Diagnosis of ADHD in Adults: What Is the Appropriate DSM-5 Symptom Threshold for Hyperactivity-Impulsivity?

Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal DSM-IV criteria for ADHD combined or predominantly inattentive subtypes based on a structured diagnostic interview keyed to DSM-IV (Conners' Adult ADHD Diagnostic Interview for DSM-IV [CAADID]). All participants also completed the Conners' Adult ADHD Rating Scale (CAARS), which was normed on the general adult population and includes subscales for DSM-IV inattentive and DSM-IV hyperactive-impulsive symptoms. A T-score threshold of 65 (at least 1.5 SD above population mean) on the CAARS DSM-IV hyperactive-impulsive dimension was used to identify participants with empirically elevated symptom severity. Results: Of 88 participating adults, 48 (55%) had a T-score of at least 65 (1.5 SD) on the CAARS DSM-IV Hyperactive-Impulsive scale. Of these, only 25 (52%) met the DSM-IV cutoff of six hyperactive-impulsive symptoms on the CAADID. Thus, approximately half of those who reported empirically elevated hyperactive-impulsive complaints on the CAARS did not concurrently meet the six-symptom DSM-IV cutoff on the CAADID. An alternative cutoff of four hyperactive-impulsive symptoms on the CAADID captured 39 (81%) cases identified by the CAARS. Conclusion: In adults, mandating at least six hyperactive-impulsive symptoms excludes a significant percentage (almost half) of adults who are at least 1.5 SD above the population mean on a dimensional measure of hyperactivity-impulsivity. These data provide a compelling basis for lowering the symptom threshold of hyperactivity-impulsivity for adults in the DSM-5.     

Stability and Invariance of Psychopathic Traits from Late Adolescence to Young Adulthood

The current study examined the longitudinal stability and invariance of psychopathic traits in a large community sample of male twins from ages 17 to 23. Participants were assessed across 6 years to gauge the stability and measurement invariance of the Minnesota Temperament Inventory (MTI), a Cleckley-based measure of psychopathic personality traits, and how family functioning and externalizing behavior were linked to these traits. A latent variable approach was used to model the structure of the MTI and provide a statistical test of measurement invariance across time. The results revealed support for invariance and moderate to strong stability of the MTI factors, which showed significant associations with the external correlates in late adolescence but not early adulthood.     

Does survival processing enhance implicit memory?

Recent research has shown that human memory may have evolved to remember information that has been processed for the purpose of survival, more so than information that has been processed for other purposes, such as home-moving. We investigated this survival-processing advantage using both explicit and implicit memory tests. In Experiment 1, participants rated words in one of three scenarios: survival, pleasantness, and moving, followed by a timed stem-cued recall/stem-cued completion task. Items were completed more quickly in the survival scenario, as compared with the other two for the explicit task, but no differences were found across conditions in the implicit task. In Experiment 2, the implicit task was changed to concreteness judgments to encourage more conceptual processing. Again, the survival-processing advantage occurred in the explicit task (speeded item recognition), but not in the implicit task. These results suggest that a survival-processing advantage may benefit participants’ memory performance only during explicit retrieval.     

Testing the associative-link hypothesis in immediate serial recall: Evidence from word frequency and word imageability effects

Two immediate serial recall experiments were conducted to test the associative-link hypothesis (Stuart & Hulme, 2000 Stuart, G. and Hulme, C. 2000. The effects of word co-occurrence on short-term memory: Associative-links in long-term memory affect short-term memory performance. Journal of Experimental Psychology: Learning, Memory, and Cognition, 26: 796–802. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). We manipulated interitem association by varying the intralist latent semantic analysis (LSA) cosines in our 7-item study word lists, each of which consists of high- or low-frequency words in Experiment 1 and high- or low-imageability words in Experiment 2. Whether item recall performance was scored by a serial-recall or free-recall criterion, we found main effects of interitem association, word imageability, and word frequency. The effect of interitem association also interacted with the word frequency effect, but not with the word imageability effect. The LSA-cosine×word frequency interaction occurred in the recency, but not primacy, portion of the serial position curve. The present findings set explanatory boundaries for the associative-link hypothesis and we argue that both item- and associative-based mechanisms are necessary to account for the word frequency effect in immediate serial recall.     

Negative Affect Shares Genetic and Environmental Influences with Symptoms of Childhood Internalizing and Externalizing Disorders

The co-occurrence of internalizing and externalizing disorders suggests that they may have common underlying vulnerability factors. Research has shown that negative affect is moderately positively correlated with both internalizing and externalizing disorders in children. The present study is the first to provide an examination of negative affect in relation to a wide spectrum of childhood internalizing and externalizing problems using a biometric model. This study extends prior findings of more narrowly focused associations by using a factor approach including multiple disorders. The sample for this study included families of 691 same-sex 7- to 13-year old twin pairs. A multifactorial independent pathway model was used to examine the genetic and environmental influences underlying the covariation of parent-reported negative affect, internalizing symptoms, and externalizing symptoms. Results of the current study suggest that negative affect shares genetic and environmental influences with both internalizing and externalizing disorders in childhood. These common influences may partially explain their comorbidity. Understanding that negative affect is at least one contributor to the covariation among these disorders may highlight avenues for early risk assessment, intervention, and perhaps prevention.     

Delusion,Dissociation and Identity

Abstract

Envy and resentment are generally thought to be unpleasant and unethical emotions which ought to be condemned. I argue that both envy and resentment, in some important forms, are moral emotions connected with concern for justice, understood in terms of desert and entitlement. They enable us to recognise injustice, work as a spur to acting against it and connect us to others. Thus, we should accept these emotions as part of the ethical life.     

Debriefing work experience: A reflection on reflection?

Using date from a pilot study into pupil work experience pre-16, it is argued that work experience has expanded rapidly on the basis of little evidence and many claims about what it can achieve. As experience-based learning, it relies heavily upon debriefing to maximise its learning potential. If work experience is to be more than a work transition exercise, then debriefing becomes central to its success. Although difficult to accomplish and surrounded by muddled definitions, this approach deserves greater attention in view of the contribution it can make to pupils' ability to manage their own learning and the foundation it can provide for continuous learning throughout life.