Thyroid function in a population of children with attention deficit hyperactivity disorder

4-Fluoro-3-nitrobenzoic acid attached to a solid support was shown to react under mild conditions with a wide range of functionalized phenols to yield, after cleavage, the corresponding biaryl ethers in excellent purity. In a similar fashion, biaryl thioethers could be obtained. Further elaboration of immobilized biaryl ethers demonstrates the potential for combinatorial library generation.     

Injury risk factors in children with attention deficit hyperactivity disorder.

Processes related to injury in children with Attention Deficit Hyperactivity Disorder (ADHD) were examined. Two groups of 7–11-year-old boys (14 ADHD and 16 controls) watched a videotape simulating play activities in order for them to identify risky behaviors and then answered questions about risky scenes. Groups did not differ in ability to identify hazards, but children with ADHD anticipated less severe consequences following risky behavior and reported fewer active methods of preventing injury than did controls. Cognitive factors, including lower expectations of personal risk in hazardous situations and less ability to generate prevention strategies and safety rules, may contribute to increased injury liability in boys with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Corpus callosum morphology in children and adolescents with attention deficit hyperactivity disorder: A meta-analytic review.

Several studies have examined corpus callosum (CC) morphology in children and adolescents with attention deficit hyperactivity disorder (ADHD). A meta-analysis of atypical brain morphology in children and adolescents with ADHD by Valera, Faraone, Murray, and Seidman (2006) reported a reduction in the splenium of the CC in this group compared with healthy controls. This meta-analysis undertook a more detailed examination of callosal morphology by also considering comorbid conditions and gender differences. The data from 13 studies were analyzed. Consistent with Valera et al. (2006), the splenium was smaller in children and adolescents with ADHD than in healthy controls. However, this result appears to be the result of a smaller splenium in females with ADHD. In addition, boys exhibited a smaller rostral body. There were no significant differences in CC measurements of studies that included ADHD samples with comorbid conditions. However, comorbidities were not consistently reported, making it difficult to accurately evaluate the impact of comorbidity on CC size. Additional research is needed to investigate whether gender differences reflect different ADHD subtypes. In addition, it is not known if these CC differences persist into adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Play therapy with children exhibiting symptoms of attention deficit hyperactivity disorder.

Sixty elementary school age children qualified as symptomatic of attention deficit/hyperactivity disorder (ADHD) were randomly assigned to 1 of 2 treatment conditions: child-centered play therapy (CCPT) or reading mentoring (RM). All children participated in 16 individual 30-min sessions in the schools. Results indicated that children who participated in 16 sessions of CCPT and RM demonstrated statistically significant improvement on the ADHD and student characteristics domains, as well as the Anxiety/Withdrawal and Learning Disability subscales of the Index of Teaching Stress and the ADHD Index of the Conners Teacher Rating Scale--Revised: Short Form. Children who participated in CCPT demonstrated statistically significant improvement over RM children on the student characteristics domain and on the Emotional Lability and Anxiety/Withdrawal subscales of the Index of Teaching Stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diversity and attention deficit hyperactivity disorder

Smooth muscle contraction is regulated primarily by the reversible phosphorylation of myosin triggered by an increase in sarcoplasmic free Ca2+ concentration ([Ca2+]i). Contraction can, however, be modulated by other signal transduction pathways, one of which involves the thin filament-associated protein calponin. The h1 (basic) isoform of calponin binds to actin with high affinity and is expressed specifically in smooth muscle at a molar ratio to actin of 1:7. Calponin inhibits (i) the actin-activated MgATPase activity of smooth muscle myosin (the cross-bridge cycling rate) via its interaction with actin, (ii) the movement of actin filaments over immobilized myosin in the in vitro motility assay, and (iii) force development or shortening velocity in permeabilized smooth muscle strips and single cells. These inhibitory effects of calponin can be alleviated by protein kinase C (PKC)-catalysed phosphorylation and restored following dephosphorylation by a type 2A phosphatase. Three physiological roles of calponin can be considered based on its in vitro functional properties: (i) maintenance of relaxation at resting [Ca2+]i, (ii) energy conservation during prolonged contractions, and (iii) Ca(2+)-independent contraction mediated by phosphorylation of calponin by PKC epsilon, a Ca(2+)-independent isoenzyme of PKC.     

The practical aspects of diagnosing and managing children with attention deficit hyperactivity disorder

AD/HD is a behaviorally defined disorder with specific behavioral criteria. The most recent definitions decrease heterogeneity by defining subtypes although the current treatments tend to be more generic. The main well-established treatments are stimulant medication and behavior modification, which are most effective when used together.     

Trauma exposure among children with oppositional defiant disorder and attention deficit–hyperactivity disorder.

Consecutive admissions to an outpatient child psychiatry clinic diagnosed with oppositional defiant disorder (ODD), attention deficit-hyperactivity disorder (ADHD), or adjustment disorder were assessed for trauma exposure by a structured clinical interview and parent report. Controlling for age, gender, severity of internalizing behavior problems, social competence, family psychopathology, and parent–child relationship quality (assessed by parent report), an ODD diagnosis, with or without comorbid ADHD, was associated with increased likelihood of prior victimization (but not nonvictimization) trauma. ADHD alone was not associated with an increased likelihood of a history of trauma exposure Traumatic victimization contributed uniquely to the prediction of ODD but not ADHD diagnoses. Children in psychiatric treatment who are diagnosed with ODD, but not those diagnosed solely with ADHD, may particularly require evaluation and care for posttraumatic sequelae. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is attention deficit hyperactivity disorder familial?

Using two sources of data, we review methodologic issues pertinent to family studies of attention deficit hyperactivity disorder to evaluate whether such studies define attention deficit hyperactivity disorder as a familial disorder. We systematically evaluate the relevant literature and provide a detailed overview of the Massachusetts General Hospital family-genetic studies of attention deficit disorder as defined in DSM-III and attention deficit hyperactivity disorder as defined in DSM-III-R. The available literature, and our double-blind, controlled studies indicate that attention deficit disorder and attention deficit hyperactivity disorder are familial. Moreover, the pattern of transmission of comorbid disorders suggests that attention deficit hyperactivity disorder is, from a familial perspective, distinct from anxiety disorders and learning disabilities. In contrast, attention deficit hyperactivity disorder with conduct disorder appears to be a familial subtype, and major depression appears to be a variable expression of the familial predisposition to attention deficit hyperactivity disorder. Although the available literature provides strong evidence for the familial transmission of attention deficit hyperactivity disorder, the mode of transmission requires further clarification. In addition, attention deficit hyperactivity disorder appears to be genetically heterogeneous, indicating that more work is needed to delineate genetically homogeneous subtypes and to describe the range of expression of their underlying genotypes. Family-genetic studies will continue to clarify the etiology and nosology of attention deficit hyperactivity disorder.     

Neuromotor functioning in children with Tourette syndrome with and without attention deficit hyperactivity disorder

Neuromotor function was assessed in 94 children of normal intelligence with Tourette syndrome, Tourette syndrome and attention-deficit hyperactivity disorder (ADHD), or ADHD only, using the Physical and Neurological Examination of Subtle Signs (PANESS). Time to complete six motor movements was analyzed separately by side (left and right) and complexity (simple and patterned). All groups performed faster on their preferred, dominant side. Although all groups took longer to complete patterned versus simple movements, the group with ADHD had a larger discrepancy for complexity than the other two groups. The speed for simple and patterned tasks was at or faster than age expectations for 54% of tasks in the group with Tourette syndrome but only 15% of tasks in the other two groups. More children in the group with Tourette syndrome (76%) than the groups with Tourette syndrome with ADHD (54%) or ADHD (54%) or ADHD only (65%) performed movements within normal time limits for age. Findings suggest that Tourette syndrome is not associated with motor slowing.     

Neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder.

The goal of this study was to assess neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder (ADHD). Participants were 156 siblings of ADHD probands with (N?=?40) and without (N?=?116) ADHD (according to criteria of the Diagnostic and Statistical Manual of Mental Disorders [3rd edition, revised; American Psychiatric Association, 1987]) and 118 siblings of non-ADHD normal controls of similar age, IQ, and grade level. Information on attention, executive, and memory functions was obtained in a standardized manner without knowledge of clinical status. Compared with siblings of controls, siblings with ADHD were significantly impaired on the Stroop test and on verbal learning and memory. In contrast, siblings without ADHD were similar to controls on virtually all measures. These data suggest that some executive, attention, and verbal learning deficits are found in nonreferred individuals with ADHD but that neuropsychological deficits are unlikely to constitute an endophenotype to ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive function in children with Tourette syndrome and/or attention deficit hyperactivity disorder

Tourette Syndrome (TS) in children is associated with various neurobehavioral disorders including attention deficit hyperactivity disorder (ADHD). Children with TS and ADHD show some difficulties with neuropsychological tasks, but we do not know if children with TS alone have neuropsychological deficits. To assess specific cognitive differences among children with TS and/or ADHD, we administered a battery of neuropsychological tests, including 10 tasks related to executive function (EF), to 10 children with TS-only, 48 with ADHD-only, and 32 with TS + ADHD. Children in all groups could not efficiently produce output on a timed continuous performance task [Test of Variables of Attention (TOVA) mean reaction time and reaction time variability]. Children with TS-only appeared to have fewer EF impairments and significantly higher perceptual organization scores than children with TS + ADHD or ADHD-only. These findings suggest that deficiencies in choice reaction time and consistency of timed responses are common to all three groups, but children with TS-only have relatively less EF impairment than children with TS + ADHD or ADHD-only.     

Asymmetrical hemispheric control of visual-spatial attention in adults with attention deficit hyperactivity disorder.

As neuropsychological mechanisms for attention have been hypothesized to be located in the right hemisphere of the brain, several investigators have begun to conceptualize attention deficit hyperactivity disorder (ADHD)-related attentional deficits as involving right-hemispheric abnormalities. The authors evaluated and compared adult patients diagnosed with ADHD with a non-ADHD group of patients using a chronometric visual-spatial attention task that is sensitive to hemispheric differences in efficiency of information processing. Reaction times across different cuing conditions, cue-target delays, and visual fields were assessed. When participants' attention was misdirected with cues in the right visual field and attention had to be switched to a target on the left visual field, there was a longer delay among ADHD adults than non-ADHD adults, specifically when the interval between the cue and target was 800 ms as compared with 100 ms. This specific pattern of dysfunction was interpreted as a difficulty with maintaining attention possibly associated with anterior attention mechanisms in the right hemisphere. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Familial subtypes of attention deficit hyperactivity disorder: a 4-year follow-up study of children from antisocial-ADHD families

ADHD is a familial disorder with high rates of comorbidity with conduct disorder in childhood and antisocial personality and substance use disorders in adulthood. A growing literature suggests that ADHD with antisocial comorbidity may be nosologically distinct from other forms of ADHD. Previously, we proposed a family-based stratification that defined Antisocial families as those with either conduct disorder or antisocial personality disorder in the probands or relatives. To provide predictive validity for that stratification, we assessed psychopathology in these families 4 years after their initial assessment. Results show that the probands and siblings from Antisocial families had higher rates of psychopathology during the 4-year follow-up period compared with siblings from Non-antisocial and control families. They also had more deviant ratings on the Child Behavior Checklist (especially for anxious/depressed, delinquent, and aggressive behavior). We found fewer group differences in the academic, psychosocial, and intellectual correlates of ADHD. These results confirm and extend previous work indicating that Antisocial ADHD may be a nosologically and clinically meaningful subform of ADHD.     

Neuropharmacological basis of stimulant drug action in attention deficit disorder with hyperactivity: A review and synthesis.

A review of the literature reveals that while stimulants reliably decrease gross motor activity, diminish impulsive responding, and improve attention; the nature of the stimulant effects on these variables is similar in normal and hyperactive children, a finding that argues against the possibility of specific drug interaction with an organic disturbance in hyperactivity. The neurophysiological effect of amphetamine and methylphenidate in animals is to facilitate the action of dopamine and norepinephrine by blocking reuptake from the synapse, inhibiting the action of MAO, and facilitating release of catecholamines. One hypothesis emerging from an integration of these findings is that decreased activity and increased ability to focus attention following stimulant drug administration are analogous to the increased constriction and stereotypy observed in animal studies. It is suggested that children who become more hyperactive on a given dose of stimulant may improve at higher doses and that injection of dopamine into striatal nuclei would reproduce the beneficial effects of amphetamine. (6 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive factors differentiating attention deficit–hyperactivity disorder with and without a comorbid mood disorder.

Mood disorders and attention deficit–hyperactivity disorder (ADHD) co-occur in 20–30% of children and adolescents diagnosed in both epidemiological and clinical studies, but little information is available regarding cognitive factors that may be relevant to the expression of co-occurring mood disorders and ADHD. This study examined whether ADHD with and without a comorbid mood disorder could be differentiated on the basis of cognitive factors associated with prominent theories of depression. Children meeting diagnostic criteria for ADHD (n?=?14) or ADHD and a comorbid mood disorder (n?=?27) were assessed on a variety of cognitive indices. Children in the comorbid group reported more negative views of themselves and a more depressogenic attributional style. Cognitive disturbances associated with A. T. Beck's (1967) cognitive model and attributional style theories of depression differentiate ADHD children with significant mood pathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Divided attention in youth-onset psychosis and attention deficit/hyperactivity disorder.

The authors used pupillary dilations to test whether divided attention deficits in youth-onset psychosis and attention deficit/hyperactivity disorder (ADHD) were because of limitations in recruitment of cognitive resources or abnormalities in attention allocation. Eight- to 19-year-olds with youth-onset psychosis or ADHD were administered a divided attention test consisting of an auditory digit span (DS) task and a simple visual response time (RT) task. In 4 conditions, participants performed neither (no task), 1 (DS or RT only), or both tasks (dual). Dependent variables were DS accuracy, RT, and pupillary dilation to digits as an estimate of recruitment of cognitive resources. The authors found no evidence for an abnormal attention strategy in either disorder. Instead, results were consistent with the hypothesis that both clinical groups have limitations in resource recruitment. These limitations were more severe in psychosis than in ADHD. Findings indicate that both clinical groups had difficulties in regulating physiological arousal on a moment-to-moment basis in accordance with task demands. Findings also demonstrate the importance of taking into account difficulties that constrain performance on simple tasks before interpreting impairments on complex tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The WISC-III Freedom from Distractibility factor: Its utility in identifying children with attention deficit hyperactivity disorder.

This study examined the construct validity and diagnostic utility of the Wechsler Intelligence Scale for Children—Third Edition (WISC-III; Wechsler, 1991) Freedom From Distractibility (FFD) factor within a sample of 40 clinic-referred children having attention deficit hyperactivity disorder (ADHD). For the group as a whole, the FFD factor index score was significantly lower than either the Verbal Comprehension (VC) or Perceptual Organization (PO) factor index scores. Group-level correlational analyses also revealed significant associations between the FFD factor and teacher ratings of inattention. Nevertheless, when analyzed at an individual level, the FFD factor was not significantly lower than either the VC or PO factors for a substantial number of children and so may not be suitable for identifying children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity.

Despite the early onset of attention deficit disorder with hyperactivity (ADDH), there is a dearth of treatment studies with preschoolers with this disorder. Forty-six families with ADDH preschoolers were randomly assigned to either an immediate or a delayed group parent training program aimed at improving child compliance. Groups were balanced on demographic variables. Treatment outcome was evaluated by comparing the groups at pre- and posttreatment and 3-month follow-up on measures of parent–child interactions during free play, a compliance task, and parent-supervised activities, as well as on parent-completed Conners Hyperkinesis Index (C. H. Goyette et al; see record 1980-22450-001) scores. Positive treatment effect was obtained on measures of compliance, parental style of interaction, and management skills. These improvements were maintained at 3-month follow-up. Evaluation of treatment effects on nontargeted child behaviors indicated no generalization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative electroencephalographic profiles of children with attention deficit disorder

Quantitative electroencephalogram (QEEG) was obtained from 407 children with attention deficit disorder. These QEEGs were compared to those of 310 normal children. Discriminant analysis resulted in a specificity of 88% and a sensitivity of 93.7% for distinguishing normal children from those with attention deficit disorder. Two major neurophysiological subtypes were evident within the 92.6% abnormal QEEG profiles encountered. The first showed varying degrees of EEG slowing, especially in frontal regions, whereas the second showed an increase in EEG activity, especially in frontal regions. Deviations from normal development rather than maturational lag were present as the source of the neurophysiological abnormality in the majority of these children. In conjunction with recent magnetic resonance imaging, positron emission tomography, and regional cerebral blood flow studies, these results indicate neurophysiological dysfunction within the cortical and subcortical structures that serve the frontal/striatal system. Models suggesting both hypo- or hyperarousal of these structures are supported.