Trichotillomania in an Autistic Spectum Disroder: Single Case Intervention

The following work addresses trichotillomania and dermatillomania, both symptoms of the impulses control, in a 11 years old girl, who courses the sixth grade in a private elementary school and with a diagnose of first degree autism spectrum disorder and Attention Deficit Hyperactivity Disorder (ADHD) as a comorbidity. The objective was to reduce the frequency of tearing her hair and the skin imperfections in the school context throughout an intervention based on cognitive behavioral techniques. Within the used methodology to analyze the case an exhaustive evaluation of the patient has been performed using grade observation records, before and during the intervention period in order to systematize the whole process. The intervention techniques used where Token Economy and self-instruction. The results show a progressive improvement of the symptoms, reflected in the diminish of frequency of the behaviors registered that were conducted. In spite of the limited time for the intervention for these kinds of behaviors and the base line phase, it was possible to get to know the girl well and establish bonds with her, in spite of her condition, which can be noted in a better adaptation on her school context. This work seeks to favor the increase of research on this disorder since there is information related on the etiological factors, but it still is not enough, likewise, the related information on these disorders and its possible comorbidities is useful to continue with the advance on the treatments in this area.

Attention deficit hyperactivity disorder and its relation to aggressive behavior among primary school students of both genders in Riyadh, Saudi Arabia

The current study aimed to examine the correlation type between attention deficit hyperactivity disorders among primary school students of both genders in Riyadh, Saudi Arabia. It also sought to make comparisons between the male and female primary school students regarding attention deficit hyperactivity disorder and aggressive behavior. Further, the present study examined ADHD in children and its relationship to a number of other potentially related variables. The sample of the study consisted of 200 primary school students of both genders whose ages ranged between 9 to 13 years. To achieve the objectives of the study, it relied on the descriptive (correlative/comparative) method, especially the Pearson correlation coefficient and the T-test. The findings of the study show that there were more male children with attention deficit hyperactivity disorder (ADHD) and aggressive behavior than female students. The results of the study confirm the results of other studies. The study recommends that there is a need for early detection of children with developmental and emotional disorders (like children with ADHD). The results of the present study are also consistent with the findings of previous studies that indicated that attention disorder associated with hyperactivity is positively associated with aggressive behavior in children of both sexes. It also proposes to prepare and arrange guidance programs for them and their parents and strive towards achieving optimal treatment of such children in the school environment.

Verbal Expression and Mother’s Desperation about Their Children with Attention Deficit/Hyperactivity Disorder

Parents who have children with Attention Deficit Hyperactivity Disorder (ADHD) are challenging because these children are special and need special treatment. Because they are challenging, parents need support from their inner or outer circle. One of the strategies to get a support is by expressing what they feel. Feelings can be expressed in various ways, verbal and non-verbal. It can be in a non-formal situation like having a conversation in a community or a home environment. Thus, this research aims to describe the verbal expressions and desperation of the mothers to raise their children with Attention Deficit Hyperactivity Disorder (ADHD). This research uses phenomenological method called Interpretative Phenomenological Analysis (IPA) because this study focuses on interpretive processes in understanding participants’ experiences ideographically. 25 participants are observed and interviewed in-depth regarding their experiences in raising their children with Attention Deficit Hyperactivity Disorder (ADHD). The participants’ verbal expression of desperation are classified into seven themes: Repeating the same instruction or warning over and over, Being different and isolated, Mess things up in the house, Could not stay still and unpredictable, Aggressiveness, irritation and tantrums, Extra effort for visual learner, Child lacks of motivation. The results show that the feeling of desperation persistently happened because it is difficult to understand the characteristics of a child with Attention Deficit Hyperactivity Disorder (ADHD). The also admit that it is difficult to make normal children and mothers to accept their circumstances. Meanwhile, other participants state that they seek more information and knowledge about ADHD by joining a community to get help or support psychologically and medically, practice and more practice at home in order to help their children grow better.

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.

Which Factor Is More Relevant to the Effectiveness of the Cognitive Intervention? A Meta-Analysis of Randomized Controlled Trials of Cognitive Training on Symptoms and Executive Function Behaviors of Children With Attention Deficit Hyperactivity Disorder

Objective: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention, hyperactivity, and impulsivity. Multiple cognitive training appeared to be more effective than working memory training, but the evidence remains insufficient, particularly for the subgroup symptoms and executive function behaviors at home. Further analysis of the impact of factors on the effectiveness would facilitate the development of cognitive training.Methods: We searched PubMed, Cochrane Library, Psyche, Embase, Chinese Biomedical Literature Database, CNKI, and Weifang Database, and included randomized controlled trials (RCTs) of children with ADHD undergoing cognitive intervention. Metaanalysis and univariate metaregression were performed by STATE. The risk of bias was assessed with the Cochrane risk of bias tool 2.0 by the two investigators separately. This study was registered with INPLASY, number INPLASY202140065.Results: We included 17 RCTs in the systematic review, with a combined 1,075 participants. For metaanalyses of both subgroups of ADHD symptoms and the executive function behaviors, the test of published bias failed to reach the p < 0.05 level. When all of the training are considered together, cognitive training can improve the presentation of inattention symptoms [SMD = −0.390, 95%CI (−0.675, −0.104)] and executive function behaviors (SMD = −0.319, 95%CI (−0.527, −0.111)]. In the subgroup analysis, the effects of working memory training on both presentations were not statistically significant. In contrast, the multiple cognitive training had significant effects on the presentation of inattention symptoms [SMD = −0.507, 95% CI (−0.722, −0.292)], hyperactivity/impulsivity [SMD = −0.305, 95% CI (−0.518, −0.09)], and the executive function behaviors [SMD = −0.499, 95%CI (−0.707, −0.290)]. In addition, metaregression analysis showed that only training frequency did significantly impact the symptoms of ADHD and the executive function behaviors.Conclusion: This study showed that improvements in symptoms and executive function behaviors were related to the domains of cognitive intervention. The findings suggest that multiple domains of cognitive training and moderate training frequency may have wider clinical benefits. All the above results highlight further research in refining the executive functions of children with ADHD and developing individually tailored cognitive intervention on homes based for children with vulnerable executive functions.Systematic Review Registration: [http://inplasy.com/], [INPLASY202140065].

Cannabis for the Treatment of Attention Deficit Hyperactivity Disorder: A Report of 3 Cases

Attention deficit hyperactivity disorder (ADHD) is a chronic neurobehavioral disorder that is highly prevalent in children and adults. An increasing number of patients with ADHD are self-medicating with cannabis, despite a lack of evidence on efficacy and safety. This case report describes 3 males (ages 18, 22, and 23) who have integrated cannabis into their treatment regimen with positive results. Semistructured interviews conducted with the patients describe subjective improvements in symptoms and on quality of life. Improvements on validated rating scales conducted post-cannabis initiation, compared to pre-cannabis initiation obtained from the medical chart, corroborated their personal accounts. Scores on the PHQ-9 (measuring depression) improved by 8–22 points (30–81%), and the SCARED (measuring anxiety) ranged from 0 to 27 points (up to 33%). Improvements on the CEER-9 scale (measuring regulation) ranged from 2 to 7 points (22–78%), and the 9-item SNAP scale (measuring inattention) showed improvements of 2–8 points (7–30%). Mild adverse events including short-term memory problems, dry mouth, and sleepiness were reported. Blood samples were also collected from the patients to determine the plasma concentrations of the cannabinoids and relevant metabolites before and after a cannabis administration. After cannabis use, the plasma levels for CBD and THC ranged from 0 to 15.29 ng/mL and 1.32 to 13.76 ng/mL, respectively. Cannabinoids, however, were not detected prior to dosing, suggesting that cannabis played a complimentary role in the therapeutic regimen of these 3 patients. Clinical trials are recommended to confirm the efficacy of cannabis in the treatment of ADHD.