children’s temperament (i.e., level of negative emotionality; NE) and gender. Children (N?=?235, 102 boys, 133 girls, M?=?7.94 years, SD?=?0.33) reported on exposure to peer victimization. Parents rated children’s NE and depressive symptoms, and teachers rated children’s coping. For girls with high NE, problem solving protected against depressive symptoms whereas seeking retaliation heightened risk for depressive symptoms. Advice seeking protected children with low NE against depressive symptoms whereas ignoring protected children with high NE against depressive symptoms. Humor predicted fewer depressive symptoms in boys with high NE but more depressive symptoms in boys with low NE. This research helps to elucidate individual differences in the effects of coping on adjustment, and has implications for interventions aimed at reducing risk resulting from exposure to peer aggression.     

What can boys and girls do? Preschoolers’ perspectives regarding gender roles across domains of behavior

Previous research has examined at what age and in what contexts males and females develop gender-congruent stereotypes. Research indicates that social experience may provide a great influence on the presence of such stereotypes, but this is likely influenced by the development of gender schemas. The current study interviewed 99 children (3–6.5 years) in a sub-rural Midwestern university community. Females (N = 51, M _age = 4.6, SD = 0.73) and males (N = 48, M _age = 4.6, SD = 0.82) were individually asked who—boys, girls, or both—can do particular (1) occupations, (2) activities, (3) aggressive behaviors, and (4) prosocial behaviors. Generally, males tended to express holding no stereotypic beliefs, indicating gender-congruent expectations for only 2 items in one of the domains; however, females expressed multiple stereotypic beliefs for each of the four contexts. Social and cognitive explanations for these phenomena are discussed. The current study is an important addition to the existing literature in that preschool teachers and parents alike might be able to assist children to better develop activities and behavioral habits such that gender-related stereotypes fail to develop.     

Social Identification and Well-Being Following a Terrorist Attack: A Longitudinal Study of Israeli Adolescents

The authors examined the role of familial and national social identification in shaping the well-being (positive self-esteem [PSE] and satisfaction with life [SL]) among Israeli adolescents following a terrorist attack. Adolescents living in an attacked town (n = 259; M age = 16.19 years, SD = 0.74 years) and adolescents living in a not attacked town (n = 281; M age = 16.14 years, SD = 0.69 years) were studied longitudinally at 3 weeks and 1 year after the attack. Family identification promoted SL concurrently and PSE concurrently and longitudinally in both groups. Israeli identification hindered subsequent PSE and SL among trauma exposure group adolescents. The authors apply the findings to explain the protective and detrimental potential of social identification following traumatic experiences.