Insomnia in adult ADHD patients. Role of clinical subtypes and stimulant treatment

Previous studies have indicated a consistent profile of basic personality traits correlated with adult Attention Deficit Hyperactivity Disorder (ADHD) (e.g., Ranseen, Campbell, & Baer, 1998; Nigg et al., 2002). In particular, research has found that low scores of the Conscientiousness trait and high scores on Neuroticism have been correlated with ADHD symptomatology. However, to date there is limited information concerning the range of effect resulting from medication treatment for adult ADHD. During an 18 month period, 60 adults were diagnosed with ADHD based on strict, DSM-IV criteria at an outpatient clinic. This evaluation included a battery of neuropsychological tests and a measure of general personality (i.e., the NEO PI-R). Eleven of these participants returned to complete the battery a second time. The pre-post comparisons revealed significant changes following sustained stimulant treatment on both the neuropsychological and self-report measures. These individuals also displayed significant changes on two domains of the NEO PI-R. They showed a significant decrease on the domain of Neuroticism, indicating that now see themselves as less prone to experience negative emotional states such as anxiety and depression. Additionally, they also reported a significant increase on their scores on the domain of conscientiousness. This increase suggests that they see themselves as more organized and dependable.

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The Role of Self- and Informant-Reports on Symptoms and Impairments in the Clinical Evaluation of Adult ADHD

Sustainability ◽

10.3390/su13084564 ◽

2021 ◽

Vol 13 (8) ◽

pp. 4564

Author(s):

Nana Guo ◽

Anselm B. M. Fuermaier ◽

Janneke Koerts ◽

Bernhard W. Mueller ◽

Christian Mette ◽

...

Keyword(s):

Clinical Evaluation ◽

Test Performance ◽

Adult Adhd ◽

Comparison Group ◽

Neuropsychological Test ◽

Neuropsychological Testing ◽

Adhd Group ◽

Adhd Symptoms ◽

Clinical Comparison

Little is known about which clinical features may aid the differentiation between attention deficit hyperactivity disorder (ADHD) and other clinical conditions. This study seeks to determine the role of self- and informant reports on symptoms and impairments in the clinical evaluation of adult ADHD and explore their association with objective neuropsychological test performance by examining data of 169 outpatients referred for a diagnostic evaluation of adult ADHD. Participants were assigned either to an ADHD group (ADHD, n = 73) or one of two clinical comparison groups, depending on whether they show indications (Clinical Comparison Group, CCG, n = 53) or no indications (Clinical Comparison Group—Not Diagnosed, CCG-ND, n = 43) of psychiatric disorders other than ADHD. All participants and their informants completed a set of questionnaires. Compared to the CCG-ND, the ADHD group obtained significantly higher scores on ADHD symptoms, impulsivity, cognitive deficits, and anxiety. Compared to the CCG, the ADHD group scored significantly higher on ADHD symptoms but lower on depression. Further regression analyses revealed that self- and informant reports failed to predict neuropsychological test performance. Self- and informant reported information may be distinct features and do not correspond to results of objective neuropsychological testing.

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Prevalence of ADHD in Accident Victims: Results of the PRADA Study

Journal of Clinical Medicine ◽

10.3390/jcm8101643 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1643 ◽

Cited By ~ 4

Author(s):

Kittel-Schneider ◽

Wolff ◽

Queiser ◽

Wessendorf ◽

Meier ◽

...

Keyword(s):

General Population ◽

Incidence Rate ◽

Adult Adhd ◽

Demographic Data ◽

Trauma Surgery ◽

Self Report ◽

Stimulant Treatment ◽

Surgery Patient ◽

Increased Risk ◽

History Of

Background: Recent research has shown an increased risk of accidents and injuries in ADHD patients, which could potentially be reduced by stimulant treatment. Therefore, the first aim of our study was to evaluate the prevalence of adult ADHD in a trauma surgery population. The second aim was to investigate accident mechanisms and circumstances which could be specific to ADHD patients, in comparison to the general population. Methods: We screened 905 accident victims for ADHD using the ASRS 18-item self-report questionnaire. The basic demographic data and circumstances of the accidents were also assessed. Results: Prevalence of adult ADHD was found to be 6.18% in our trauma surgery patient sample. ADHD accident victims reported significantly higher rates of distraction, stress and overconfidence in comparison to non-ADHD accident victims. Overconfidence and being in thoughts as causal mechanisms for the accidents remained significantly higher in ADHD patients after correction for multiple comparison. ADHD patients additionally reported a history of multiple accidents. Conclusion: The majority of ADHD patients in our sample had not previously been diagnosed and were therefore not receiving treatment. The results subsequently suggest that general ADHD screening in trauma surgery patients may be useful in preventing further accidents in ADHD patients. Furthermore, psychoeducation regarding specific causal accident mechanisms could be implemented in ADHD therapy to decrease accident incidence rate.

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Stimulant treatment of adult ADHD

ADHD in Adults ◽

10.1017/cbo9780511780752.018 ◽

2011 ◽

pp. 191-197 ◽

Cited By ~ 1

Author(s):

Thomas Spencer ◽

Joseph Biederman

Keyword(s):

Adult Adhd ◽

Stimulant Treatment

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Pharmacology of Adult ADHD with Stimulants

CNS Spectrums ◽

10.1017/s1092852900026018 ◽

2007 ◽

Vol 12 (S6) ◽

pp. 8-11 ◽

Cited By ~ 2

Author(s):

Thomas J. Spencer

Keyword(s):

Primary Care Physicians ◽

Adult Adhd ◽

Brain Disorder ◽

Stimulant Treatment ◽

Children With Adhd ◽

Adolescents And Adults ◽

Stimulant Medications ◽

Long Acting ◽

Core Symptoms ◽

The Brain

AbstractAttention-deficit/hyperactivity disorder (ADHD) is a lifelong condition that begins in childhood and continues with adult manifestations related to the core symptoms. Approximately 50% to 75% of children with ADHD continue to meet criteria for the disorder as adolescents and adults. Adults with the disorder increasingly present to primary care physicians, psychiatrists, and other practitioners for diagnosis and treatment. Understanding the diagnosis of ADHD in adults requires knowledge of age-dependent decline of symptoms over time. Retrospective recall of symptoms and impairment are valid methods of diagnosing the disorder. ADHD is also a brain disorder with a strong neurobiologic basis, complex etiology, and genetic component. Genetic and environmental vulnerabilities give rise to abnormalities in the brain and subsequent behavioral and cognitive deficits, which may produce the symptoms associated with ADHD. Magnetic resonance imaging studies of ADHD have provided evidence that abnormalities in the brain are caused by the disorder itself rather than treatment of the disorder. Psychiatric comorbidity is common among patients with ADHD and tends to complicate treatment. Acute and long-term use of long-acting stimulant formulations (methylphenidate and amphetamine compounds) have shown robust efficacy and tolerability consistent with the treatment response established in children with ADHD. Non-stimulant medications have demonstrated efficacy as well, and may be preferred in patients with tic and substance use disorders.In this expert roundtable supplement, Timothy E. Wilens, MD, reviews the epidemiology and clinical presentation of adult ADHD. Next, Joseph Biederman, MD, provides an overview of recent advances in the neurobiology of ADHD. Thomas J. Spencer, MD, reviews stimulant treatment of adult ADHD, and Lenard A. Adler concludes with a discussion of non-stimulant trials in adult ADHD.

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Panel Discussion

CNS Spectrums ◽

10.1017/s1092852900026031 ◽

2007 ◽

Vol 12 (S6) ◽

pp. 14-14 ◽

Cited By ~ 2

Keyword(s):

Primary Care Physicians ◽

Adult Adhd ◽

Panel Discussion ◽

Brain Disorder ◽

Stimulant Treatment ◽

Children With Adhd ◽

Adolescents And Adults ◽

Stimulant Medications ◽

Long Acting ◽

The Brain

AbstractAttention-deficit/hyperactivity disorder (ADHD) is a lifelong condition that begins in childhood and continues with adult manifestations related to the core symptoms. Approximately 50% to 75% of children with ADHD continue to meet criteria for the disorder as adolescents and adults. Adults with the disorder increasingly present to primary care physicians, psychiatrists, and other practitioners for diagnosis and treatment. Understanding the diagnosis of ADHD in adults requires knowledge of age-dependent decline of symptoms over time. Retrospective recall of symptoms and impairment are valid methods of diagnosing the disorder. ADHD is also a brain disorder with a strong neurobiologic basis, complex etiology, and genetic component. Genetic and environmental vulnerabilities give rise to abnormalities in the brain and subsequent behavioral and cognitive deficits, which may produce the symptoms associated with ADHD. Magnetic resonance imaging studies of ADHD have provided evidence that abnormalities in the brain are caused by the disorder itself rather than treatment of the disorder. Psychiatric comorbidity is common among patients with ADHD and tends to complicate treatment. Acute and long-term use of long-acting stimulant formulations (methylphenidate and amphetamine compounds) have shown robust efficacy and tolerability consistent with the treatment response established in children with ADHD. Non-stimulant medications have demonstrated efficacy as well, and may be preferred in patients with tic and substance use disorders.In this expert roundtable supplement, Timothy E. Wilens, MD, reviews the epidemiology and clinical presentation of adult ADHD. Next, Joseph Biederman, MD, provides an overview of recent advances in the neurobiology of ADHD. Thomas J. Spencer, MD, reviews stimulant treatment of adult ADHD, and Lenard A. Adler concludes with a discussion of non-stimulant trials in adult ADHD.

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The mediating role of emotional lability in the relation between adult ADHD symptoms, alcohol and cannabis consumption: an ecological momentary assessment study

10.31219/osf.io/9vwmc ◽

2021 ◽

Author(s):

Ruth Brown ◽

Lydia Gabriela Speyer ◽

Ingrid Obsuth ◽

Denis Ribeaud ◽

Manuel Eisner ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Adult Adhd ◽

Emotional Lability ◽

Adhd Symptoms ◽

Mediating Role ◽

Assessment Study ◽

Cannabis Consumption ◽

Ecological Momentary ◽

Momentary Assessment

Objective: To explore the mediating role of emotional lability in the relationship between adult ADHD symptoms, and cannabis and alcohol consumption.Method: Emotional lability and concurrent cannabis and alcohol consumption were measured as part of the ecological momentary assessment study, ‘Decades to Minutes’; embedded within the longitudinal z-proso study. Adults (n = 289, aged 20) completed measures of concurrent alcohol and cannabis consumption, and emotional lability at four quasi-random time periods per day, over a 14-day period. ADHD symptoms were retrieved from the participants’ corresponding z-proso data. Results: Structural equation modelling revealed that ADHD symptoms, but not emotional lability, had a direct effect on concurrent cannabis use. Contrastingly, emotional lability, but not ADHD symptoms, had a direct effect on concurrent alcohol use. Conclusion: Results highlight the differing effects of emotional lability in the association between ADHD symptoms and different types of substance use. Clinical implications of these findings are discussed.

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