Attention Deficit Hyperactivity Disorder: Anxiety Phenomena in Children Treated with Psychostimulant Medication for 6 Months or More

1999 ◽  
Vol 33 (3) ◽  
pp. 399-406 ◽  
Author(s):  
Alasdair L.A. Vance ◽  
Ernest S.L. Luk ◽  
Jan Costin ◽  
Bruce J. Tonge ◽  
Christos Pantelis
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Poor Response ◽  
Significant Finding ◽  
Children With Adhd ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
Core Symptoms ◽  
Psychostimulant Medication

Objective: The intermediate- to long-term use of psychostimulant medication has unclear benefits on the core symptoms of attention deficit hyperactivity disorder (ADHD) and delayed onset affective symptom side effects which can mimic these core ADHD symptoms. ‘ADHD and anxiety’ has also been associated with a poor response to short-term psychostimulant medication treatment. In addition, it is unclear whether ‘ADHD and anxiety’ should be defined from the child's and/or the parent's perspective. We propose that anxiety will be increased in children with ADHD who are treated with psychostimulant medication in the intermediate- to long-term who are identified by clinicians as poor responders. Method: Twenty children with ADHD who were medicated for 6 months or more and who had ongoing core symptoms of ADHD were compared to 20 age- and IQ-matched children with ADHD who were medication-naive. Chi-squared tests were performed on the categorical dependent variables and independent t-tests on the dependent continuous variables. Results: Anxiety is significantly increased in children with ADHD treated with psychostimulant medication in the intermediate- to long-term who are noted by clinicians to have ongoing core symptoms of ADHD. This statistically significant finding is evident with both categorical and dimensional measures of anxiety from the child's perspective. Conclusions: The recognition of anxiety and its management in children with ADHD is generally poorly understood. In this particular group of children with ADHD, anxiety may be a side effect of intermediate- to long-term psychostimulant medication and/or a potential marker for a poor response to intermediate- to long-term psychostimulant medication treatment.

Attention Deficit Hyperactivity Disorder and Anxiety: Is There an Association with Neurodevelopmental Deficits?

1998 ◽  
Vol 32 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Empirical Studies ◽  
Poor Response ◽  
Continuous Variables ◽  
Research Issues ◽  
Hyperactivity Disorder ◽  
Neurodevelopmental Deficits ◽  
Psychostimulant Medication

Objective: The co-occurrence of attention deficit hyperactivity disorder (ADHD) and anxiety is a well-established clinical observation. However, its status as a clinical construct is debated. We review the prevalence of ‘ADHD and anxiety’, its definitions, and its clinical correlates and we hypothesise that neurodevelopmental deficits may be increased in ‘ADHD and anxiety’. Method: The authors identified empirical studies in the psychiatric and psychological literature. The search categories included hyperactivity, attention deficit hyperactivity disorder, attention deficit disorder and anxiety. Results: ‘ADHD and anxiety’ is considerably more common in clinical than epidemiological samples. There are a range of definitions which address the situational variation in both ADHD and anxiety symptoms and the use of categorical and continuous variables to define them. Yet the nature of the anxiety is still unclear. It is associated with a poor response to psychostimulant medication treatment, and alternative pharmacotherapy approaches have been suggested. There is a controversy about whether neurodevelopmental deficits are associated with hyperactivity alone, or anxiety, or both. Conclusions: ‘ADHD and anxiety’ is important clinically because it is common and less responsive to psychostimulant medication. Important research issues include its heterogeneity which necessitates the collection of parent, teacher, and child self-reports of symptoms' presence or absence and the hypothesis that neurodevelopmental deficits may be increased in this group of children.

Students Diagnosed with Attention Deficit Hyperactivity Disorder: Collaborative Strategies for School Counselors

2012 ◽  
Vol 16 (2_suppl) ◽  
pp. 2156759X1201600
Author(s):  
M. Ann Shillingford-Butler ◽  
Lea Theodore
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
School Counselors ◽  
Attention Deficit ◽  
School Setting ◽  
Negative Consequences ◽  
Effective School ◽  
Children With Adhd ◽  
Social And Emotional ◽  
Hyperactivity Disorder ◽  
Core Symptoms

The school setting can be a difficult place for children with attention deficit hyperactivity disorder (ADHD). The core symptoms of ADHD, which include inattention, hyperactivity, and impulsivity, make meeting the curriculum demands of the classroom challenging. That ADHD negatively impacts not only academic performance but also social and emotional functioning is well established (Lee, Lahey, Owens, & Hinshaw, 2008). Given the negative consequences of ADHD, effective school-based interventions are warranted. School counselors are uniquely positioned to implement strategies for children with ADHD to maximize their capacity for learning. This article provides specific strategies that school counselors can provide collaboratively to enhance the academic and social functioning of children with ADHD in school.

scholarly journals PARENTAL PERCEPTIONS OF MEDICATION IMPACT ON BEHAVIOUR AND LEARNING IN CHILDREN WITH ATTENTION/DEFICIT-HYPERACTIVITY DISORDER

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e35-e35
Author(s):  
Jean-Francois Lemay ◽  
Julie-Anne Lemay ◽  
Hanna Kubas
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Parental Perceptions ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Long Term Treatment ◽  
Stimulant Medications ◽  
The Impact

Abstract BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often negatively impacts behaviour, cognition, and learning. Stimulant medications are the most commonly used treatment for ADHD, with informant reports (e.g., parent questionnaires, surveys) frequently used to evaluate medication impact on behavioural and academic functioning in affected children. OBJECTIVES To determine parental perceptions of medication impact on behaviour and learning in a long-acting methylphenidate (LA-MPH) trial of their children with ADHD. DESIGN/METHODS A randomized controlled LA-MPH medication trial was conducted with children ages 8–12 with a diagnosis of ADHD. Trial began with one-week of baseline assessment, followed by a randomized three-week standard of care medication trial, and a one-week best dose assessment. Following the conclusion of the study (6 months to 2 years’ range post-treatment), families were asked to participate in a voluntary follow-up phone survey to evaluate parental perceptions on child’s behaviour and learning. RESULTS A total of 34/42 (81%) families participated (male to female ratio: 2.1/1). At the time of the follow-up survey, 53% (18/34) and 68% (23/34) of patients were having “difficulty” or “significant difficulty” with their behaviour and learning, respectively. Twenty-three patients (68%) were still on psycho-stimulant medications. Although parents of those 23 children said LA-MPH had in general “significant” or “very significant” impact on their child’s behaviour (87%) and learning (79%), these parents were still reporting challenges with behaviour (52%) and learning (61%) at follow-up. In addition, parents of children not on medication said that their current child’s behaviour and learning was still having the same or more challenging issues (82% and 73% respectively). CONCLUSION Overall, parents reported that medication significantly impacted their child’s behaviour and learning; however, long-term medication impact appears less effective. Thus, an ongoing relationship with families and paediatricians is recommended to better understand the impact of medication on behaviour and learning. Evaluating the effects of medication on behaviour and learning may ultimately lead to targeted intervention that help foster long-term treatment efficacy for children with ADHD.

Attention Deficit Hyperactivity Disorder: Current Progress and Controversies

2000 ◽  
Vol 34 (5) ◽  
pp. 719-730 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Ernest S. L. Luk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Individual Factors ◽  
Health Issues ◽  
Comorbid Conditions ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
Careful Assessment ◽  
Ongoing Monitoring ◽  
Psychostimulant Medication

Objective: Attention deficit hyperactivity disorder (ADHD) is a common chronic and disabling condition in children. This paper reviews the taxonomic issues and the major comorbid conditions, neurobiological correlates, treatment and public health issues associated with ADHD. Method: Pertinent recent papers are reviewed from the psychological and psychiatric literature. Results: The two major taxonomies now define a similar group of children with ADHD of a combined type/hyperkinetic disorder. Advances in the understanding and treatment of ADHD demonstrate the complex multidimensional links between neurobiology, psychology and behaviour. Careful assessment of individual factors in treatment planning and ongoing monitoring of psychostimulant medication treatment in the longer term are recommended. Conclusions: There is much still to learn about ADHD, and increased levels of clinical research and treatment resources are required.

Attention Deficit Hyperactivity Disorder, Combined Type: Better Executive Function Performance With Longer-Term Psychostimulant Medication

2003 ◽  
Vol 37 (5) ◽  
pp. 570-576 ◽  
Author(s):  
Alasdair L. A. Vance ◽  
Paul Maruff ◽  
Rebecca Barnett
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Executive Function ◽  
Primary School ◽  
Attention Deficit ◽  
School Age Children ◽  
School Age ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Primary School Age ◽  
Psychostimulant Medication

Objective: Executive function deficits are evident in primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT) and are possibly improved by longer-term psychostimulant medication. In contrast, a substantial subgroup of children with ADHD-CT become symptomatic despite longer-term psychostimulant medication use. We investigated the hypothesis that better executive function performance is associated with the use of longer-term psychostimulant medication in primary school-age children with ADHD-CT who are again symptomatic of ADHD-CT, despite its use. Method: A cross-sectional study of 40 primary school-age psychostimulant medicationnaïve children with ADHD-CT, 26 with symptomatic ADHD-CT and treated with psychostimulant medication, and 26 control children without ADHD-CT was conducted. Nonverbal tasks of executive function were compared across the three groups. Results: The longer-term psychostimulant medication-treated group had a better executive function performance, despite being symptomatic for ADHD-CT, than the psychostimulant medication-naïve group. Conclusion: Improved executive function may be a marker of psychostimulant medication effect in children with ADHD-CT treated in the longer term. This improvement may not correlate with that of the ADHD-CT symptoms. Longitudinal studies are required.

Long-Term Stimulant Medication Treatment of Attention-Deficit/Hyperactivity Disorder

2014 ◽  
Vol 35 (7) ◽  
pp. 448-457 ◽  
Author(s):  
William J. Barbaresi ◽  
Slavica K. Katusic ◽  
Robert C. Colligan ◽  
Amy L. Weaver ◽  
Cynthia L. Leibson ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Stimulant Medication ◽  
Medication Treatment ◽  
Hyperactivity Disorder

scholarly journals Attention-deficit/hyperactivity disorder medication and seizures

Neurology ◽  
2018 ◽  
Vol 90 (13) ◽  
pp. e1104-e1110 ◽  
Author(s):  
Kelsey K. Wiggs ◽  
Zheng Chang ◽  
Patrick D. Quinn ◽  
Kwan Hur ◽  
Robert Gibbons ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Medication Use ◽  
Adhd Medication ◽  
Medication Treatment ◽  
Hyperactivity Disorder ◽  
Increased Risk ◽  
History Of ◽  
Antiepileptic Medications

ObjectiveIndividuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of seizures, but there is uncertainty about whether ADHD medication treatment increases risk among patients with and without preexisting seizures.MethodsWe followed a sample of 801,838 patients with ADHD who had prescribed drug claims from the Truven Health MarketScan Commercial Claims and Encounters databases to examine whether ADHD medication increases the likelihood of seizures among ADHD patients with and without a history of seizures. First, we assessed overall risk of seizures among patients with ADHD. Second, within-individual concurrent analyses assessed odds of seizure events during months when a patient with ADHD received ADHD medication compared with when the same individual did not, while adjusting for antiepileptic medications. Third, within-individual long-term analyses examined odds of seizure events in relation to the duration of months over the previous 2 years patients received medication.ResultsPatients with ADHD were at higher odds for any seizure compared with non-ADHD controls (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 2.24–2.42 males; OR = 2.31, 95% CI = 2.22–2.42 females). In adjusted within-individual comparisons, ADHD medication was associated with lower odds of seizures among patients with (OR = 0.71, 95% CI = 0.60–0.85) and without (OR = 0.71, 95% CI = 0.62–0.82) prior seizures. Long-term within-individual comparisons suggested no evidence of an association between medication use and seizures among individuals with (OR = 0.87, 95% CI = 0.59–1.30) and without (OR = 1.01, 95% CI = 0.80–1.28) a seizure history.ConclusionsResults reaffirm that patients with ADHD are at higher risk of seizures. However, ADHD medication was associated with lower risk of seizures within individuals while they were dispensed medication, which is not consistent with the hypothesis that ADHD medication increases risk of seizures.

scholarly journals The Need for Effective Early Behavioural Family Interventions for Children with Attention Deficit Hyperactivity Disorder

1996 ◽  
Vol 13 (1) ◽  
pp. 29-39 ◽  
Author(s):  
Judith Sheridan ◽  
Matthew R Sanders
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Social Adjustment ◽  
Attention Deficit ◽  
Developmental Trajectory ◽  
Behavioural Intervention ◽  
Family Interventions ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant

AbstractThere is a pressing need for the development of effective early family intervention programs for children showing Attention Deficit Hyperactivity Disorder (ADHD) behaviours with Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD) behaviours. Previous research has indicated that children with ADHD are at high risk of developing comorbid CD or ODD behaviours. In addition, it has been shown that ODD or CD behaviours in childhood tend to persist and to have adverse effects on later social adjustment. However, ODD or CD behaviours are not necessary concomitants of ADHD, and it has been demonstrated that behavioural intervention can have both short- and long-term beneficial effects for children showing early signs of ODD or CD behaviours. In the short term, behavioural family interventions may be able to reduce oppositional behaviour, particularly in the preschool years. In the long term, early intervention has been shown to reduce the incidence of later antisocial behaviour in children at risk for this developmental trajectory. In this paper, it will be argued that behavioural family interventions have not been effectively utilised or promulgated in the community for children with ADHD despite the demonstrated efficacy of these types of interventons. A model of a multilevel system of intervention that can be tailored to the individual family's needs is presented.

scholarly journals Attention-deficit hyperactivity disorder in adults

1999 ◽  
Vol 5 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Brian Toone ◽  
Maria Clarke ◽  
Susan Young
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Support Group ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Psychiatric Comorbidity ◽  
Hyperkinetic Disorder ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder are well-established diagnoses in children, with estimates of prevalence in pre-adolescent children from 3 to 5%. Until recently ADHD was not thought to persist beyond adolescence, but results from long-term prospective outcome studies indicate that 30–70% of children with ADHD exhibit some symptoms as adults. Recognition of this disorder is important as the persistence of ADHD symptoms has been shown to be associated with academic and occupational failure and high rates of psychiatric comorbidity. With the establishment of a UK support group (LADDER) and increasing media attention highlighting this problem it is likely that there will be an increased demand for psychiatric assessment of adult ADHD in the next few years.

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