Gender-Related Clinical Characteristics in Children and Adolescents with ADHD

Attention Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed neurodevelopmental disorder in school-age children, and it is usually associated with a significant impairment in global functioning. Traditionally, boys with ADHD are more likely to be referred for clinical assessments due to a higher prevalence of externalizing symptoms. However, as regards gender-related differential clinical characteristics between boys and girls with ADHD, further investigation is warranted in light of conflicting results found in currently available literature. In fact, a more precise clinical characterization could help increase appropriate diagnoses and treatment planning. In this context, we carried out a retrospective observational study on 715 children and adolescents diagnosed with ADHD from 2018 to 2020 at our center, in order to describe their gender-related clinical characteristics. Boys displayed higher average IQs, but they were comparable to girls in functional impairments and adaptive skills. Girls displayed higher scores on the Attention Problems subscale of the CBCL 6–18 and on several CPRS-R:L subscales, suggesting higher general ADHD symptom severity. Boys showed higher scores on CBCL 6–18 subscales, such as withdrawn/depressed, internalizing, and obsessive-compulsive problems. In conclusion, girls showed more severe ADHD features and lower IQ in clinically referred settings, while boys showed more internalizing problems and obsessive-compulsive symptoms.

Cognitive flexibility in 12-month-old preterm and term infants is associated with neurobehavioural development in 18-month-olds

There is growing evidence that preterm children are at an increased risk of poor executive functioning, which underlies behavioural and attention problems. Previous studies have suggested that early cognitive flexibility is a possible predictor of later executive function; however, how it develops in infancy and relates to the later neurobehavioural outcomes is still unclear in the preterm population. Here, we conducted a longitudinal study to investigate oculomotor response shifting in 27 preterm and 25 term infants at 12 months and its relationship with general cognitive development and effortful control, which is a temperamental aspect closely associated with executive function, at 18 months. We found that moderate to late preterm and term infants significantly inhibited previously rewarded look responses, while very preterm infants did not show significant inhibition of perseverative looking at 12 months. Moreover, lower inhibition of perseverative looking was significantly associated with lower general cognitive development and attentional shifting at 18 months. These findings suggest that the early atypical patterns of oculomotor response shifting may be a behavioural marker for predicting a higher risk of negative neurobehavioural outcomes, including attention-related problems in preterm children.

The usefulness of virtual, augmented, and mixed reality technologies in the diagnosis and treatment of attention deficit hyperactivity disorder in children: an overview of relevant studies

Background Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by attention problems, excessive physical activity, and impulsivity. ADHD affects not only the patients but also their families. The development and use of technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR) for ADHD has increased over recent years. However, little is known about their potential usefulness. This overview aimed to clarify the current knowledge about the use of these three innovative technologies for the diagnosis and treatment of children with ADHD. Methods This overview was conducted using the PubMed, Web of Science, and Scopus databases until January 24th, 2021. The following descriptive information was compiled from the identified studies: country, year of publication, sample size, study design, ADHD diagnosis methods, applied technology, hardware equipment, clinical target, and main findings. Results The initial database searches yielded 409 articles, but 103 were removed as duplicates. Eventually, 30 eligible studies remained for analysis, the majority of which were case-control (n = 22, 73%). Regarding the applied technology/hardware equipment, VR (n = 27; 90%), head-mounted displays (n = 19, 63%), VR-based continuous performance tests (VR-CPT) (n = 21, 70%) were most frequently used. Most studies (n = 21, 70%) used the DSM criteria for the diagnosis of childhood ADHD. They primarily evaluated the utility of these technologies in assessing ADHD symptoms (n = 10, 33%) and improving the ADHD diagnostic process (n = 7, 23%). Conclusion This comprehensive overview evaluated the studies on the use of VR, AR, and MR technologies for children with ADHD. These technologies seem to be promising tools for improving the diagnosis and management of ADHD in this population.

Overall Media Use and ADHD-Related Behaviors Among Children in China: A Meta-Analysis

There are several theoretical reasons to believe that overall media use might be related to attention deficit hyperactivity disorder (ADHD) or ADHD-related behaviors (i.e., attention problems, hyperactivity, and impulsivity). Although studies on media-ADHD relationship have accumulated, they have yielded inconsistent results, especially those from different countries. Therefore, it is still undisclosed whether children’s overall media use and ADHD-related behaviors are related to region and culture. A meta-analysis has been performed on three empirical studies investigating the relationship between overall media use and ADHD-related behaviors in children and adolescents from China. The results indicated significant relationship between overall media use and ADHD-related behaviors, OR = 2.597.

he effects of neurofeedback on attention and sleep in individuals with and without ADHD or insomnia: a literature review

Electroencephalography-Neurofeedbacktraining (E-NFT) is a method to support subjects in learning to self-regulate their own brain activity. Besides that E-NFT may improve cognitive functions in healthy people, it may improve symptoms in different disorders, such as Attention Deficit and Hyperactivity Disorder (ADHD) and insomnia. The evidence of E-NFT for the treatment of attention problems in ADHD is still under debate just as the suggested efficacy of E-NFT for reducing sleep problems in individuals suffering from insomnia and for improving attention and sleep in the general population. Therefore, this review examines the efficacy of E-NFT on attention and sleep in patients and healthy individuals. The reviewed literature provides evidence that standard E-NFT protocols may have a positive long-lasting effect on the inattention and hyperactivity/impulsivity symptoms in children with ADHD. In healthy children and young adults, E-NFT has been found to improve different aspects of attention and to reduce impulsivity. In addition, positive effects of E-NFT have been documented on sleep onset latency and on tiredness in healthy individuals. Sleep improvements have also been found in insomnia patients after standard E-NFT, although these subjective sleep improvements may likely depend on unspecific E-NFT training effects.

Correlate the Level of Internet Dependence and Associated Behavioral Problems among the Preschooler Children in the Selected Urban Area of Wardha District

India is seeing an increase in internet usage, particularly among young and children, as a result of the low cost and easy availability to touch screen mobile phones, tablet devices, and Wi-Fi. Since the previous decade, Internet use in India has grown at an exponential rate, resulting in a generation of gloomy anxiety about it, which has progressed to the point of becoming a hazardous addiction. Behavioral problems are arising due to internet dependence such as temper tantrum, aggression, thought problems, attention problems and rule breaking behaviors in the children and youth people too. Aim: To correlate the level of internet dependence and level of associated behavioral problems among the preschooler children. Materials and Methods: Descriptive correlation research design was used to conduct this study. A non-probability Convenience sampling was used to select the samples. This research study included 100 preschooler children from the Gajanan nagar (Arvi Naka) selected area of wardha district. Samples must select according to the inclusion and exclusion criteria. Young's Internet Addiction Test and behavioral scale was used to assess the level of internet dependence and also the level of associated behavioral problems of internet dependence. Results: The level of internet dependence: 3% of the preschooler children were disagree that they had internet dependence 4% had not sure, 80% had agree and 13% of them had strongly agree. Minimum Internet dependence score was 28 and maximum internet dependence score was 64. Mean Internet dependence score was 54.70±6.84 and mean percentage of Internet dependence score was 72.93±9.12. and associated Behavioural problems are 2% of the preschooler children were disagree that they had behavioral problem, 3% had not sure, 77% had agree and 18% of them had strongly agree. Minimum associated behavioral problem score was 37 and maximum associated behavioral problem score was 87. Mean associated behavioral problem score was 75.26±8.07 and mean percentage of associated behavioral problem score was 75.26±8.7. The hypothesis is tested statistically with association between internet dependence and behavioral problem. Conclusion: Parents and schools should educate their children on how to use the internet responsibly and how to balance time between online surfing, schoolwork, and outside physical activity. This study shows that there is a correlation-ship between the levels of internet dependency and associated behavioral issues in preschoolers. The situation is serious, and it will soon develop to an addicted state. Interventions such as setting limits and identifying early warning indications of underlying psychopathology are necessary.

Educational level, attention problems, and externalizing behaviour in adolescence and early adulthood: the role of social causation and health-related selection—the TRAILS study

Social causation and health-related selection may contribute to educational differences in adolescents’ attention problems and externalizing behaviour. The social causation hypothesis posits that the social environment influences adolescents’ mental health. Conversely, the health-related selection hypothesis proposes that poor mental health predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as attention problems and externalizing behaviour have the potential to interfere with educational attainment, but may also be affected by differences in the educational context. Furthermore, educational gradients in mental health may reflect the impact of ‘third variables’ already present in childhood, such as parental socioeconomic status (SES), and IQ. We investigated both hypotheses in relation to educational differences in externalizing behaviour and attention problems throughout adolescence and young adulthood. We used data from a Dutch cohort (TRAILS Study; n = 2229), including five measurements of educational level, externalizing behaviour, and attention problems from around age 14–26 years. First, we evaluated the directionality in longitudinal associations between education, externalizing behaviour, and attention problems with and without adjusting for individual differences using fixed effects. Second, we assessed the role of IQ and parental SES in relation to attention problems, externalizing behaviour, and educational level. Attention problems predicted decreases in education throughout all of adolescence and young adulthood. Differences in parental SES contributed to increases in externalizing behaviour amongst the lower educational tracks in mid-adolescence. Childhood IQ and parental SES strongly predicted education around age 14. Parental SES, but not IQ, also predicted early adolescent attention problems and externalizing behaviour. Our results provide support for the health-related selection hypothesis in relation to attention problems and educational attainment. Further, our results highlight the role of social causation from parental SES in determining adolescent educational level, attention problems, and externalizing behaviour.

Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis

Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10–19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.

Anger and Attention Problems as Mechanisms Linking Maltreatment Subtypes and Witnessed Violence to Social Functioning Among Children in Out-of-Home Care

Research has consistently shown that child maltreatment and witnessed violence lead to disrupted patterns of social functioning, yet the mechanisms underlying these pathways remain unclear. This cross-sectional study evaluated whether anger and/or attention problems mediated the links from abuse, neglect, and witnessed violence to peer problems and aggressive behavior. Participants included a diverse sample of 470 children (ages 8–11; 52.1% boys) living in out-of-home care. Subtype and severity of maltreatment exposure were coded using Child Protection Services’ intake reports and court records. Witnessed violence and anger were assessed using child-reports, and caregivers provided ratings of attention problems and social functioning. Indirect effects were tested using a series of structural equation path analysis models. Results indicated that anger fully mediated the links from witnessed violence to both peer problems and aggressive behavior. Further, attention problems fully mediated the links from physical abuse and physical neglect to both peer problems and aggressive behavior. These findings highlight the need for interventions to target anger regulation and attentional control among children in out-of-home care in order to mitigate their risk for social maladjustment.