Background
Self‐regulation (SR) is central to developmental psychopathology, but progress has been impeded by varying terminology and meanings across fields and literatures.
Methods
The present ...review attempts to move that discussion forward by noting key sources of prior confusion such as measurement‐concept confounding, and then arguing the following major points.
Results
First, the field needs a domain‐general construct of SR that encompasses SR of action, emotion, and cognition and involves both top‐down and bottom‐up regulatory processes. This does not assume a shared core process across emotion, action, and cognition, but is intended to provide clarity on the extent of various claims about kinds of SR. Second, top‐down aspects of SR need to be integrated. These include (a) basic processes that develop early and address immediate conflict signals, such as cognitive control and effortful control (EC), and (b) complex cognition and strategies for addressing future conflict, represented by the regulatory application of complex aspects of executive functioning. Executive function (EF) and cognitive control are not identical to SR because they can be used for other activities, but account for top‐down aspects of SR at the cognitive level. Third, impulsivity, risk‐taking, and disinhibition are distinct although overlapping; a taxonomy of the kinds of breakdowns of SR associated with psychopathology requires their differentiation. Fourth, different aspects of the SR universe can be organized hierarchically in relation to granularity, development, and time. Low‐level components assemble into high‐level components. This hierarchical perspective is consistent across literatures.
Conclusions
It is hoped that the framework outlined here will facilitate integration and cross‐talk among investigators working from different perspectives, and facilitate individual differences research on how SR relates to developmental psychopathology.
Read the Commentary on this article at doi: 10.1111/jcpp.12707
Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in ...social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes.
► Health-related outcomes of ADHD are not well understood. ► ADHD is associated with elevated morbidity and mortality. ► ADHD is related to obesity but prospective data are lacking. ► ADHD is associated with elevated risk of accidental injury. ► Research on interventions targeting secondary health correlates of ADHD is necessary.
Attention Deficit Hyperactivity Disorder (ADHD) is a persistent, and impairing pediatric-onset neurodevelopmental condition. Its high prevalence, and recurrent controversy over its widespread ...identification and treatment, drive strong interest in its etiology and mechanisms. Emerging evidence for a role for neuroinflammation in ADHD pathophysiology is of great interest. This evidence includes 1) the above-chance comorbidity of ADHD with inflammatory and autoimmune disorders, 2) initial studies indicating an association with ADHD and increased serum cytokines, 3) preliminary evidence from genetic studies demonstrating associations between polymorphisms in genes associated with inflammatory pathways and ADHD, 4) emerging evidence that early life exposure to environmental factors may increase risk for ADHD via an inflammatory mechanism, and 5) mechanistic evidence from animal models of maternal immune activation documenting behavioral and neural outcomes consistent with ADHD. Prenatal exposure to inflammation is associated with changes in offspring brain development including reductions in cortical gray matter volume and the volume of certain cortical areas –parallel to observations associated with ADHD. Alterations in neurotransmitter systems, including the dopaminergic, serotonergic and glutamatergic systems, are observed in ADHD populations. Animal models provide strong evidence that development and function of these neurotransmitters systems are sensitive to exposure to in utero inflammation. In summary, accumulating evidence from human studies and animal models, while still incomplete, support a potential role for neuroinflammation in the pathophysiology of ADHD. Confirmation of this association and the underlying mechanisms have become valuable targets for research. If confirmed, such a picture may be important in opening new intervention routes.
•ADHD etiology is complex with genetic and environmental factors contributing to risk.•Initial studies indicate an association with ADHD and peripheral inflammation.•Emerging evidence exists for a role for neuroinflammation in ADHD pathophysiology.•Animal models support link between developmental exposure to inflammation and ADHD.
This review discusses conceptual issues in relating temperament to psychopathology, including the disputed relation of temperament to personality in children. A potential integrative framework is ...discussed that links trait and biological markers of temperament (reactive, incentive–response tendencies) with regulatory processes. This framework is utilized to highlight potential temperamental pathways to specific forms of psychopathology, noting that in some instances their relations may reflect a spectrum model (with psychopathology closely related as an extreme of a temperament‐based trait), but in many instances it likely reflects a vulnerability‐transaction set of processes. Conduct disorder involves at least two temperamental paths, one emanating from low fear response and one from either high incentive approach or high anger reactivity. Attention deficit hyperactivity disorder also involves at least two temperament pathways, one involving extremely low effortful control and the other likely involving strong approach. Anxiety disorders appear to result from the confluence of high negative emotionality and low effortful control. Hypotheses for future research are presented and limitations discussed.
Interest in the value of omega−3 (n−3) fatty acid supplementation for treatment of ADHD remains high. No prior meta-analysis has examined whether ADHD is associated with alterations in blood lipid ...levels and meta-analyses of supplementation have reached conflicting conclusions.
We report two new meta-analyses. Study 1 examined blood levels of omega−3 fatty acids in relation to ADHD. Study 2 examined a larger sample of randomized intervention trials than previously reported.
Study 1 included 9 studies (n=586) and found lower overall blood levels of n−3 in individuals with ADHD versus controls (g=0.42, 95% CI=0.26–0.59; p<.001). Study 2 included 16 studies (n=1408) and found that n−3 supplementation improved ADHD composite symptoms; using the best available rating and reporter (g=0.26, 95% CI=0.15–0.37; p<.001). Supplementation showed reliable effects on hyperactivity by parent and teacher report, but reliable effects for inattention only by parent report.
Omega−3 levels are reduced in children with ADHD. Dietary supplementation appears to create modest improvements in symptoms. There is sufficient evidence to consider omega−3 fatty acids as a possible supplement to established therapies. However it remains unclear whether such intervention should be confined to children with below normal blood levels.
•Meta-analysis found lower blood levels of n-3 fatty acids in ADHD versus controls.•Study verified efficacy with small effect of n-3 supplementation for improving ADHD symptoms.•Evidence may justify n-3 as a potential supplementary treatment for ADHD.
Parsing ADHD With Temperament Traits Nigg, Joel T.
Current directions in psychological science : a journal of the American Psychological Society,
08/2022, Letnik:
31, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Attention-deficit/hyperactivity disorder (ADHD) is common, is costly, and confers substantial risk of chronic poor outcome. It exemplifies the need to better understand variation within psychiatric ...conditions (heterogeneity) and co-occurrence of different conditions. In particular, ADHD’s broad clinical heterogeneity has required clarification, as subtypes for which there is consensus have not emerged. The outlook for making progress in understanding ADHD heterogeneity is promising, however, when one considers dimensions of trait affectivity, such as surgency and negative affectivity; their constituent lower-order traits, such as irritability; and the integrative function of self-regulation. Several lines of investigation focusing on ADHD and temperament traits (related to emotional regulation and dysregulation) are proving useful. Work in this area has the potential to improve theory, nosology, and clinical assessment in the future.
Few if any experts believe that existing psychiatric diagnostic categories included in DSM and ICD are actually discrete disease entities. Attention-deficit/hyperactivity disorder (ADHD) is ...emblematic of the problems in the existing psychiatric classification system. ADHD symptoms reliably cluster into two correlated dimensions in factor analysis. However, children with ADHD vary considerably in their symptom profiles, symptom trajectories, clinical outcomes, and biological and psychological correlates. Thus, the field has sought alternative approaches that harness the dimensions of emotional, cognitive, and behavioral functioning that underlie ADHD and other existing psychiatric categories to create informative phenotypes that improve clinical prediction and clarify etiology. Within ADHD, cognitive (neuropsychological) and temperament/personality features have received considerable attention. In some cases, subphenotypes based on these features appear to improve on existing classifications and could eventually be translated into clinical practice. This review summarizes findings from subphenotyping efforts in ADHD that use cognitive, emotion-related, and other features to highlight major considerations for research applying person-oriented approaches to inform an improved psychiatric nosology. Considerations related to feature selection, validation of newly proposed divisions, defining populations of interest, and incorporating a developmental perspective are discussed.
Recent studies using Magnetic Resonance Imaging (MRI) have proposed that the brain's white matter is organized as a rich club, whereby the most highly connected regions of the brain are also highly ...connected to each other. Here we use both functional and diffusion-weighted MRI in the human brain to investigate whether the rich club phenomena is present with functional connectivity, and how this organization relates to the structural phenomena. We also examine whether rich club regions serve to integrate information between distinct brain systems, and conclude with a brief investigation of the developmental trajectory of rich-club phenomena. In agreement with prior work, both adults and children showed robust structural rich club organization, comprising regions of the superior medial frontal/dACC, medial parietal/PCC, insula, and inferior temporal cortex. We also show that these regions were highly integrated across the brain's major networks. Functional brain networks were found to have rich club phenomena in a similar spatial layout, but a high level of segregation between systems. While no significant differences between adults and children were found structurally, adults showed significantly greater functional rich club organization. This difference appeared to be driven by a specific set of connections between superior parietal, insula, and supramarginal cortex. In sum, this work highlights the existence of both a structural and functional rich club in adult and child populations with some functional changes over development. It also offers a potential target in examining atypical network organization in common developmental brain disorders, such as ADHD and Autism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The past decade has witnessed the establishment of several now well-replicated findings in the neuropsychology of attention-deficit/hyperactivity disorder (ADHD), which have been confirmed by ...meta-analyses. Progress has been notable from the importing of cognitive science and neuroscience paradigms. Yet these findings point to many neural networks being involved in the syndrome and to modest effect sizes suggesting that any one neuropsychologic deficit will not be able to explain the disorder. In this article, leading theories and key findings are briefly reviewed in four key domains: attention, executive functions, state regulation and motivation, and temporal information processing. Key issues facing the field of neuropsychologic research and theory in ADHD include 1) the need for more integrative developmental accounts that address both multiple neural systems and the socialization processes that assure their development; 2) consideration of multiple models/measures in the same study so as to examine relative contributions, within-group heterogeneity, and differential deficit; and 3) better integration of cognitive process models with affective and temperament theories so that early precursors to ADHD can be better understood. Overall, the field has witnessed notable progress as it converges on an understanding of ADHD in relation to disruption of a multicomponent self-regulatory system. The next era must articulate multipathway, multilevel developmental accounts of ADHD that incorporate neuropsychologic effects.
The imprecise nature of psychiatric nosology restricts progress towards characterizing and treating mental health disorders. One issue is the ‘heterogeneity problem’: different causal mechanisms may ...relate to the same disorder, and multiple outcomes of interest can occur within one individual. Our review tackles this heterogeneity problem, providing considerations, concepts, and approaches for investigators examining human cognition and mental health. We highlight the difficulty of pure dimensional approaches due to ‘the curse of dimensionality’. Computationally, we consider supervised and unsupervised statistical approaches to identify putative subtypes within a population. However, we emphasize that subtype identification should be linked to a particular outcome or question. We conclude with novel hybrid approaches that can identify subtypes tied to outcomes, and may help advance precision diagnostic and treatment tools.
The heterogeneity problem limits efforts to characterize typical and atypical cognitive phenomenon.Multidimensional approaches to overcome the heterogeneity problem are promising, but also limited by the curse of dimensionality.Identification of subpopulations through supervised and unsupervised methods offers an alternative approach toward characterizing heterogeneity.Supervised and unsupervised approaches toward characterizing heterogeneity are limited in that subpopulations are not tied to specific questions of interest.Hybrid methods that combine both supervised and unsupervised methods, such as FRF and SVA, are able to identify subpopulations tied to specific questions of interest (e.g., cognitive performance or treatment outcome), and may ultimately help refine psychiatric nosology.
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