ADHD across the lifespan

2017 ◽  
Author(s):  
David W. Goodman
Keyword(s):  
Family Environment ◽  
Developmental Trajectory ◽  
Personality Characteristics ◽  
Functional Impairments ◽  
Psychosocial Dysfunction ◽  
Hyperactivity Disorder ◽  
Psychotherapeutic Interventions ◽  
Psychiatric Conditions ◽  
Primary Care Practitioners ◽  
Substance Related Disorders

Attention deficit/hyperactivity disorder (ADHD) is a chronic neuropsychiatric condition that affects most patients throughout their lives and is associated with substantial underachievement and psychosocial dysfunction. Furthermore, ADHD is associated with a greater likelihood for psychiatric comorbidity and substance related disorders. Primary care practitioners are at the forefront of helping patients with ADHD manage their symptoms and overcoming functional impairments. The differential diagnosis of ADHD is challenging and the presentation of the illness is similar to other psychiatric conditions (e.g. ADHD in adults may appear similar to mood episodes, anxiety, or personality disorder). The developmental trajectory of ADHD appears to be moderated by family environment, personality characteristics, life events, and adaptive skills. The pharmacological treatment of ADHD is highly effective with stimulants as recommended first-line medications. The clinical use of these medications will be highlighted in this chapter along with behavioural/psychotherapeutic interventions individualized for patients and families.

Attention Deficit Hyperactivity Disorder in Autism Spectrum Disorder

2020 ◽  
pp. 158-176
Author(s):  
Karen Bearss ◽  
Aaron J. Kaat
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Developmental Trajectory ◽  
Spectrum Disorder ◽  
Adhd Symptoms ◽  
Functional Impairments ◽  
Hyperactivity Disorder ◽  
Delayed Recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

scholarly journals Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 10 (2) ◽  
pp. 79 ◽  
Author(s):  
Yanni Liu ◽  
Gregory L. Hanna ◽  
Barbara S. Hanna ◽  
Haley E. Rough ◽  
Paul D. Arnold ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Child Behavior Checklist ◽  
Performance Monitoring ◽  
Longitudinal Design ◽  
Flanker Task ◽  
Developmental Trajectory ◽  
Time Variability ◽  
Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.

scholarly journals Self-Directedness and Cooperativeness, Psychosocial Dysfunction and Suffering in ESSENCE

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Danilo Garcia ◽  
Henrik Anckarsäter ◽  
Sebastian Lundström
Keyword(s):  
Developmental Coordination Disorder ◽  
Population Level ◽  
Autism Spectrum ◽  
Severe Form ◽  
Therapeutic Interventions ◽  
Psychosocial Dysfunction ◽  
Hyperactivity Disorder ◽  
Character Inventory ◽  
Novel Method ◽  
The Impact

Background. The acronym ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) highlights that children seeking clinical treatment are often multiply impaired, thus requiring treatment from several specialties. The aim was to map and relate, on a population level, ESSENCE to two salient predictors of health and adaptation to adversities, namely, Self-Directedness and Cooperativeness and also to dysfunction and suffering.Methods. Participants were twins(N=1892)aged 9 or 12 whose parents were interviewed with the Autism-Tics, ADHD and other Comorbidities inventory (A-TAC), and the Junior Temperament and Character Inventory (J-TCI). The A-TAC was first used to discern four ESSENCE-related screening diagnoses: autism spectrum disorders, attention deficit hyperactivity disorder, learning disabilities, and developmental coordination disorder; second, to quantify dysfunction and suffering in important social areas.Results. ESSENCE symptoms were continuously and categorically associated with deficiency in Self-Directedness and Cooperativeness and higher ratings of dysfunction and suffering. The impact of ESSENCE symptoms on these measures of mental health was found in a milder form in about 16% of all children and in a severe form in about 2%.Conclusion. Therapeutic interventions focusing on Self-Directedness and Cooperativeness might provide a novel method for child psychiatry in its approach to ESSENCE.

scholarly journals The general impact of haploinsufficiency on brain connectivity underlies the pleiotropic effect of neuropsychiatric CNVs

2020 ◽  
Author(s):  
Clara Moreau ◽  
Guillaume Huguet ◽  
Sebastian Urchs ◽  
Elise Douard ◽  
Hanad Sharmarke ◽  
...  
Keyword(s):  
Brain Connectivity ◽  
Copy Number Variants ◽  
Neuropsychiatric Disorders ◽  
Pleiotropic Effect ◽  
Autism Spectrum ◽  
Hyperactivity Disorder ◽  
Severity Scores ◽  
Psychiatric Conditions ◽  
The Mean ◽  
Neutral Effect

AbstractCopy number variants (CNVs) are among the most highly penetrant genetic risk factors for neuropsychiatric disorders. Their impact on brain connectivity remains mostly unstudied. Because they confer risk for overlapping conditions, we hypothesized that they may converge on shared connectivity patterns.We performed connectome-wide analyses using resting-state functional MRI data from 436 carriers of neuropsychiatric CNVs at the 1q21.1, 15q11.2, 16p11.2, 22q11.2 loci, 4 “neutral effect” CNVs, 66 carriers of scarcer neuropsychiatric CNVs, 756 individuals with idiopathic autism spectrum disorder (ASD), schizophrenia, attention deficit hyperactivity disorder, and 5,377 controls. Neuropsychiatric CNVs showed global shifts of mean connectivity. The effect size of CNVs on relative connectivity (adjusted for the mean) was correlated with the known level of neuropsychiatric risk conferred by CNVs. Individuals with idiopathic schizophrenia and ASD had similarities in connectivity with neuropsychiatric CNVs. We reported a linear relationship between connectivity and intolerance to haploinsufficiency measured for all genes encompassed by CNVs across 18 loci. This profile involved the thalamus, the basal ganglia, somatomotor and frontoparietal networks and was correlated with lower general intelligence and higher autism severity scores. An exploratory factor analysis confirmed the contribution of these regions to three latent components shared across CNVs and neuropsychiatric disorders.We posit that deleting genes intolerant to haploinsufficiency reorganize connectivity along general dimensions irrespective of where deletions occur in the genome. This haploinsufficiency brain signature opens new avenues to understand polygenicity in psychiatric conditions and the pleiotropic effect of CNVs on cognition and risk for neuropsychiatric disorders.One sentence summaryNeuropsychiatric CNVs across the genome reorganize brain connectivity architecture along dominant patterns contributing to complex idiopathic conditions.

scholarly journals Are changes in ADHD course reflected in differences in IQ and executive functioning from childhood to young adulthood?

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Jessica C. Agnew-Blais ◽  
Guilherme V. Polanczyk ◽  
Andrea Danese ◽  
Jasmin Wertz ◽  
Terrie E. Moffitt ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Young Adulthood ◽  
Twin Study ◽  
Late Onset ◽  
Population Based ◽  
Developmental Trajectory ◽  
Control Task ◽  
Hyperactivity Disorder ◽  
Longitudinal Twin Study ◽  
Study Participants

Abstract Background Attention-deficit hyperactivity disorder (ADHD) is associated with poorer cognitive functioning. We used a developmental, genetically-sensitive approach to examine intelligence quotient (IQ) from early childhood to young adulthood among those with different ADHD courses to investigate whether changes in ADHD were reflected in differences in IQ. We also examined executive functioning in childhood and young adulthood among different ADHD courses. Methods Study participants were part of the Environmental Risk (E-Risk) Longitudinal Twin Study, a population-based birth cohort of 2232 twins. We assessed ADHD in childhood (ages 5, 7, 10 and 12) and young adulthood (age 18). We examined ADHD course as reflected by remission, persistence and late-onset. IQ was evaluated at ages 5, 12 and 18, and executive functioning at ages 5 and 18. Results ADHD groups showed deficits in IQ across development compared to controls; those with persistent ADHD showed the greatest deficit, followed by remitted and late-onset. ADHD groups did not differ from controls in developmental trajectory of IQ, suggesting changes in ADHD were not reflected in IQ. All ADHD groups performed more poorly on executive functioning tasks at ages 5 and 18; persisters and remitters differed only on an inhibitory control task at age 18. Conclusions Differences in ADHD course – persistence, remission and late-onset – were not directly reflected in changes in IQ. Instead, having ADHD at any point across development was associated with lower average IQ and poorer executive functioning. Our finding that individuals with persistent ADHD have poorer response inhibition than those who remitted requires replication.

Psychotherapy for Adolescents With Attention-Deficit Hyperactivity Disorder: A Pediatrician’s Guide

2016 ◽  
Vol 56 (7) ◽  
pp. 667-674 ◽  
Author(s):  
Vania Modesto-Lowe ◽  
Victoria Charbonneau ◽  
Pantea Farahmand
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Treatment Strategies ◽  
Relationship Formation ◽  
Residual Symptoms ◽  
Behavioral Challenges ◽  
Hyperactivity Disorder ◽  
Psychotherapeutic Interventions ◽  
Novel Treatment Strategies ◽  
Function Relationship

Attention-deficit hyperactivity disorder (ADHD) presents with high levels of inattention, impulsiveness, and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. ADHD symptoms lead to decreased functionality in various life domains and result in poor academics, behavioral challenges, delayed independence, and strained relationships. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. This article aims to provide a review of the psychotherapeutic interventions available for teens that receive pharmacotherapy but continue to struggle with the residual symptoms of ADHD that interfere with academic function, relationship formation, and psychological development.

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