Does stimulant medication decrease the lower extremity response times of children with and without attention-deficit/hyperactivity disorder?

In 2005 Pedersen and Surburg reported that stimulant medications reduced the lower extremity response times of 16 boys with Attention-Deficit/Hyperactivity Disorder. However, as boys without ADHD and girls with and without ADHD were not studied, one cannot conclude that reported effects represent a medication effect unique to children with ADHD. An alternative hypothesis is presented: that stimulant medications produce an excitatory effect in the central nervous system by increased occupancy of postsynaptic dopamine receptors to reduce the lower extremity response times of children in general. Well-designed controlled clinical trials are needed to evaluate this hypothesis.     

Does comorbid attention-deficit/hyperactivity disorder impact the clinical expression of pediatric obsessive-compulsive disorder?

What is the impact of attention-deficit/hyperactivity disorder (ADHD) on the phenotypic expression of pediatric obsessive-compulsive disorder (OCD). We examined phenotypic features, and functional and clinical correlates in youths with OCD, with and without comorbid ADHD, from a large sample of consecutively referred pediatric psychiatry patients. Although comorbid ADHD had no meaningful impact on the phenotypic expression or clinical correlates of OCD, it was associated with higher rates of compromised educational functioning compared with other OCD youths. Our findings suggest that the OCD phenotype runs true and is not impacted by comorbid ADHD in youths diagnosed with both OCD and ADHD. In such affected youths, both disorders contribute to morbid dysfunction and require treatment. More work is needed to determine whether OCD plus ADHD represents a developmentally and etiologically distinct form of the OCD syndrome.     

Do boys with attention-deficit/hyperactivity disorder have positive illusory self-concepts?

One hundred ninety-five boys with attention-deficit/hyperactivity disorder (ADHD) were compared with 73 comparison boys (M = 9.83 years, SD = 1.30) on self-perceptions relative to a teacher-rated criterion. Emphasis was placed on ADHD subgroup comparisons according to level of aggression, academic achievement, and depression compared with control boys. Consistent with the authors' prediction, ADHD boys overestimated relative to teacher report, more than did controls, in the scholastic competence, social acceptance, and behavioral conduct domains. Examination of discrepancy scores (child rating - teacher rating) by comorbidity subgroups suggested that aggressive and low-achieving ADHD boys tended to overestimate their competence the most in the domains in which they were the most impaired. Results are discussed in terms of prior literature on "positive illusions" in ADHD children.     

Does attention-deficit/hyperactivity disorder have a dimensional latent structure? A taxometric analysis

An understanding of the latent structure of attention-deficit/hyperactivity disorder (ADHD) is essential for developing causal models of this disorder. Although some researchers have presumed that ADHD is dimensional and others have assumed that it is taxonic, there has been relatively little research directly examining the latent structure of ADHD. The authors conducted a set of taxometric analyses using data from the NICHD Study of Early Child Care and Youth Development (ns between 667 and 1,078). The results revealed a dimensional latent structure across a variety of different analyses and sets of indicators for inattention, hyperactivity/impulsivity, and ADHD. Furthermore, analyses of correlations with associated features indicated that dimensional models demonstrated stronger validity coefficients with these criterion measures than dichotomous models. These findings jibe with recent research on the genetic basis of ADHD and with contemporary models of ADHD.     

To do or not to do? Prospective memory versus response inhibition in autism spectrum disorder and attention-deficit/hyperactivity disorder

In the present research, event-based prospective memory and response inhibition (RI) abilities were investigated in children with ASD (Study 1), with ADHD (Study 2), and their matched neurotypical controls. Children engaged in a categorisation (ongoing) task and, concurrently, in either an event-based prospective memory (PM) or a Go/No-Go secondary task. Results showed that, as compared to their matched controls, ASD children's performance was more impaired in the PM task than in the Go/No-Go task, while the performance pattern of ADHD children was reversed. In the ongoing task, ASD children were as accurate as, but significantly slower than, controls, independently of conditions. ADHD children did not differ from controls in the presence of a concurrent PM task, while they were less accurate than controls in the presence of the go/no-go task. Overall, the two patterns of findings suggest important differences in the way ASD and ADHD children remember and realise intentions requiring opposite behaviours (acting vs stopping).     

Does within-person variability predict errors in healthy adults aged 18–90?

This study investigated within-person variability on basic psychomotor tasks in relation to errors on a higher order cognitive task. We were interested in whether more variable individuals were more prone to making errors, and whether this relationship varied with age. Variability was assessed using simple and choice reaction time, while errors of omission (misses) and commission (false alarms) were obtained from simple and complex visual search tasks. Data from 557 participants aged 18–90 years were included in the analysis. Greater variability was associated with more misses, and distribution analyses showed that slower responses were behind this effect. Variability was also associated with false alarms, but the pattern was inconsistent. Taking age into account revealed that the association between variability and misses in the simple visual search condition was stronger in older (aged 65–90 years) participants. The results suggest the relationship between greater variability and errors of omission (misses) may be related to inattention. Measures of variability may therefore provide valuable insights into individual differences in error rates and, more broadly, may also offer early warning of persons who are more prone to errors in visual search.     

Does rapid response to two group psychotherapies for binge eating disorder predict abstinence?

Objective

Extend understanding of a rapid response (RR) to treatment by examining its prognostic significance at end-of-treatment (EOT) and 1 year follow-up within two group treatments for binge eating disorder (BED): Dialectical Behavior Therapy for BED (DBT-BED) and an active comparison group therapy (ACGT).

Methods

101 adults with BED randomized to 20-weeks DBT-BED versus ACGT (Safer, Robinson, & Jo, 2010). RR defined as ≥65% reduction in the frequency of days of binge eating by week 4. RR across and within treatment conditions used to predict binge eating abstinence and secondary outcomes (e.g., binge eating pathology, treatment attrition) at EOT and 1 year follow-up.

Results

(1) Significantly higher binge eating abstinence for rapid responders (RR; n = 41) vs. non-rapid responders (non-RRs; n = 60) at EOT (70.7% vs. 33.3%) and 1 year follow-up (70.7% vs. 40.0%), respectively, as well as improvement on most secondary measures (2) Significantly less attrition among RRs vs. non-RRs (3) Significantly higher binge eating abstinence rates at both time points for DBT-RRs vs. DBT-non-RRs, but not for ACGT-RRs vs. ACGT-non-RRs.

Conclusions

Current study extends prognostic significance of RR to 1 year follow-up. RR more prominent for those randomly assigned to DBT-BED than ACGT. Implications discussed.     

Does coping predict CO2-induced panic in patients with panic disorder?

Patients with panic disorder (PD) show maladaptive coping but the role of coping in the pathogenesis of panic is unclear. This study examined general coping and panic-specific coping as predictors of fear responding to CO2 inhalation. Subjective and physiological responses including panic attacks were assessed in 45 patients with PD and 45 matched nonclinical controls. Measures of coping were the primary predictors used in the analyses. Consistent with other reports, patients with PD reported increased emotion-focused coping and there was an association between emotion-focused coping and subjective reactivity. However, only panic-specific coping predicted panic attacks in response to the CO2 challenge.     

A meta-analytic review of stopping performance in attention-deficit/hyperactivity disorder: deficient inhibitory motor control?

This review discusses whether deficient inhibitory motor control is the core deficit of attention-deficit/hyperactivity disorder (ADHD). Inhibitory motor control is commonly assessed using the stop-signal paradigm. Since the last meta-analysis that was performed, 33 new studies have appeared. The current meta-analysis revealed a significant difference between ADHD patients and matched controls in stop latency (stop-signal reaction time) in both children and adults. Basic reaction time was significantly longer in children with ADHD, but not in adults, and there was a significant interaction between the elongation of the latency to stop and to respond in adults, but not in children. Deficient inhibitory motor control may be less crucial in children than in adults with ADHD.     

Multiple causal pathways in attention-deficit/hyperactivity disorder – Do emerging executive and motivational deviations precede symptom development?

The multiple causal pathways model on the etiology of attention-deficit/hyperactivity disorder (ADHD) is well established. However, developmental implications of the model are not yet sufficiently analyzed. The model implies that critical neural and neuropsychological deviations from normative development precede secondarily developing ADHD symptoms. Cognitive, “cool” inhibitory control (CIC) and reward-related, “hot” functions (RRF) are regarded as neuropsychological basic deficits that indicate independent causal pathways. Both functions involve top-down control networks that undergo major normative developmental changes in the preschool period. We formalized the following assumptions in a path model: (a) CIC and RRF predict change in ADHD symptoms in the preschool period, (b) the reverse is not true, and (c) CIC and RRF independently contribute to this prediction. A community-based sample of 125 (71 boys) preschoolers was assessed at at age 4 and 5 years. At each assessment wave, CIC and RRF were measured by a battery of age-appropriate valid tasks. ADHD symptoms were measured by a clinical parent interview. Evaluation of model fit using manifest maximum likelihood parameter estimation clearly supported the hypothesized path model while controlling for gender of child and maternal education level. Thus, regarding the basic deficits of CIC and RRF, the results add evidence on the developmental implications of the multiple causal pathways model. Our findings point to the potential significance of these early emerging characteristics as indicators of risk and as targets for preventive interventions.     

Inhibitory deficits and symptoms of attention-deficit hyperactivity disorder: How are they related to effortful control?

Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms – inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.     

A multi-dimensional model of the origins of attitude certainty: teachers’ attitudes toward attention-deficit/hyperactivity disorder

This research tested and extended a laboratory-derived model of the origins of attitude certainty using a real attitude object: Teaching children with attention-deficit/hyperactivity disorder (ADHD). In Study 1, an experiment manipulated the amount of information, thought, and consistency of information delivered to pre-service teachers ( $n = 224$ ) with no prior experience with ADHD. Structural equation modelling (SEM) of Study 1 did not support the original model, in which relationships between attitude certainty and objective knowledge, thought, and consistency were mediated by perceived knowledge, thought, and ambivalence. Instead, objective amount of information, thought, and consistency interacted in their effect on attitude certainty. Study 2 ( $n = 368$ ) used a survey to test whether experiences with ADHD (personal, direct and indirect) among in-service and pre-service teachers were antecedents of attitude certainty, and to test perceived accessibility as a mediator. SEM supported both these hypotheses. Perceived accessibility and perceived knowledge mediated the relationship between attitude certainty and prior experiences with ADHD, and between attitude certainty and objective knowledge. Together, the results suggest that psychological processes underlying strong attitude certainty differ according to the familiarity and personal relevance of the attitude object, and the context and stage of attitude formation. The results have practical utility for teacher training at pre-service and in-service levels.     

Is the Cogmed program effective for youths with attention deficit/hyperactivity disorder under pharmacological treatment?

The primary objective of this study was to examine the effects of the Cogmed training program on working memory among youths 7 to 13 years old, with attention deficit/hyperactivity disorder (ADHD) type and comorbidity controlled for. A secondary objective was to examine the generalization of effects to ADHD symptoms, nonverbal reasoning, attentional and executive functions, inhibition, reading comprehension, and mathematical reasoning. Participants were under pharmacological treatment for ADHD combined type and a comorbidity. They were randomized into an experimental group that received the Cogmed program and an active control group that received a low-intensity comparison version of the training. They were evaluated at three time points: 6 weeks prior to intervention onset (T1), immediately prior to onset (T2), and 1 week following intervention completion (T3). Results indicate no significant effect attributable to the Cogmed program. The fact that participants were on medication at the time of training and evaluation normalized their performances and limited the detection of effects. Moreover, cognitive training did not lead to a reduction in ADHD symptoms or to an improvement in the other cognitive functions measured or in academic performance. The results of this study do not demonstrate the effectiveness of the Cogmed program for youths with ADHD combined type and a comorbidity when they receive the training while under pharmacological treatment.     

Does role stress predict burnout over time among health care professionals?

Abstract

The main objective of this study is to test the effects over time of three role stress variables (role conflict, role ambiguity and role overload) on the three burnout dimensions (emotional exhaustion, depersonalization and personal accomplishment). Based on theoretical models on burnout and on meta-analytical research, it is hypothesized that the three role stress variables will predict changes over time in emotional exhaustion and depersonalization, but not in personal accomplishment. The results obtained by means of hierarchical regression analysis partially support the hypothesis. The three role stress variables predict emotional exhaustion over time. Role conflict and role overload predict depersonalization over time. Finally, contrary to expectations, role ambiguity predicts personal accomplishment over time.     

Does role stress predict burnout over time among health care professionals?

Abstract The main objective of this study is to test the effects over time of three role stress variables (role conflict, role ambiguity and role overload) on the three burnout dimensions (emotional exhaustion, depersonalization and personal accomplishment). Based on theoretical models on burnout and on meta-analytical research, it is hypothesized that the three role stress variables will predict changes over time in emotional exhaustion and depersonalization, but not in personal accomplishment. The results obtained by means of hierarchical regression analysis partially support the hypothesis. The three role stress variables predict emotional exhaustion over time. Role conflict and role overload predict depersonalization over time. Finally, contrary to expectations, role ambiguity predicts personal accomplishment over time.     

Ear-catching? Real-world distractibility scores predict susceptibility to auditory attentional capture

Although many of the everyday distractions that we encounter are auditory, most research on distractor processing to date has focused on the visual domain. A common measure of everyday distractibility is the Cognitive Failures Questionnaire (CFQ; Broadbent, Cooper, FitzGerald, & Parkes British Journal of Clinical Psychology 21: 1–16, 1982), which has previously been successfully linked with performance on controlled visual-attention tasks (e.g., Forster & Lavie Psychological Science 18: 377–381, 2007; Kanai, Dong, Bahrami, & Rees Journal of Neuroscience 31: 6620–6626, 2011; Tipper & Baylis Personality and Individual Differences 8: 667–675, 1987), such that high scorers tend to display greater distractor interference than do low scorers. We examined whether the same relationship would hold in hearing. Participants performed an auditory attentional-capture task, by responding to a target sound while ignoring an irrelevant singleton distractor (presented on half of the trials). We found that CFQ score successfully predicted distractor interference, since participants who reported being more distractible in everyday life produced more errors in the presence of the irrelevant singleton than did low scorers on the CFQ. This finding is the first to demonstrate a relationship between auditory distractor interference and everyday distractibility, and it confirms that performance on this type of laboratory-based attentional-capture task can successfully be related to behavior outside the laboratory.     

Passive coping response to depressive symptoms among low-income homebound older adults: Does it affect depression severity and treatment outcome?

Due to their homebound state, lack of financial resources, and/or other life demands, a significant proportion of depressed, low-income homebound older adults experience depression. Because of their limited access to psychotherapy, most of these older adults self-manage their depressive symptoms. The purposes of this study were to examine (1) the relationship between homebound older adults' coping responses to depressed mood and the severity of their depressive symptoms at baseline (n = 121), and (2) the moderating effect of passive coping responses on the relationship between participation in problem-solving therapy (PST: in-person or telehealth delivery) and depressive symptoms at 12- and 24-week follow-ups. Controlling for the effects of demographic and disability characteristics, cognitive passive coping was significantly associated with baseline depressive symptoms, while behavioral passive coping was not. The main effect of baseline cognitive passive coping response was also significant in mixed-effects regression analysis, but the interaction between coping pattern and group was not significant. The results point to a possibility that cognitive passive copers may have benefited as much from PST as the rest of the PST participants. Further research needs to examine the moderating effect of coping responses to depressive symptoms on treatment efficacy of PST and other psychosocial interventions for late-life depression.