Examining the validity of the ADHD concept in adults and older adults

CNS Spectrums ◽  
2018 ◽  
Vol 24 (5) ◽  
pp. 518-525 ◽  
Author(s):  
Brandy L. Callahan ◽  
André Plamondon
Keyword(s):  
Older Adults ◽  
Executive Functions ◽  
Factor Structure ◽  
Adult Adhd ◽  
Rating Scale ◽  
Age Groups ◽  
Adhd Symptoms ◽  
Confirmatory Factor Analyses ◽  
Neuropsychological Measures ◽  
Adhd Symptomatology

ObjectiveIt is crucial to clarify the structure of attention-deficit/hyperactivity disorder (ADHD) symptomatology in all age groups to determine how to best conceptualize this disorder across the lifespan. We tested the ADHD factor structure across adulthood and investigated independent associations with executive functions.MethodData from 645 adults aged 18–59 and 233 adults aged 60–85 were drawn from the Nathan Kline Institute Rockland Sample. Participants completed the Conners Adult ADHD Rating Scale and tests of executive functioning. Invariance of the ADHD factor structure was investigated using confirmatory factor analyses. Associations with cognition were explored using multiple linear regression.ResultsResults confirmed a bifactor model with 3 specific factors (inattention, hyperactivity, and impulsivity). Factor loadings and item intercepts were invariant across ages. Levels of hyperactivity and impulsivity were lower in older adults. Inattentive symptoms in young adults were positively related to cognitive flexibility. In older adults, ADHD symptoms predicted poorer working memory.ConclusionADHD symptoms manifest similarly across adulthood. The lack of robust associations between ADHD symptomatology and executive functions raises concerns about the usefulness of neuropsychological measures in diagnosing adult ADHD. These results support the validity of the ADHD concept in older adults but suggest a need for age-appropriate normative criteria.

scholarly journals Quality of Life in European Older Adults of SHARE Wave 7: Comparing the Old and the Oldest-Old

2021 ◽  
Vol 10 (13) ◽  
pp. 2850
Author(s):  
Amparo Oliver ◽  
Trinidad Sentandreu-Mañó ◽  
José M. Tomás ◽  
Irene Fernández ◽  
Patricia Sancho
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Measurement Invariance ◽  
Factor Structure ◽  
External Validity ◽  
Oldest Old ◽  
Age Groups ◽  
Depression Scale ◽  
Scalar Invariant

CASP-12 (Control, Autonomy, Self-realization, and Pleasure scale) is one of the most common internationally used measures for quality of life in older adults, although its structure is not clearly established. Current research aims to test the factor structure of the CASP-12, so as to provide evidence on reliability and external validity, and to test for measurement invariance across age groups. Data from 61,355 Europeans (≥60 years old) from the Survey of Health, Ageing and Retirement in Europe wave 7 were used. CASP-12, EURO-D (European depression scale), self-perceived health, and life satisfaction measurements were included. Reliability and validity coefficients, competing confirmatory factor models, and standard measurement invariance routine were estimated. A second-order factor model with the original factor structure was retained. The scale showed adequate reliability coefficients except for the autonomy dimension. The correlation coefficients for external validity were all statistically significant. Finally, CASP-12 is scalar invariant across age. We conclude that the best-fitting factor structure retained allows using CASP-12 either by factors, or as an overall score, depending on the research interests. Findings related to CASP-12 measurement invariance encourage its use in the oldest-old too. When comparing the dimensions across age groups, as people age, autonomy slightly increases and the rest of the dimensions decline.

Maternal ADHD symptoms, child ADHD symptoms and broader child outcomes

2018 ◽  
Vol 103 (9) ◽  
pp. 841-846 ◽  
Author(s):  
Daryl Efron ◽  
Kirsten Furley ◽  
Alisha Gulenc ◽  
Emma Sciberras
Keyword(s):  
Adhd Symptom ◽  
Symptom Severity ◽  
Adult Adhd ◽  
Rating Scale ◽  
Child Outcomes ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Maternal Report ◽  
Child Adhd ◽  
Maternal Adhd

ObjectiveThis study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD.Design and settingIn this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure.Patients117 children with ADHD and 149 control children were included in the analyses.Main outcome measuresMaternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years.ResultsMothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01).ConclusionsMaternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.

Incidence of Internet addiction in adult attention deficit hyperactivity disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S396-S397
Author(s):  
B. Tuzun Mutluer ◽  
T.G. Yener Orum ◽  
S. Sertcelik
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Internet Addiction ◽  
Attention Deficit ◽  
Internet Use ◽  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Dsm Iv

ObjectiveIn this study, it was aimed to determine the internet use properties of Adult Attention Deficit Hyperactivity Disorder (ADHD) patients who were followed-up at Haydarpasa Numune Research and Training Hospital, Psychiatry Department; ADHD Outpatient Clinic.MethodThirty participants who were diagnosed with adult ADHD aged between 18–31 years rated their ADHD symptoms in childhood retrospectively, using Wender Utah Rating Scale. Patients rated current adult ADHD symptoms with the Adult ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (DSRS) and severity of symptoms measured by Adult ADHD Self-Report Scale (ASRS). Internet addiction (IA) was assessed with Young's Internet Addiction Scale (IAS). It was determined that, none of 30 Adult ADHD patients have been diagnosed with IA.29 of patient have moderate internet use although 1 of patients have risky internet use. The results revealed that total ASRS score (P = 0.020), total Adult ADHD DSM-IV-Based DSRS score (P = 0.036) and the Attention Deficit related properties subscale total score (P = 0.042) were significantly correlated with the IAS total score. Subscale of the self-report scales including; failing to finish schoolworks, chores, or duties at workplace, difficulty of following through on instructions (P = 0.017), restiveness; impaired inhibitory performance (P = 0.017), feeling not confident (P = 0.017), difficulty of managing time (P = 0.047), failing to give close attention to details or making careless mistakes (P = 0.037) are closely relevant to IAS total score.ResultIn conclusion, clinical features, which are characteristic of Adult ADHD could have same shared etiology with IA. Furthermore, ADHD patients are more likely to have an IA diagnosis. However, it was thought that this result had to be supported with studies including larger samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Triple-Bead Mixed Amphetamine Salts (SHP465) in Adults With ADHD: Results of a Phase 3, Double-Blind, Randomized, Forced-Dose Trial

2017 ◽  
Vol 24 (3) ◽  
pp. 402-413 ◽  
Author(s):  
Glen Frick ◽  
Brian Yan ◽  
Lenard A. Adler
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Safety Profile ◽  
Adult Adhd ◽  
Rating Scale ◽  
Adhd Symptoms ◽  
Score Change ◽  
Phase 3 ◽  
Double Blind ◽  
Dose Trial

Objective: Evaluate the efficacy and tolerability of triple-bead mixed amphetamine salts (MAS) in ADHD. Method: Adults with ADHD Rating Scale IV (ADHD-RS-IV) total scores ≥32 were randomized to 6 weeks of triple-bead MAS (25, 50, or 75 mg) or placebo. The primary endpoint was ADHD-RS-IV total score change from baseline at end of study (EOS). Results: Least squares mean (95% confidence interval [CI]) treatment differences for ADHD-RS-IV total score changes from baseline to EOS significantly favored triple-bead MAS (all doses combined: −10.6 [−13.2, −8.0]; p < .0001); there were no significant differences between triple-bead MAS dosages. The most frequently reported TEAEs with triple-bead MAS (all doses combined) included insomnia, decreased appetite, and dry mouth. Mean ± SD pulse and systolic blood pressure increases at EOS were 3.5 ± 10.33 bpm and 0.3 ± 10.48 mmHg with triple-bead MAS (all doses combined). Conclusion: Triple-bead MAS significantly reduced adult ADHD symptoms; the safety profile was consistent with previous triple-bead MAS studies.

scholarly journals ADHD symptoms in the adult general population are associated with factors linked to ADHD in adult patients

2018 ◽  
Author(s):  
Ting Li ◽  
Nina Roth Mota ◽  
Tessel E. Galesloot ◽  
Janita Bralten ◽  
Jan Buitelaar ◽  
...  
Keyword(s):  
General Population ◽  
Adult Adhd ◽  
Negative Binomial ◽  
Rating Scale ◽  
Adult Population ◽  
Neurodevelopmental Disorder ◽  
Continuous Distribution ◽  
Anxiety Symptoms ◽  
Adhd Symptoms ◽  
Childhood Adhd

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children and adults. It is characterized by inappropriate levels of inattention (IA) and/or hyperactivity and impulsivity (HI). The ADHD diagnosis is hypothesized to represent the extreme of a continuous distribution of ADHD symptoms in the general population. In this study, we investigated whether factors linked to adult ADHD as a disorder are associated with adult ADHD symptoms in the general population. Our population-based sample included 4,987 adults (mean age 56.1 years; 53.8% female) recruited by the Nijmegen Biomedical Study (NBS). Participants completed the Dutch ADHD DSM-IV Rating Scale for current and childhood ADHD symptoms, the Symptom Check List-90-R (SCL-90-R) anxiety subscale, and the Eysenk Personality Questionnaire (EPQR-S). Partial Spearman correlation and Hurdle negative binomial regression analysis were used to assess how age, sex, childhood ADHD symptoms, anxiety symptoms, and personality traits (neuroticism, extraversion, and psychoticism) are associated with current IA and HI symptoms. Increasing age was associated with a lower proportion of participants reporting HI symptoms and with reduced levels of HI; IA levels remained fairly stable over the age-range, but the probability of reporting IA symptoms increased throughout middle/late adulthood. Females were more likely to report IA symptoms than males. Childhood ADHD symptoms, neuroticism, and psychoticism were positively associated with current IA and HI symptoms, while extraversion had an opposite association with these symptom domains. Anxiety symptoms affected HI symptoms in females. Our results indicate that factors associated with categorical ADHD are also correlated with ADHD symptoms in the adult population.

scholarly journals Attachment and Executive Functions in ADHD Symptomatology—Independent Inputs or an Interaction?

2020 ◽  
Vol 10 (11) ◽  
pp. 765
Author(s):  
Łukasz Konowałek ◽  
Tomasz Wolańczyk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Executive Functions ◽  
Attachment Style ◽  
Attention Deficit ◽  
Synthetic Approach ◽  
Adhd Symptoms ◽  
Attachment Representation ◽  
Hyperactivity Disorder ◽  
Adhd Symptomatology ◽  
Executive Dysfunctions

Despite a multitude of research on executive functions and attachment in Attention Deficit Hyperactivity Disorder (ADHD), a synthetic approach to the matter seems to have been lacking. In this review, we attempt to check the available data against two hypotheses: (1) executive functions and attachment influence ADHD symptoms independently; (2) executive functions and attachment interact to produce ADHD symptoms. We found no evidence falsifying the former hypothesis and some evidence to refute the latter. Limitations of current study approaches and suggestions for further research are discussed. Specifically, we propose an attachment representation, rather than attachment style, approach to measuring the mediation thereof between executive dysfunctions and ADHD.

scholarly journals Parenting practices of Singaporean mothers of children with ADHD

2017 ◽  
Vol 27 (1) ◽  
pp. 33-40
Author(s):  
Alefiya Nomanbhoy ◽  
Russell Hawkins
Keyword(s):  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
Control Group ◽  
Adhd Symptoms ◽  
Parenting Skills ◽  
Parenting Strategies ◽  
Parent Rating ◽  
Children With Adhd ◽  
Care Giving

Objectives: We wanted to determine: (1) whether ADHD symptoms were more common in mothers of children with ADHD; (2) whether mothers of children with ADHD differed in their parenting strategies; and (3) whether there was a difference in care-giving arrangements for children with ADHD and without ADHD. This was done by comparing mothers of children with ADHD with mothers of children without ADHD in Singapore. Methods: Mothers of children with ADHD ( n=46) and mothers of children without ADHD ( n=45) completed the Conners’ Parent Rating Scale-Revised, the Conners’ Adult ADHD Rating Scale-Self Report and the Alabama Parenting Questionnaire. Results: Mothers of children with ADHD did not report higher levels of current ADHD symptoms compared with the control group. However, they did use less adaptive parenting strategies. There were also no differences in the reported behaviours of children cared for by a paid worker and those cared for by mothers. Conclusions: Data support the Singapore Clinical Guidelines recommendations for the promotion of parenting skills, and referral to parenting programmes for parents of children with ADHD. The promotion of parenting skills and referral to parenting programmes for mothers of children with ADHD might include the option of electronic forms of programme delivery. The model of using paid help in the home, which is commonplace in Singapore, does not seem to disadvantage children with ADHD.

Apathy and executive function in Alzheimer's disease

2002 ◽  
Vol 8 (3) ◽  
pp. 373-381 ◽  
Author(s):  
SUSAN McPHERSON ◽  
LYNN FAIRBANKS ◽  
SIBEL TIKEN ◽  
JEFFREY L. CUMMINGS ◽  
CARLA BACK-MADRUGA
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Executive Function ◽  
Executive Functions ◽  
Rating Scale ◽  
Executive Dysfunction ◽  
Neuropsychological Measures ◽  
Behavior Rating Scale ◽  
Interference Test ◽  
The Relationship

Apathy is a common behavioral disturbance in patients with Alzheimer's disease (AD). Recent studies have linked the presence of apathy to alterations in frontal lobe functions, but few studies have explored the relationship using standard neuropsychological measures in patients with AD. We administered a comprehensive battery of neuropsychological tests and a behavior rating scale to 80 patients with AD. We explored the relationship of apathy to executive dysfunction. AD patients with apathy performed significantly worse on tests of executive function (WAIS–R Digit Symbol, Trail-Making, Stroop Color Interference Test) than AD patients without apathy. The presence of dysphoria did not modify these results and no significant relationships were found between tests of executive functions and dysphoria. Performance on executive measures as a group were effective in correctly classifying patients as apathetic or nonapathetic with 75% accuracy. Neuropsychological measures not dependent on executive functions were unrelated to apathy. Apathy is associated with executive dysfunction and not with other neuropsychological deficits. Apathy is distinct from dysphoria. (JINS, 2002, 8, 373–381.)

scholarly journals The Uniform Dataset 3.0 Neuropsychological Battery: Factor Structure, Invariance Testing, and Demographically Adjusted Factor Score Calculation

2020 ◽  
Vol 26 (6) ◽  
pp. 576-586 ◽  
Author(s):  
Andrew M. Kiselica ◽  
Troy A. Webber ◽  
Jared F. Benge
Keyword(s):  
Older Adults ◽  
Factor Structure ◽  
Cognitive Abilities ◽  
Factor Score ◽  
Higher Order ◽  
Factor Scores ◽  
Neuropsychological Battery ◽  
Confirmatory Factor Analyses ◽  
Invariance Testing ◽  
Metric Invariance

AbstractObjective:The goals of this study were to (1) specify the factor structure of the Uniform Dataset 3.0 neuropsychological battery (UDS3NB) in cognitively unimpaired older adults, (2) establish measurement invariance for this model, and (3) create a normative calculator for factor scores.Methods:Data from 2520 cognitively intact older adults were submitted to confirmatory factor analyses and invariance testing across sex, age, and education. Additionally, a subsample of this dataset was used to examine invariance over time using 1-year follow-up data (n = 1061). With the establishment of metric invariance of the UDS3NB measures, factor scores could be extracted uniformly for the entire normative sample. Finally, a calculator was created for deriving demographically adjusted factor scores.Results:A higher order model of cognition yielded the best fit to the data χ2(47) = 385.18, p < .001, comparative fit index = .962, Tucker-Lewis Index = .947, root mean square error of approximation = .054, and standardized root mean residual = .036. This model included a higher order general cognitive abilities factor, as well as lower order processing speed/executive, visual, attention, language, and memory factors. Age, sex, and education were significantly associated with factor score performance, evidencing a need for demographic correction when interpreting factor scores. A user-friendly Excel calculator was created to accomplish this goal and is available in the online supplementary materials.Conclusions:The UDS3NB is best characterized by a higher order factor structure. Factor scores demonstrate at least metric invariance across time and demographic groups. Methods for calculating these factors scores are provided.

Current Mood Symptoms Do Not Affect the Accuracy of Retrospective Self-Ratings of Childhood ADHD Symptoms

2016 ◽  
Vol 20 (12) ◽  
pp. 1039-1046 ◽  
Author(s):  
Katie Grogan ◽  
Jessica Bramham
Keyword(s):  
Adult Adhd ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Anxiety And Depression ◽  
Future Research ◽  
Adhd Symptoms ◽  
Childhood Adhd ◽  
Current Mood

Objective: Given that the diagnosis of adulthood ADHD depends on the retrospective self-report of childhood ADHD symptoms, this study aimed to establish whether current mood affects the accuracy of retrospective self-ratings of childhood ADHD. Method: Barkley’s Adult ADHD Rating Scale (BAARS) was used to assess the retrospective self- and parent-reports of childhood ADHD symptoms of 160 adults with ADHD and 92 adults without ADHD. Self-rated current mood was also measured using the Hospital Anxiety and Depression Scale (HADS). Results: Higher BAARS self-ratings correlated with higher HADS self-ratings. Strongest correlations were evident between hyperactive/impulsive symptoms and anxiety symptoms. There was no relationship between current mood and accuracy of self-report. Conclusion: Current mood does not affect the accuracy of retrospective self-ratings of ADHD. Future research should aim to provide new measures of anxiety in ADHD to avoid the double counting of hyperactive/impulsive and anxiety symptoms.

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