Multiple family therapy for Chinese families of children with attention deficit hyperactivity disorder (ADHD): treatment efficacy from the children’s perspective and their subjective experiences

This paper reports the results of our study that assessed the treatment efficacy of multiple family therapy (MFT) from the perspective of participating Chinese children with attention deficit hyperactivity disorder (ADHD) and identified their subjective experiences. Forty‐three children with ADHD in the experimental group (EG) completed a forty‐two‐hour MFT, whilst forty‐five children with ADHD in the control group (CG) had attended two writing classes scheduled three months apart that were similar to those of the MFT. Data from the outcome study were gathered using standardized questionnaires and data from the qualitative study were drawn from thirteen children with ADHD who had completed the MFT and attended the focus group interviews (n = 5) or individual interviews (n = 8) conducted in the post‐treatment phase. The results of the Paired sample t‐test and MANOVA indicated no significant changes on the scores for the four measures adopted (perception of competence, hopefulness, parent‐child relationship and perceived social support) in the pre‐ and post‐treatment for the EG and the CG. Five themes emerged from the narratives of children with ADHD, which revealed the children’s subjective experiences with the MFT: (a) full of fun; (b) building friendships through common experiences; (c) a happy family time; (d) safe space; and (e) positive parental responses and communications.     

Examining Latino Family Participation in Treatment for Childhood ADHD: The Role of Parental Cultural Factors and Perceptions

Attention-deficit/hyperactivity disorder (ADHD) is a common mental health disorder in childhood. Unfortunately, Latino youth and their families are at increased risk of demonstrating poor treatment outcomes. The current study examined the impact of parental cultural factors and perceptions on Latino family participation in a psychosocial intervention for childhood ADHD. Sixty-one Latino youth and at least one of their primary parents and teachers participated in the current study. Results indicated that parental acculturation, attitudes regarding treatment, and baseline severity of child symptomatology and functional impairment were related to treatment participation outcomes. Implications and future directions are discussed.     

Writing abilities and the role of working memory in children with symptoms of attention deficit and hyperactivity disorder

The writing abilities of children with ADHD symptoms were examined in a simple dictation task, and then in two conditions with concurrent verbal or visuospatial working memory (WM) loads. The children with ADHD symptoms generally made more spelling mistakes than controls, and the concurrent loads impaired their performance, but with partly different effects. The concurrent verbal WM task prompted an increase in the phonological errors, while the concurrent visuospatial WM task prompted more non-phonological errors, matching the Italian phonology, but not the Italian orthography. In the ADHD group, the children proving better able to cope with a concurrent verbal WM load had a better spelling performance too. The ADHD and control groups had a similar handwriting speed, but the former group’s writing quality was poorer. Our results suggest that WM supports writing skills, and that children with ADHD symptoms have general writing difficulties, but strength in coping with concurrent verbal information may support their spelling performance.     

Which components of processing speed are affected in ADHD subtypes?

The term “processing speed” (PS) encompasses many components including perceptual, cognitive and output speed. Despite evidence for reduced PS in Attention-Deficit/Hyperactivity Disorder (ADHD), little is known about which component(s) is most impacted in ADHD, or how it may vary by subtypes. Participants included 151 children, ages 8–12 years, with ADHD Predominantly Inattentive Type, ADHD Combined Type and typically developing controls using DSM-IV criteria. All children completed four measures of processing speed: Symbol Search, Coding, Decision Speed, and simple reaction time. We found children with ADHD-PI and ADHD-C had slower perceptual and psychomotor/incidental learning speed than controls and that ADHD-PI had slower decision speed than controls. The subtypes did not differ on any of these measures. Mean reaction time was intact in ADHD. Hence, at a very basic output level, children with ADHD do not have impaired speed overall, but as task demands increase their processing speed becomes less efficient than controls’. Further, perceptual and psychomotor speed were related to inattention, and psychomotor speed/incidental learning was related to hyperactivity/impulsivity. Thus, inattention may contribute to less efficient performance and worse attention to detail on tasks with a higher perceptual and/or psychomotor load; whereas hyperactivity/impulsivity may affect psychomotor speed/incidental learning, possibly via greater inaccuracy and/or reduced learning efficiency. Decision speed was not related to either dimension. Results suggest that PS deficits are primarily linked to the inattention dimension of ADHD but not exclusively. Findings also suggest PS is not a singular process but rather a multifaceted system that is differentially impacted in ADHD.     

Laterality of the frontal aslant tract (FAT) explains externalizing behaviors through its association with executive function

We investigated the development of a recently identified white matter pathway, the frontal aslant tract (FAT) and its association with executive function and externalizing behaviors in a sample of 129 neurotypical male and female human children ranging in age from 7 months to 19 years. We found that the FAT could be tracked in 92% of those children, and that the pathway showed age‐related differences into adulthood. The change in white matter microstructure was very rapid until about 6 years, and then plateaued, only to show age‐related increases again after the age of 11 years. In a subset of those children (5–18 years; n = 70), left laterality of the microstructural properties of the FAT was associated with greater attention problems as measured by the Child Behavior Checklist (CBCL). However, this relationship was fully mediated by higher executive dysfunction as measured by the Behavior Rating Inventory of Executive Function (BRIEF). This relationship was specific to the FAT—we found no relationship between laterality of a control pathway, or of the white matter of the brain in general, and attention and executive function. These findings suggest that the degree to which the developing brain favors a right lateralized structural dominance of the FAT is directly associated with executive function and attention. This novel finding provides a new potential structural biomarker to assess attention deficit hyperactivity disorder (ADHD) and associated executive dysfunction during development.     

Comorbidity of Attention Deficit Hyperactive Disorder (ADHD) and major depression in primary school children

The study investigated comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and depression in a sample of rural primary school children in Limpopo Province, South Africa. A total of 320 learners participated in this study of whom 160 learners had teacher and parent identified ADHD symptoms (females?=?50%; age range 6–14 years). All the learners took the Beck Depression Youth Inventory, second edition. Data were analysed applying ANOVA to investigate the possible differences between and within age, gender, and ADHD subtype group differences in depression symptomatology. Results indicated no statistically significant differences in the scores on the depression scale between the children with ADHD as identified by parents and teachers and the comparison group peers.     

Neuropsychological deficits in preschool as predictors of ADHD symptoms and academic achievement in late adolescence

High levels of ADHD symptoms are related to severe negative outcomes, which underscore the importance of identifying early markers of these behavior problems. The main aim of the present study was therefore to investigate whether neuropsychological deficits in preschool are related to later ADHD symptoms and academic achievement, over and above the influence of early ADHD symptom levels. The present study is unique because it includes a broader range of predictors compared to previous studies and the participants are followed over time for as long as 13 years (i.e., ages 5–18 years). Preschool data included measures of executive functioning and reaction time variability as well as emotional reactivity and emotion regulation of both positive and negative emotions. When controlling for early ADHD symptom levels, working memory, reaction time variability, and regulation of happiness/exuberance were significantly related to inattention whereas regulation of happiness/exuberance and anger reactivity were significantly related to hyperactivity/impulsivity. Furthermore, working memory and reaction time variability in preschool were significantly related to academic achievement in late adolescence beyond the influence of early ADHD symptoms. These findings could suggest that it is possible to screen for early neuropsychological deficits and thereby identify children who are at risk of negative outcomes. Furthermore, our results suggest that interventions need to look beyond executive functioning deficits in ADHD and also target the role of emotional functioning and reaction time variability. The importance of including both the positive and negative aspects of emotional functioning and distinguishing between emotion regulation and emotional reactivity was also demonstrated.     

Quantitative EEG Assessment During Neuropsychological Task Performance in Adults with Attention Deficit Hyperactivity Disorder

This study evaluated the neuropsychological performance of adults with and without Attention Deficit Hyperactivity Disorder (ADHD) during the Paced Auditory Serial Addition Test (PASAT), Wisconsin Card Sorting Test: Computerized Version 3 (WCST), and the Integrated Visual and Auditory Continuous Performance Test (IVA). Quantitative electroencephalographic (QEEG) data were also collected during task performance to examine differences in cortical activity between groups and tasks. Results suggest that adults with ADHD demonstrated lower levels of performance on the PASAT and IVA, tasks that involve working memory and processing speed, and sustained attention, respectively. Adults with ADHD also had more upper alpha activity during the IVA. Lastly, for the ADHD group, an increased theta/beta ratio during the IVA was significantly related to poorer attentional performance. The current results support reinforcing specific types of cortical activity though EEG operant conditioning (neurofeedback) as a treatment option in adults with ADHD. This paper is based largely in part on a dissertation by J. Noland White in partial fulfillment of the requirements of his doctoral program at The University of Tennessee. Portions of this study have been presented in summary form at several professional conferences.     

成人注意缺陷多动障碍诊断与心理治疗的研究进展

注意缺陷多动障碍（ADHD）是指一种以注意缺陷、多动、冲动的行为表现为主要特征的精神病理障碍。对儿童注意缺陷多动障碍的研究有了长足的进步,但对成人注意缺陷多动障碍的研究相对较少。本文阐明了国际上对成人注意缺陷多动障碍的诊断与心理治疗的研究进展,希望引起国内临床心理学家、精神病学家和心理咨询师等的充分重视。