Briefly Noted

Researchers have found that attention‐deficit hyperactivity disorder (ADHD) may be a risk factor for developing smartphone addiction, based on the neurobiological substrates underlying each separately and those that are shared. The study found a greater than six times likelihood that children with ADHD also had smartphone addiction. The study looked at the prevalence of smartphone addiction and its association with depression, anxiety, and ADHD symptoms in a total of 4,512 South Korean middle and high school students, who completed surveys. There were 338 subjects (7.5%) in the smartphone addiction group. The odds ratio of the ADHD group compared to the non‐ADHD group for smartphone addiction was 6.43, the highest among all variables. The study, “The relationship between smartphone addiction and symptoms of depression, anxiety, and attention‐deficit/hyperactivity in South Korean adolescents” is published in the March issue of the Annals of General Psychiatry.     

Approaching ADHD as a chronic condition: implications for long-term adherence

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic conditions of childhood. Although evidence-based treatments for ADHD, including stimulant medication and behavior modification, have long been established, and guidelines for care of ADHD in primary care settings have been developed, adherence to long-term therapy is poor among youth with ADHD. This article proposes use of the Chronic Care Model for Child Health, the purpose of which is to develop informed, activated patients who will interact with a prepared, proactive health care team. Six "pillars" make up the model: decision support, delivery system design, clinical information systems, family and self-management support, community resources and policies, and health care organizations. Each of these is discussed, and an individual example is described. Adopting the Chronic Care Model for Child Health has the potential to improve the quality of care for ADHD.     

Nonmedication Treatments for Adult ADHD: Evaluating Impact on Daily Functioning and Well-Being

Abstract

Professor J. Russell Ramsey has written a short book aimed at practicing mental health clinicians, describing various non-medication approaches to the treatment of adult attention-deficit/hyperactivity disorder (ADHD). It includes a variety of strategies, some of which are validated and others of which are currently being developed but do not yet demonstrate effectiveness, alongside the documented effectiveness of medications for the treatment of core symptoms of ADHD, especially inattention, hyperactivity and impulsivity. He includes an up-to-date bibliography and critical evaluations of effectiveness for each treatment, especially functional outcomes. Given the high rate of postsecondary students with ADHD, the book should be helpful for college health professionals who are trying to assist such students.     

Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant,sex, and subtype differences

Objective: This study examined symptoms of anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD). Participants: Data were collected between March 2011 and March 2016 from 150 college students with ADHD and 150 college students without ADHD. Method: Participants with ADHD were compared to a sex- and ethnicity-matched control group. For the ADHD group, parent and self-report of anxiety and depression were also compared. Results: College students with ADHD self-reported significantly higher anxiety and depressive symptoms than did students without ADHD. Scores on parent-report measures of anxiety and depressive symptoms were significantly higher than scores on self-report measures. Significant sex differences were found for participants with ADHD, with females showing higher depressive and anxiety symptoms than males. Parent-reported anxiety symptoms were higher for those with inattentive type ADHD compared to combined type ADHD. Conclusion: The current study highlights the importance of multi-informant assessment in ADHD evaluations for college-aged adults.     

Social Perception in Students with Learning Disabilities and Attention-Deficit/Hyperactivity Disorder

The current study investigated whether students' classification of learning disabled (LD), learning disabled with attention-deficit/hyperactivity disorder (LD/ADHD), or no classification (REG) was related to their ability to perceive nonverbal social cues. Participants in the study were 57 students between the ages of six and ten years identified as being LD, LD/ADHD, or REG. The Diagnostic Analysis of Nonverbal Accuracy test (DANVA) and the Social Perception Behavior Rating Scale (SPBRS) were used to measure social perception. A MANOVA was computed for the four subtests of the DANVA (Facial Expressions, Postures, Gestures, and Paralanguage). A separate ANOVA was computed on the SPBRS. Significant differences were found for Facial Expressions and SPBRS scores. Follow-up analysis revealed that on the Facial Expressions subtest, students with LD demonstrated significantly more difficulty in the accurate perception of cues than the REG or LD/ ADHD groups. On the SPBRS, the LD/ADHD group was rated by teachers as significantly less socially perceptive than the REG group.     

Qualitative data analysis with hypertext: A case of New York City crack dealers

Ethnography has become a useful method in procuring sensitive information from the ‘hidden population’ who may not be accessed with quantitative survey techniques. Researchers are generating huge amounts of qualitative/textual data. Qualitative data require careful planning in storage, coding, retrieval, and analysis. Personal computers have solved data management problems, but data analysis remains problematic. The paper describes some qualitative data management and analytic problems faced by a team of ethnographers engaged in a longitudinal epidemiological study of cocaine and crack distribution/abuse in New York City. Ethnographic data was collected through multi-session open-ended interviews with more than one hundred cocaine/crack dealers and extensive field-notes were kept. Compared to other programs, a hypertext software — Folio Views — was more useful in solving (a) data management and (b) analytical problems. Authors used this software to handle more than twenty-five thousand pages of texts; search and sort the database by any words or codes; and retrieve relevant textual materials needed to complete comparative and thematic analysis. Authors analyzed the data from outsiders’ point of view (etic) as well as from the viewpoint of the subject populations (emic).     

Young Adult Romantic Couples’ Conflict Resolution and Satisfaction Varies with Partner's Attention–Deficit/Hyperactivity Disorder Type

Attention‐deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem‐solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C‐couples), having one partner identified with ADHD inattentive type (IA‐couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self‐reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C‐couples’ behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples’ relational satisfaction. IA‐couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C‐couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.     

Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

Using an interview‐based analysis of the accounts of interactions between educators, parents, and clinicians, this study explores educators' roles in interpreting childhood troubles as the medical phenomenon of attention deficit‐hyperactivity disorder (ADHD). The analysis of interviews shows how children's “personal” troubles become understood as “relational” ones, prompting increasingly sophisticated social responses. I argue that the institution of education, operating in a clinical capacity but lacking the legitimate authority to assign ADHD diagnoses, plays a hybridized, semiofficial role in the medicalization process. This assertion informs a critique of the “informal/official” dichotomy found in the sociology of deviance lexicon, and furthers previous positions in the sociology of mental health that have implicated school representatives in the social construction of behavior disorders.     

Perceived social support in Chinese parents of children with attention deficit hyperactivity disorder in a Chinese context: Implications for social work practice

This article reports the results of a Hong Kong study (no. of parents = 121) which identified perceived social support (PSS), both overall and four types of support, of Chinese parents of children with attention deficit hyperactivity disorder (ADHD) and examined the impact of PSS on the interrelationship between the ADHD symptoms and parenting stress. The parents perceived support of their primary social network as more satisfactory than professionals’. Parenting stress of the high PSS group was lower than the low PSS group’s. The PSS-overall, parenting role, and the ADHD symptoms explained a significant variance of parenting stress. The results pave the way to develop a complex social work model in helping.     

Professor Perceptions of College Students With Attention Deficit Hyperactivity Disorder

Objective: From April to June 2005, the authors investigated professor perceptions of college students with attention deficit hyperactivity disorder (ADHD). Participants: 253 participants completed the ADHD Beliefs Survey-Revised, a 40-question survey measuring professor perceptions of ADHD. Methods: Analysis of variance measured false and reasonable beliefs related to ADHD. Results: Results indicated that professors with differing levels of education, years of teaching experience, colleges in the university or community college, previous experiences with a student with ADHD, and ADHD training did not differ significantly in perceptions regarding general ADHD knowledge or college students with ADHD.     

Attention deficit disorder: Problems with preconceived diagnosis

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) has become a household term with many inaccurate conceptions and expectations. The label is being applied to children with a broad range of mental health problems and developmental disorders. This study looks at the impact of preconceived diagnosis on assessment and treatment of children and adolescents. Alarming trends of overidentification of ADHD, which lead to inappropriate treatment and management, are identified. Other causes of the target symptoms are discussed. The impact of preconceived diagnosis on treatment outcome, patient functioning, and other areas are addressed. The need for greater community awareness of the broad spectrum of disorders of childhood and adolescence is identified.     

The construction of fear: Americans' preferences for social distance from children and adolescents with mental health problems

Debates about children's mental health problems have raised questions about the reliability and validity of diagnosis and treatment. However, little research has focused on social reactions to children with mental health problems. This gap in research raises questions about competing theories of stigma, as well as specific factors shaping prejudice and discrimination toward those children. Here, we organize a general model of stigma that synthesizes previous research. We apply a reduced version of this model to data from a nationally representative sample responding to vignettes depicting several stigmatizing scenarios, including attention-deficit/hyperactivity disorder (ADHD), depression, asthma, or "normal troubles." Results from the National Stigma Study-Children suggest a gradient of rejection from highest to lowest, as follows: ADHD, depression, "normal troubles," and physical illness. Stigmatizing reactions are highest toward adolescents. Importantly, respondents who label the vignette child's situation as a mental illness compared to those who label the problem as a physical illness or a "normal" situation report greater preferences for social distance, a pattern that appears to result from perceptions that the child is dangerous.     

Dysfunctional Career Thoughts and Perceived Quality of Parental Relationships in Adolescents With Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is known to cause significant difficulties in interpersonal relationships. Empirical research in career development has demonstrated that close, supportive relationships are associated with positive vocational behaviors (Kenny et al., 2018). We examined dysfunctional career thoughts and perceived quality of parental relationships in high school students with ADHD. One hundred two adolescents (76 boys, 26 girls) with ADHD responded to measures of career thoughts and interpersonal relationship quality. Preliminary exploratory analysis, using multiple linear regression, showed that male participants' dysfunctional career thoughts were statistically significantly related to their relationships with their mothers. For female participants, relationships with fathers represented an area for further exploration. Results suggest that career professionals can enhance positive outcomes of decision-making and problem-solving issues in adolescence with additional focus on relational interventions. Future research should incorporate the influence of gender and race/ethnicity on crucial relationships and focus on paternal relationships using cognitive information processing–based interventions with this population.     

Bipolar disorder in children

This article presents an overview of bipolar disorder (BPD) in children, a condition that only recently has been recognized as a legitimate diagnosis. Bipolar disorder in children is underrecognized for many reasons including lack of awareness, diagnostic confusion, and the different clinical picture in children. Available data strongly suggest that prepubertal childhood BPD is a non-episodic, chronic, rapid cycling, mixed manic state. It may be comorbid with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) or it may demonstrate features of ADHD and CD, further complicating recognition and subsequent treatment. Treatment issues are discussed, and some reasons for the urgency of early recognition and treatment are explained.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part I

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of Attention-deficit/hyperactivity disorder (ADHD). Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. This meta-synthesis compiled and analyzed a systematic review of the qualitative studies of parents’ lived experience of having a child with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to seventy-three studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. One major finding involved the emotional burden of caring for a child with ADHD. Parents struggled with a variety of intense and painful emotions as they attempted to manage family routines. Disciplining children only worked in a limited way and took constant effort throughout the day. The challenges of parenting spilled into other areas of the parents’ lives, such as their health, psychological, marital, and occupational functioning. Implications for practitioners are discussed, including the need to validate parental stress and the difficulty of applying behavioral management strategies with their children, the need for increased support of partner relationships, and the need to connect parents with support to prevent poorer outcomes for the child.     

Dictating the boundaries of ab/normality: a critical discourse analysis of the diagnostic criteria for attention deficit hyperactivity disorder and hyperkinetic disorder

In this article we report the findings of a critical discourse analysis of the diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and hyperkinetic disorder (HD) in two clinical manuals – Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. We examine the actions (behaviors) that are said to indicate the presence of ADHD/HD and analyze what the inclusion of these actions reveals about the relationship between ADHD/HD, cultural knowledge, and values. Our analysis reveals that both manuals use subjective, value-laden language to construct a mentally ill individual in opposition to an unseen, supposedly ‘normal’ person. We argue that the current criteria draw into question whether ADHD/HD meets the manuals’ own definitions of a disorder, and further that the discourse of the manuals is intertwined with the everyday practices of schools and serve to legitimize status quo educational practices.     

Pemoline in Adult Attention Deficit Hyperactivity Disorder: Predictors of Nonresponse

Abstract

The psychostimulants are the most widely used treatment modality for attention deficit/hyperactivity disorder (ADHD). Although positive responses to psychostimulants have been demonstrated, 46% of adults with ADHD, on average, are nonresponsive or cannot tolerate the medications because of adverse effects. We reviewed the charts of 43 students treated with pemoline and studied parameters of nonresponse. Sixteen (37%) met the study definition of nonresponse. Of these, 5 (12%) were symptom nonresponders and 11 (25%) were nonresponders because of adverse effects. We found a significant relationship between age and nonresponse resulting from adverse effects, yet no other factors predicted nonresponse to pemoline. Clinicians should consider using smaller starting doses of pemoline in adults to minimize adverse effects.     

Disordered gamblers with and without ADHD: the role of coping in elevated psychological distress

Attention-deficit/hyperactivity disorder (ADHD) is significantly more prevalent among disordered gamblers than in the general adult population. Despite this, it remains unclear whether co-occurring ADHD is associated with clinically significant differences that call for specialized assessments and treatment planning. The purpose of this article was to explore differences in psychological distress and coping strategies among individuals presenting to an outpatient gambling treatment centre with and without co-occurring adult ADHD. Participants (n = 99) were primarily female (69%) and Caucasian (86%) outpatient treatment-seeking disordered gamblers. At intake, individuals completed self-report measures of coping (Coping Inventory for Stressful Situations – Adult Form), psychological distress (Beck Depression Inventory II) and ADHD (Brown Attention-Deficit Disorder Scales – Adult Form). Results indicated that individuals with ADHD (n = 42) reported significantly more psychological distress and less adaptive coping strategies than those without co-occurring ADHD (n = 57). Mediation analyses showed that an ADHD diagnosis had an indirect effect on psychological distress via the mediator of maladaptive coping. Assessment and treatment should be tailored to address the variety of presentations of gambling disorder. Screening for ADHD at intake may be helpful in creating an individualized treatment plan for disordered gamblers.     

Associations among sleep problems,executive dysfunctions,and attention-deficit/hyperactivity disorder symptom domains in college students

Objective: The present study examined whether executive functions (EFs) and sleep problems operate together to predict four attention-deficit/hyperactivity disorder (ADHD) symptom domains. Methods: A sample of 306 college students completed ratings of sleep quality, EFs, and ADHD symptoms from January to December 2014. Simultaneous multiple regressions were used to examine (a) the unique contribution of EFs and sleep problems to ADHD symptoms, (b) the relations among EFs, sleep problems, and GPA, and (c) the relations between specific EF facets (i.e., time management, emotion regulation, problem solving, self-restraint, and self-motivation) and ADHD symptoms. Results: While approximately 52.8% of participants were categorized as poor-quality sleepers, 10.6% of the sample reported an ADHD diagnosis. EF ratings were associated uniquely with ADHD symptoms after controlling for sleep quality. All EF facets were related to ADHD symptoms. Conclusion: ADHD symptoms are associated with all EF facets even after controlling for sleep quality.     

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.