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.     

Mothers' and Fathers' Internal State Language with Their Young Children: An Examination of Gender Differences During an Emotions Task

The current study examined gender differences in mothers' and fathers' internal state language (ISL), children's use of ISL, and whether ISL was related to parents' ratings of the children's social skills. Fifty‐seven (28 boys, 29 girls) toddler/preschool children (M age = 32.5 months, SD = 5.38 months) were observed separately with their mothers and fathers in their homes while they discussed pictures of children's facial expressions of emotions. Parents completed a questionnaire concerning their child's social–emotional behaviours (i.e. BASC‐2). Parents used more ISL with sons compared with daughters, and sons used more ISL with mothers than with fathers. No overall differences were found between mothers' and fathers' ISL. Children's social skills as rated by mothers were predicted by mothers' ISL comments, whereas children's social skills as rated by fathers were predicted by children's age and fathers' ISL clarifications. Implications and limitations of the study are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample

Epidemiological studies of categorical mental disorders consistently report that gender differences exist in many disorder prevalence rates and that disorders are often comorbid. Can a dimensional multivariate liability model be developed to clarify how gender impacts diverse, comorbid mental disorders? We pursued this possibility in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093). Gender differences in prevalence were systematic such that women showed higher rates of mood and anxiety disorders, and men showed higher rates of antisocial personality and substance use disorders. We next investigated patterns of disorder comorbidity and found that a dimensional internalizing-externalizing liability model fit the data well, where internalizing is characterized by mood and anxiety disorders, and externalizing is characterized by antisocial personality and substance use disorders. This model was gender invariant, indicating that observed gender differences in prevalence rates originate from women and men's different average standings on latent internalizing and externalizing liability dimensions. As hypothesized, women showed a higher mean level of internalizing, while men showed a higher mean level of externalizing. We discuss implications of these findings for understanding gender differences in psychopathology and for classification and intervention.     

Children show heightened memory for threatening social actions

Three experiments investigated whether a negativity bias in social perception extends to preschool-aged children's memory for the details of others' social actions and experiences. After learning about individuals who committed nice or mean social actions, children in Experiment 1 were more accurate at remembering who was mean compared with who was nice. In Experiment 2, children showed a memory advantage for the specific details of actions committed by mean individuals compared with nice individuals. In Experiment 3, children exhibited better memory for the details of mean actions compared with nice actions when the vignettes were presented from the perspective of the recipients instead of the perpetrators of these actions. Taken together, these findings suggest that children show heightened memory for the details of negative social actions over positive social actions. Such a memory bias may be advantageous in helping children to predict potentially threatening situations in the future.     

Does power corrupt or enable? When and why power facilitates self-interested behavior

Does power corrupt a moral identity, or does it enable a moral identity to emerge? Drawing from the power literature, we propose that the psychological experience of power, although often associated with promoting self-interest, is associated with greater self-interest only in the presence of a weak moral identity. Furthermore, we propose that the psychological experience of power is associated with less self-interest in the presence of a strong moral identity. Across a field survey of working adults and in a lab experiment, individuals with a strong moral identity were less likely to act in self-interest, yet individuals with a weak moral identity were more likely to act in self-interest, when subjectively experiencing power. Finally, we predict and demonstrate an explanatory mechanism behind this effect: The psychological experience of power enhances moral awareness among those with a strong moral identity, yet decreases the moral awareness among those with a weak moral identity. In turn, individuals' moral awareness affects how they behave in relation to their self-interest.     

Searching for the self: an identity control theory approach to triggers of occupational exploration

Identity control theory researchers have found evidence for two processes of identity development (identity defense and identity change) and have theorized a third process (identity exploration). College students (N = 123) self-rated as high or low in occupational identity certainty and importance received self-discrepant feedback to induce identity disturbance, and dependent measures of identity defense, identity change, and identity exploration were obtained. As predicted, high certainty about identity standards led to identity defense, while low certainty led to identity change. Although an interaction between certainty and importance was hypothesized to predict identity exploration, results showed that the two operated independently. Low certainty predicted exploration of additional occupational areas, whereas high importance predicted exploration of self, environment, and additional occupational areas.     

The Role of Spiritual Experiences and Activities in the Relationship Between Chronic Illness and Psychological Well-Being

Our research explores the correlates of spiritual experiences over a 2-year period in a sample of older adults (N = 164; mean age 81.9 years) living in a continuing care retirement community. Utilizing responses to the Daily Spiritual Experiences Scale, scores were analyzed for changes over time and for their hypothesized moderating effect in the relationship between chronic illness impact and markers of psychological well-being (as measured by the Geriatric Depression and Life Satisfaction scales). Repeated measures ANOVA indicated a significant decline (P < .01) in the reported spiritual experiences over a 2-year period of time, and t tests showed a significant difference by gender (P < .01) in years 1 and 2, with women reporting higher levels of spiritual experiences than men. Analyses found low spirituality scores associated with low life satisfaction in all years (baseline: r = ?.288, P < .01; year 1: r = ?.209, P < .05; year 2: r = ?.330, P < .001). Only weak associations were detected between low spirituality and the presence of depressive symptoms at baseline (r = .186, P < .05) and year 2 (r = .254, P < .01). Moderation effects of spirituality on the relationship between chronic illness impact and markers of psychological well-being were explored in all years, with a statistically significant effect found only for the presence of depressive symptoms in year 2. Higher impact of chronic illnesses is associated with more depressive symptoms under conditions of low spirituality. Future research may center upon longer-duration evaluation of reliance upon spiritual practices and their impact in care management models.     

Revisiting backward recall and benchmark memory effects: a reply to Bireta et al. (2010)

When participants are asked to recall lists of items in the reverse order, known as backward recall, several benchmark memory phenomena, such as the word length effect, are abolished (Bireta et al. Memory & Cognition 38:279–291, 2010). Bireta et al. (Memory & Cognition 38:279–291, 2010) suggested that in backward recall, reliance on order retention is increased at the expense of item retention, leading to the abolition of item-based phenomena. In a subsequent study, however, Guérard and Saint-Aubin (in press) showed that four lexical factors known to modulate item retention were unaffected by recall direction. In a series of five experiments, we examined the source of the discrepancy between the two studies. We revisited the effects of phonological similarity, word length, articulatory suppression, and irrelevant speech, using open and closed pools of words in backward and forward recall. The results are unequivocal in showing that none of these effects are influenced by recall direction, suggesting that Bireta et al.’s (Memory & Cognition 38:279–291, 2010) results are the consequence of their particular stimuli.     

Self-reported discrimination and discriminatory behaviour: the role of attachment security

Past research shows that attachment security is linked to low prejudice (Hofstra, Van Oudenhoven & Bunnk, 2005; Mikulincer & Shaver, 2001). We extend this research by examining the role of attachment security in discriminatory choices and discriminatory behaviour. The current study examines the influence of primed attachment security (vs. neutral prime) on self-reported discrimination and actual discriminatory behaviour towards Muslims. Results illustrate that primed attachment security (vs. a neutral prime) significantly predicts both the choice to discriminate against Muslims and subsequent behavioural discrimination towards a Muslim. Implications for increasing attachment security as a means of reducing prejudice and discrimination are discussed.     

Recognising faces seen alone or with others: why are two heads worse than one?

The ability to identify an unfamiliar target face from an identity lineup declines when the target is accompanied by a second face during visual encoding. This two-face disadvantage is still little studied and its basis remains poorly understood. We investigated several possible explanations for this phenomenon. Experiments 1 and 2 varied the number of potential targets (1 or 2) and the number of faces in a lineup (5 or 10) to explore if this effect arises from the number of identity comparisons that need to be made to detect a target in a lineup. We also explored if this effect arises from an uncertainty concerning which is the to-be-identified target in two-face displays, by cueing the relevant face during encoding. In experiment 3 we then examined whether the two-face disadvantage reflects the depth of face encoding or a memory effect. The results show that this effect arises from the additional comparisons that are necessary to compare two potential targets to an identity lineup when memory demands are minimised (experiment 1), but it reflects a difficulty in remembering several faces when targets and lineups cannot be viewed simultaneously (experiments 2 and 3). However, in both cases the two-face disadvantage could not be eliminated fully by cueing the target. This hints at a further possible locus for this effect, which might reflect perceptual interference during the initial encoding of the target. The implications of these findings are discussed.