Effectiveness of Cognitive-behavioral Play Therapy on Improving Anxiety and Aggression Disorders in a Child With ADHD: A Case Study

This study aimed to assess the effects of cognitive-behavioral play therapy on anxiety and aggression in children with attention-deficit hyperactivity disorder (ADHD) by reporting a 7-year-old boy with ADHD inattentive type diagnosed by a psychiatrist. According to the interview, it was observed that the child was physically abused by the father. The chief complaint of the patient’s family was the symptoms of aggression, anxiety disorder, and urinary incontinence. We used the trauma system therapy model, which is used for children and adolescents who have had traumatic experiences and problems with emotional and behavioral modifications. The intervention was provided in 8 sessions for 2 days a week and lasted 45 minutes each. The child was evaluated using the Aggression Scale for Preschoolers and Preschool Anxiety Scale. The results of this study showed that cognitive behavior play therapy can reduce anxiety and aggression in ADHD children who are physically abused.

What is ADHD?

This chapter discusses what ADHD is, including an overview of the features of ADHD, features of the inattentive type of ADHD (poor concentration, task impersistence, disorganization, forgetfulness), features of the combined type of ADHD (impulsivity, overactivity, noisiness), and features that may be present in either type of ADHD (performance inconsistency, low self-esteem, poor working memory, poor incentival motivation, social clumsiness, learning difficulties, inflexibility, insatiability, defiant behaviour, sleep problems), as well as associated conditions, prevalence, and a historical background.

Suicidal behaviors and attention deficit hyperactivity disorder (ADHD): a cross-sectional study among Chinese medical college students

Backgrounds Associations between attention deficit hyperactivity disorder (ADHD) subtypes and suicidal behaviors remains unclear. The current study explored the prevalence of suicidal behaviors, and its association with ADHD among Chinese medical students. Methods Five thousand six hundred ninety-three medical college students participated. Symptoms of suicidal behaviors, ADHD, anxiety, depression, tobacco and alcohol use were assessed using online questionnaires. Results The prevalence of lifetime suicidal ideation, suicide plans, and suicide attempts among medical college students were 27.5, 7.9 and 14.8% respectively. Participants with ADHD predominantly inattentive type (ADHD-I) had more than fivefold increased odds of suicidal behaviors, the adjusted odds ratios (ORs) of ADHD-I and ADHD combined type (ADHD-C) remained significant after controlling for confounding factors. Conclusions ADHD is associated with high risk of suicidal behaviors. ADHD-I and ADHD-C were strongly associated with suicidal behaviors independent of comorbidities. The finding suggests the importance of addressing ADHD symptoms in suicide prevention.

Inattention, Impulsivity, and Hyperactivity in Deaf Children Are Not Due to Deficits in Inhibitory Control, but May Reflect an Adaptive Strategy

The present study had two main aims: (1) to determine whether deaf children show higher rates of key behaviors of ADHD (inattentive, hyperactive, and impulsive behaviors) and of Conduct Disorder—CD—(disruptive, aggressive, or antisocial behaviors) than hearing children, also examining whether the frequency of these behaviors in deaf children varied based on cochlear implant (CI) use, type of school (regular vs. specific for deaf) and level of receptive vocabulary; and (2) to determine whether any behavioral differences between deaf and hearing children could be explained by deficits in inhibitory control. We measured behaviors associated with ADHD and CD in 34 deaf and hearing children aged 9–10 years old, using the revised Spanish version of the Conners scale. We then assessed inhibitory control ability using a computerized Stroop task and a short version of the Attention Network Test for children. To obtain a measure of the level of receptive vocabulary of the deaf children we used a Spanish version of the Carolina Picture Vocabulary Test for Deaf and hearing-impaired children. Deaf children showed significantly higher rates of behaviors associated with ADHD and CD, and over 85% of cases detected with high risk of ADHD-inattentive type in the entire present sample were deaf children. Further, in the group of deaf children a negative correlation was found between receptive vocabulary and frequency of disruptive, aggressive, or antisocial behaviors associated with CD. However, inhibitory control scores did not differ between deaf and hearing children. Our results suggested that the ADHD-related behaviors seen in deaf children were not associated with a deficit in inhibitory control, at least in the interference suppression subcomponent. An alternative explanation could be that these behaviors are reflecting an adaptive strategy that permits deaf children to access information from their environment which is not available to them via audition.

Impulsivity and Venturesomeness in an Adult ADHD Sample: Relation to Personality, Comorbidity, and Polygenic Risk

While impulsivity is a basic feature of attention-deficit/hyperactivity disorder (ADHD), no study explored the effect of different components of the Impulsiveness (Imp) and Venturesomeness (Vent) scale (IV7) on psychiatric comorbidities and an ADHD polygenic risk score (PRS). We used the IV7 self-report scale in an adult ADHD sample of 903 patients, 70% suffering from additional comorbid disorders, and in a subsample of 435 genotyped patients. Venturesomeness, unlike immediate Impulsivity, is not specific to ADHD. We consequently analyzed the influence of Imp and Vent also in the context of a PRS on psychiatric comorbidities of ADHD. Vent shows a distinctly different distribution of comorbidities, e.g., less anxiety and depression. PRS showed no effect on different ADHD comorbidities, but correlated with childhood hyperactivity. In a complementary analysis using principal component analysis with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ADHD criteria, revised NEO Personality Inventory, Imp, Vent, and PRS, we identified three ADHD subtypes. These are an impulsive–neurotic type, an adventurous–hyperactive type with a stronger genetic component, and an anxious–inattentive type. Our study thus suggests the importance of adventurousness and the differential consideration of impulsivity in ADHD. The genetic risk is distributed differently between these subtypes, which underlines the importance of clinically motivated subtyping. Impulsivity subtyping might give insights into the organization of comorbid disorders in ADHD and different genetic background.

Maternal Ferritin Levels during Pregnancy and ADHD Symptoms in 4-Year-Old Children: Results from the INMA–INfancia y Medio Ambiente (Environment and Childhood) Prospective Birth Cohort Study

Ferritin status during prenatal brain development may influence the risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. We investigated the association of maternal ferritin in pregnancy and ADHD-like symptoms in offspring. A total of 1095 mother-child pairs from three birth cohorts of the INMA Project (Spain) were studied. Maternal plasma ferritin in pregnancy was measured at 11.57 weeks of gestation. Children′s ADHD-like symptoms at ages 4–5 years were assessed using the ADHD Rating Scale-IV. The count model of the zero-inflated Poisson regression model showed a significant inverse association between ferritin (continuous variable) and inattention, β = −0.19 (−0.32, −0.07), for boys. Comparing ferritin level by tertiles, significant differences were observed between the first tertile ([1.98, 20.92]) and the second ([20.92, 38.79]) and third tertiles ([38.79, 216.5]) (mg/L).The number of symptoms was lower for those in the third tertile, β = −0.3 (−0.55, −0.5), and for those in the second one, β = −0.37 (−0.6, −0.14). The model stratification by sex also showed this inverse association for boys only, β = −0.21 (−0.34, −0.08). No associations were found between ferritin level and hyperactivity or total ADHD symptoms. High ferritin levels during pregnancy show a protective association with child inattentive-type ADHD symptoms.

Meta-Analysis: MRI Volumetric Data of Children with ADHD Subtypes

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder consisting of inattentive and/or hyperactive behaviors that is typically prevalent in childhood. There are three recognized subtypes of this disorder—hyperactive, inattentive, and combined. The current study’s purpose is to examine how the subtypes differentiate based on brain structure volume size. There have been studies on ADHD subtypes and brain structure volumes in children, but there are a number of limitations in available research that make it difficult to generalize findings. A meta-analysis was done using 8 studies that included volumetric data of ADHD subtypes (inattentive and combined) in children that was acquired through magnetic resonance imaging (MRI) techniques. Analyses were done looking at combined and inattentive type in comparison to controls and between the two groups. Further subgroup analyses were done on gender and brain regions in the two subtypes. Results show that there is a significant brain volume reduction in combined type in comparison to controls and inattentive type. There is also a significant volume reduction observed in males. The other analyses done yielded insignificant findings, although the volume reduction in inattentive type was only slightly above the cutoff of alpha (0.05). These findings help in better understanding the relations between brain volume and ADHD subtypes, but further research is still needed in this area.

Correlation of psychopathology and white matter abnormalities in fathers of children with ADHD: Cross sectional study

Background Attention-deficit/hyperactivity disorder (ADM)) is one of the most common neurobehavioral disorders of childhood. Children with ADHD may experience significant adaptation problems because their functional level and behavior may not correspond to their chronological age or expected development level. ADHD is a chronic disease, the symptoms of which can persist into adulthood and become lifelong. Aim of the work evaluating the biological substrate in fathers of children with ADHD, assessing rate of occurrence of ADHD among fathers of children with ADHD. Subjects and Methods This descriptive observational cross-sectional study was conducted on 40 children with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) according to the DSNI-IV criteria who attended to the Child and Adolescent Outpatient clinics of the Institute of Psychiatry, Ain Shams University Hospital. Results Prevalence rate of diagnosis of adult ADHD among fathers of children with ADHD (6 to 12) years old was 60%, 20% with mixed hyperactive—inattentive type, 15%.predominantly hyperactive—impulsive type and 25% predominantly inattentive type. There were statistically significant differences between ADHD group of children’s fathers in comparison to Non-ADHD group, as the mean ADC of right and left middle cerebellar peduncle, was lower in ADHD group which indicates absence of abnormalities in white matter integrity in those areas. Conclusion prevalence rate of adult ADHD among fathers was 60%. There were no abnormalities in white matter integrity in group of fathers with diagnosis of adult ADHD.

Exceptional Learners

Exceptional learners is the term used in the United States to refer to students with disabilities (as well as those who are gifted and talented). The majority of students with disabilities have cognitive and/or behavioral disabilities, that is, specific learning disability (SLD), intellectual disability (ID), emotional disturbance, (ED), attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD). The remaining have primarily sensory and/or physical disabilities (e.g., blindness, deafness, traumatic brain injury, cerebral palsy, muscular dystrophy). Many of the key research and policy issues pertaining to exceptional learners involve their definitions and identification. For example, prior to SLD being formally recognized by the U.S. Department of Education in the 1970s, its prevalence was estimated at approximately 2% to 3% of the school-age population. However, the prevalence of students identified for special education as SLD grew rapidly until by 1999 it reached 5.68% for ages 6 to 17 years. Since then, the numbers identified as SLD has declined slowly but steadily. One probable explanation for the decrease is that response to intervention has largely replaced IQ-achievement as the method of choice for identifying SLD. The term intellectual disability has largely replaced the classification of mental retardation. This change originated in the early 2000s because of the unfortunate growing popularity of using retard as a pejorative. Although ID used to be determined by a low IQ-test score, one must also have low adaptive behavior (such as daily living skills) to be diagnosed as ID. That is the likely reason why the prevalence of students with ID at under 1% is well below the estimated prevalence of 2.27% based solely on IQ scores two standard deviations (i.e., 70) below the norm of 100. There are two behavioral dimensions of ED: externalizing (including conduct disorder) and internalizing (anxiety and withdrawal) behaviors. Research evidence indicates that students with ED are underserved in public schools. Researchers have now confirmed ADHD as a bona fide neurologically based disability. The American Psychiatric Association recognizes three types of ADHD: (a) ADHD, Predominantly Inattentive Type; (b) ADHD, Predominantly Hyperactive-Impulsive Type; and (c) ADHD, Combined Type. The American Psychiatric Association recognizes two types of ASD: social communication impairment and repetitive/restricted behaviors. The prevalence of ASD diagnosis has increased dramatically. Researchers point to three probable reasons for this increase: a greater awareness of ASD by the public and professionals; a more liberal set of criteria for diagnosing ASD, especially as it pertains to those who are higher functioning; and “diagnostic substitution”—persons being identified as having ASD who previously would have been diagnosed as mentally retarded or intellectually disabled. Instruction for exceptional children, referred to as “special education,” differs from what most (typical or average) children require. Research indicates that effective instruction for students with disabilities is individualized, explicit, systematic, and intensive. It differs with respect to size of group taught and amount of corrective feedback and reinforcement used. Also, from the student’s viewpoint, it is more predictable. In addition, each of these elements is on a continuum.

Penerapan Intervensi Self-Management untuk Meningkatkan Perilaku on-Task pada Anak Usia Sekolah dengan Attention Deficit Hyperactivity Disorder (ADHD) Inattentive Type

Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit problem behavior and struggle in the classroom both academically and behaviorally. To be successful in school, children are required to have the ability to engage in tasks during learning activities (on-task behavior). One of the intervention known as an effective strategy to increase on-task behavior of school-age children diagnosed with ADHD is a behaviorally-based self-management technique. This study was designed for a fifth grade student aged 11 years old with ADHD predominantly inattentive type. The study took place in an inclusive school at Bojong Gede. Using a single case AB design, four self-management strategy were implemented to increase the on-task behavior. Each baseline and follow-up data was collected over four days, while the intervention it self was implemented over 16 days. The result indicated that the self-management technique appeared to be effective in increasing on-task behavior of participant (from 38% to 90,5%). Keywords: ADHD, on-task; academic engagement, self-management; student