Creative Thinking in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD)

A widened attentional focus, that is typically associated with ADHD, has been postulated to be accompanied by enhanced creative ability. However, creativity has been only limitedly examined in ADHD. Performance across several creativity measures were investigated in three groups: adolescents with ADHD, those with conduct disorder, and a healthy control sample. The ADHD group exhibited selective cognitive advantages and disadvantages by demonstrating an enhanced ability in overcoming the constraining influence of examples, but a reduced capacity to generate a functional invention during an imagery task. These findings are interpreted with reference to inhibitory control mechanisms and the contextual modulation of creative cognition.     

The Iowa Personality Disorder Screen: development and preliminary validation of a brief screening interview

The length and expense of comprehensive personality disorder interviews makes them unwieldy for routine use. A brief but sensitive screen could eliminate administration of longer instruments in many instances. We describe the development of the Iowa Personality Disorder Screen (IPDS)--a mini-structured interview which can be completed in less than 5 minutes. Retrospective analyses using 1,203 SIDP-R interviews suggested that the IPDS items should provide good sensitivity and specificity. We present results from a prospective validation study, using a mixed group of 52 nonpsychotic inpatients and outpatients who were diagnosed using the SIDP-IV. Blind administration of the IPDS yielded excellent sensitivity (92%) and good specificity (79%), using a subset of five screening items. Addition of two more items leads to an estimated sensitivity of 79% and specificity of 86%. The IPDS shows promise as a quick personality disorder screen for use in research settings or standard clinical interviews.     

Methodological Issues in the Assessment of Medication Effects in Children Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in school-aged children and is usually treated with stimulant medications, including methylphenidate (MPH; Ritalin®, Ritalin-LA®, Concerta®, Metadate®, or Focalin®) and other drug compounds (e.g., Adderall®, Adderall-XR®, or Dexedrine). Assessment of school behavior and performance is a critical component in determining the safety and efficacy of these medications. This paper reviews methodological issues in assessing drug effects in school settings by considering features of the independent variable (the medication), the dependent variables (the endpoints selected for assessment), and the design (the structure of the assessment). In addition, we consider recent conceptual advances in understanding the behavioral mechanisms of action of drugs used to treat ADHD that may influence the structure and interpretation of medication assessments.     

儿童注意缺陷多动障碍(ADHD)的“冷”“热”执行功能

近30多年来,对注意缺陷多动障碍(ADHD)的认知缺损机制的关注一直停留在"冷"执行功能领域,为更全面地揭示其执行缺损机制,文章旨在从"冷""热"执行功能的角度来探讨ADHD的缺陷。论文简要回顾了注意缺陷多动障碍的界定、生理基础和若干理论模型,着重阐述ADHD儿童在经典"冷""热"两类执行功能任务上的表现差异。总结认为ADHD儿童并非在所有类型的"热"执行任务上表现落后,ADHD儿童的表现要视情感和动机的卷入对不同任务情景的作用性质是消极还是积极而定,文章也比较分析了几位研究者相关的理论解释。     

Decision Making with Uncertain Reinforcement in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

Reward-related processes are impaired in children with ADHD. Whether these deficits can be ascribed to an aversion to delay or to an altered responsiveness to magnitude, frequency, valence, or the probability of rewards still needs to be explored. In the present study, children with ADHD and normal controls aged 7 to 10 years performed a simple probabilistic discounting task. They had to choose between alternatives where the magnitude of rewards was inversely related to the probability of outcomes. As a result, children with ADHD opted more frequently for less likely but larger rewards than normal controls. Shifts of the response category after positive or negative feedback, however, occurred as often in children with ADHD as in control children. In children with ADHD, the frequency of risky choices was correlated with neuropsychological measures of response time variability but unrelated to measures of inhibitory control. It is concluded that the tendency to select less likely but larger rewards possibly represents a separate facet of dysfunctional reward processing, independent of delay aversion or altered responsiveness to feedback.     

前摄抑制对儿童注意缺陷多动障碍(ADHD)和阅读障碍的言语工作记忆的影响

ADHD和阅读障碍儿童在言语工作记忆上的缺陷得到了大量研究的证实,但是二者机制并不相同,前摄抑制对工作记忆容量产生了不利的影响,主要影响的也是中央执行功能。研究将最近探测任务和n-back任务相结合,直接比较被试在最近负探测和非最近负探测条件下记忆成绩的差异,以考察前摄抑制对两种障碍言语工作记忆的影响,被试是60名障碍儿童(阅读障碍和ADHD)和17名正常儿童,年龄均在7至12岁之间。结果发现,受前摄抑制的影响,正常被试和障碍被试成绩均明显下降,具体而言,ADHD和ADHD伴随阅读障碍组成绩大幅下滑(26.44%,28.44%),程度明显高于正常儿童和阅读障碍儿童(14.62%,15.84%),后两者差异并不明显,这说明前摄抑制是影响工作记忆容量的重要因素,并且ADHD儿童更加容易受到前摄抑制的影响,这是导致其工作记忆成绩缺损的重要原因,而阅读障碍儿童能够像正常儿童一样,在一定程度上处理前摄抑制,ADHD和阅读障碍组在言语工作记忆缺损机制上存在差异。     

White Noise to Decrease Problem Behaviors in the Classroom for a Child With Attention Deficit Hyperactivity Disorder (ADHD)

Continuous white noise played through headphones was used as a classroom intervention to reduce off-task behavior and increase assignment production and accuracy for a child with Attention Deficit Hyperactivity Disorder (ADHD). When listening to white noise the student's off-task behavior decreased from 89% during baseline to 62%. Subsequently, he began taking a stimulant medication for his ADHD. Pharmacotherapy alone (65% off task) was approximately equivalent to white noise alone. When medication was combined with white noise his off-task behavior decreased to 45%. Assignment production was also enhanced while listening to white noise, whereas accuracy remained high throughout.     

Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

The Test of Variables of Attention (TOVA): Internal Consistency (Q1 vs. Q2 and Q3 vs. Q4) in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

The internal consistency of the Test of Variables of Attention (TOVA) was examined in a cohort of 6- to 12-year-old children (N = 63) strictly diagnosed with ADHD. The internal consistency of errors of omission (OMM), errors of commission (COM), response time (RT), and response time variability (RTV) of different test conditions (stimulus infrequent condition [Q₁ vs. Q₂] and stimulus frequent condition [Q₃ vs. Q₄]) was assessed via correlation analyses. All TOVA index scores under investigation assessing its internal consistency exhibited statistically significant correlations. All correlations fell in the moderate-high range.     

Cognitive functioning self-assessment scale (CFSS): preliminary psychometric data

The cognitive functioning is included in the concept of quality of life. Many times well-being remains incomplete because of cognitive difficulties, that people are not always able to properly recognize and explain. Nonetheless, only few instruments, specifically thought for non-clinical neurologic populations, are available to measure them. The present study is an attempt at providing a self-report instrument--cognitive functioning self-assessment scale (CFSS)--to measure the individual cognitive functioning in general population. The CFSS is itemized into18 questions to which participants answer on a five-point scale. Two hundred and eighty-two patients in a General Practitioner study have filled-in the CFSS together with a clinical and socio-demographic data form. Explorative factor analysis, using principal component analysis, suggests the consideration of the CFSS as one-dimensional; internal reliability = 0.856. Non-parametric tests have shown that women report a worse cognitive functioning than men, while no differences emerged in relation to age, manual prevalence, presence of an illness or being in pharmacological treatment. Although further verifications are necessary, the CFSS seems to be a promising self-report cognitive functioning measure.     

A preliminary validation of the Regional Proficiency Assessment Tool (RPAT)

Regional proficiency is a multidimensional construct created by the Department of Defense (DoD) to characterize a person’s knowledge of a region’s social, economic, political, and linguistic features. The Regional Proficiency Assessment Tool (RPAT) was designed to capture the regional proficiency of the military workforce. The RPAT collects biographical self-report data (e.g., professional travel, language test scores) to provide military personnel with scores for each dimension of regional proficiency (e.g., study of a region, utility of language skills) for each of the different global regions. Cluster scores combine to render the overall ratings. In two studies, we provide evidence for the RPAT’s construct validity. In Study 1, 44 military participants completed the RPAT and individual difference measures. Aggregated, person-level RPAT ratings and appropriate cluster scores were moderately positively associated with cultural intelligence (.35–.47), but unrelated with self-reported cognitive styles and the Big Five personality dimensions, except for negative correlations with neuroticism. In Study 2, 11 subject matter experts rated the estimated RP of individuals by several world regions via reading narrative biographical sketches. The aggregate of the expert ratings was strongly, positively associated with the RPAT ratings (M across regions = .72), and was moderately correlated with cultural intelligence (.38–.48). This finding suggests that the RPAT provides assessments in line with the best of current practice (individual expert heuristic judgments), and that cultural intelligence assessments cannot replace the RPAT. Future research can examine the validity of the RPAT across larger samples and using different types of validation.     

Self-Handicapping Prior to Academic-Oriented Tasks in Children with Attention Deficit/Hyperactivity Disorder (ADHD): Medication Effects and Comparisons with Controls

Examined self-handicapping prior to academic-oriented tasks in children with and without ADHD and examined whether stimulant medication influenced self-handicapping. Participants were 61 children ages 6 to 13, including 22 children with ADHD tested after taking a placebo, 21 children with ADHD tested after taking stimulant medication, and 18 non-ADHD controls. Participants completed three measures of self handicapping and also completed self-evaluations of their performance. Results showed greater self handicapping and more positive self-evaluations in children with ADHD than in controls regardless of medication condition. Findings suggest children with ADHD may use self handicapping to ameliorate the effects of experiencing high rates of academic failure.     

“热”执行对注意缺陷多动障碍和阅读障碍儿童言语工作记忆的影响

ADHD儿童在与背外侧前额叶(DLPFC)相关的"冷"执行功能上的缺陷已大量证实,但在与眼眶和中前额叶皮层(OMPFC)相关的"热"执行功能上,ADHD儿童是否存在缺陷则未可知。与儿童赌博任务实验范式(该任务中"热"启动对"冷"执行起到抑制作用)不同,本研究考察趣味言语N-back任务是否对ADHD和阅读障碍儿童的成绩有促进作用。枯燥N-back任务考察的是言语工作记忆的纯认知特征,而趣味任务则卷入了"热"执行对"冷"执行的影响。结果表明,在枯燥任务上,ADHD和阅读障碍儿童的成绩均明显低于正常儿童,二者之间差异不显著,在趣味任务成绩上,ADHD儿童与正常儿童的成绩没有显著差异,而阅读障碍儿童成绩落后于正常控制组和ADHD组,在成绩变化的趋势上,ADHD儿童在趣味任务上成绩明显提高,而阅读障碍儿童则无明显改善。结果说明ADHD和阅读障碍儿童的言语工作记忆均存在明显的缺陷,但是机制不同,"热"执行对提高ADHD的言语工作记忆有明显的促进作用,ADHD的"冷"执行缺陷能够通过"热"执行的调节得到改善。     

The development and initial validation of the Multicultural Environmental Inventory: a preliminary investigation

This article describes the development and initial validation of the Multicultural Environmental Inventory (MEI). The MEI is an instrument designed to measure an individual's perceptions about the degree to which graduate counseling programs address multicultural issues within curriculum, supervision, climate, and research. This investigation was conducted using the data from 208 students and faculty from counseling psychology graduate programs across the United States approved by the American Psychological Association. By using techniques of exploratory factor analysis, a 4-factor solution was determined to account for the relationships among the items on the MEI. The instrument was modified from 53 to 27 items on the basis of the items' effectiveness in measuring the underlying constructs of interest, and internal consistency information is provided on the final revised instrument (MEI-R). The factors underlying the MEI-R are discussed within the context of a multicultural environment in graduate counseling programs, and directions for future research are considered.     

The Assessment and Diagnosis of Attention Deficit Hyperactivity Disorder in Adult Forensic Psychiatric Outpatients

The primary purpose of the present study was to examine the validity of commonly utilized ADHD rating scales within an adult forensic population. Participants were 120 patients assessed for dysfunctional anger and impulsive aggression at a hospital-based clinic. Two psychiatrists made independent diagnoses about the presence or absence of ADHD among individuals presenting with symptoms consistent with this disorder. Following the diagnoses, participants were assessed with multiple ADHD measures, including measures based on self-report, observer-report, or a computerized neuropsychological measure (IVA + Plus). With the exception of the IVA + Plus, the ADHD measures significantly differentiated individuals diagnosed with ADHD from individuals who were not so diagnosed. These measures also demonstrated good diagnostic utility via test specific parameters (sensitivity, specificity, positive predictive power, and negative predictive power). A sub-set of measures demonstrated particularly good classification accuracy, with high sensitivity (91 %) and good specificity (81 %). Implications of these findings for the effective assessment and diagnosis of ADHD in adult outpatient psychiatric settings are discussed.     

Executive Functioning, Temporal Discounting, and Sense of Time in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD)

Clinic-referred teens (ages 12–19) with ADHD and ODD (N = 101) were compared to community control (CC) teens, equated for age and sex, (N = 39) on a variety of psychological tasks assessing executive functioning (EF), temporal reward discounting, and time estimation and reproduction. A factor analysis reduced the EF measures to three dimensions, representing CPT Inattention, Working Memory, and CPT Inhibition. Results indicated that the ADHD group had significantly more CPT Inattention than the CC group. No differences were found for Working Memory or CPT Inhibition. The ADHD group displayed significantly greater temporal discounting of delayed hypothetical monetary rewards relative to immediate ones and manifested more impaired time reproduction, but not time estimation, than did the CC group. Main effects for level of IQ were found only on the Working Memory factor and largely did not interact with the group factor otherwise. The group differences in CPT Inattention, temporal discounting, and time reproduction were not a function of level of comorbid oppositional defiant disorder, delinquency, or anxiety–depression. Results are reasonably consistent with past research on EF and sense of time in children with ADHD and extend these findings to the adolescent age group. Problems with working memory and CPT inhibition found in prior studies of children with ADHD, however, were not evident here, perhaps owing to age-related improvements or insufficient task difficulty.     

Time Perception: Modality and Duration Effects in Attention-Deficit/Hyperactivity Disorder (ADHD)

Time perception performance was systematically investigated in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Specifically, the effects of manipulating modality (auditory and visual) and length of duration (200 and 1000 ms) were examined. Forty-six adolescents with ADHD and 44 controls were administered four duration discrimination tasks and two control tasks, and a set of standardized measures. Participants with ADHD had higher thresholds than controls on all of the duration discrimination tasks, with the largest effect size obtained on the visual 1000 ms duration discrimination task. No group differences were observed on the control tasks. Visual–spatial memory was found to be a significant predictor of visual and auditory duration discrimination at longer intervals (1000 ms) in the ADHD sample, whereas auditory verbal working memory predicted auditory discrimination at longer intervals (1000 ms) in the control sample. These group differences suggest impairments in basic timing mechanisms in ADHD.     

Treatment Sensitivity of a Brief Rating Scale for Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms

This study examined the treatment sensitivity of the ADHD Questionnaire (ADHD-Q), which is a brief rating scale for measuring symptoms of inattention, hyperactivity, and impulsivity in children. Parent, teacher, and child self-report data of the ADHD-Q were obtained for 17 clinically referred children with ADHD on the three occasions: (1) during the regular intake assessment, (2) just before the start of the stimulant medication (i.e., methylphenidate) intervention, and (3) four weeks after the start of the medication intervention. Results showed that ADHD-Q scores remained fairly stable in the period prior to the intervention, but then showed a substantial decline after the stimulant medication had been administered. Clearly, this finding supports the treatment sensitivity of the ADHD-Q.     

The surgical anxiety questionnaire (SAQ): development and validation

Objective: Preoperative anxiety is often assessed using general anxiety measures; existing specific measures might lack content coverage and/or are not psychometrically validated. This study aimed to develop a new self-report measure of surgery-specific anxiety and test its psychometric properties.

Design: The surgical anxiety questionnaire (SAQ) was developed from themes identified in qualitative research and reviewed by an interdisciplinary expert team. It was administered preoperatively to 135 patients (56% female, mean age 51) on the day of surgery alongside additional measures of preoperative anxiety, state anxiety, perceived stress, depression and social desirability. Follow-up assessment was conducted immediately post-surgery and two weeks post-surgery (n?=?114) to examine recovery and predictive validity of the scale.

Results: Factor analysis revealed a three component structure, including: concerns about health (six items), concerns about recovery (four items) and concerns about procedures (four items). Three additional items of relatively high concern were retained in the total score (17 items). The SAQ displayed good reliability, validity (content, construct and predictive) and adequate overall psychometric properties.

Conclusions: Preliminary results suggest that the SAQ is a promising tool for measuring preoperative anxiety and predicting recovery. Recommendations for future research include employing a confirmatory factor analysis and examining test-retest reliability.