Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = ...10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.
Autism spectrum disorders (ASDs) represent a formidable challenge for psychiatry and neuroscience because of their high prevalence, lifelong nature, complexity and substantial heterogeneity. Facing ...these obstacles requires large-scale multidisciplinary efforts. Although the field of genetics has pioneered data sharing for these reasons, neuroimaging had not kept pace. In response, we introduce the Autism Brain Imaging Data Exchange (ABIDE)-a grassroots consortium aggregating and openly sharing 1112 existing resting-state functional magnetic resonance imaging (R-fMRI) data sets with corresponding structural MRI and phenotypic information from 539 individuals with ASDs and 573 age-matched typical controls (TCs; 7-64 years) (http://fcon_1000.projects.nitrc.org/indi/abide/). Here, we present this resource and demonstrate its suitability for advancing knowledge of ASD neurobiology based on analyses of 360 male subjects with ASDs and 403 male age-matched TCs. We focused on whole-brain intrinsic functional connectivity and also survey a range of voxel-wise measures of intrinsic functional brain architecture. Whole-brain analyses reconciled seemingly disparate themes of both hypo- and hyperconnectivity in the ASD literature; both were detected, although hypoconnectivity dominated, particularly for corticocortical and interhemispheric functional connectivity. Exploratory analyses using an array of regional metrics of intrinsic brain function converged on common loci of dysfunction in ASDs (mid- and posterior insula and posterior cingulate cortex), and highlighted less commonly explored regions such as the thalamus. The survey of the ABIDE R-fMRI data sets provides unprecedented demonstrations of both replication and novel discovery. By pooling multiple international data sets, ABIDE is expected to accelerate the pace of discovery setting the stage for the next generation of ASD studies.
Objective: Identification of biomarkers is a priority for attention-deficit/hyperactivity disorder (ADHD). Studies have documented macrostructural brain alterations in ADHD, but few have examined ...white matter microstructure, particularly in preadolescent children. Given dramatic white matter maturation across childhood, microstructural differences seen in adolescents and adults with ADHD may reflect compensatory restructuring, rather than early neurophenotypic markers of the disorder. Method: Using tract-based spatial statistics, mean fractional anisotropy (FA) maps were created using diffusion tensor imaging. FA, mean diffusivity (MD), and associated axial and radial diffusivities were compared between 16 children with ADHD and 20 healthy children (age 7-9 years). Results: Youth with ADHD showed decreased FA in frontoparietal, frontolimbic, cerebellar, corona radiata, and temporo-occipital white matter compared with controls. In addition, ADHD was associated with lower MD in the posterior limb of the internal capsule and frontoparietal white matter and greater MD in frontolimbic white matter. Lower axial diffusion and/or higher radial diffusion were differentially observed for youth with ADHD in earlier versus later maturing areas of group FA/MD difference. Conclusions: This study suggests that, even prior to adolescence, ADHD represents a disorder of altered structural connectivity of the brain, characterized by distributed atypical white matter microstructure. In addition, later maturing frontolimbic pathways were abnormal in children with ADHD, likely due to delayed or decreased myelination, a finding not previously demonstrated in the adolescent or adult stages of the disorder. These results suggest that disruptions in white matter microstructure may play a key role in the early pathophysiology of ADHD. (Contains 2 tables and 1 figure.)
The science of attention‐deficit/hyperactivity disorder (ADHD) is motivated by a translational goal – the discovery and exploitation of knowledge about the nature of ADHD to the benefit of those ...individuals whose lives it affects. Over the past fifty years, scientific research has made enormous strides in characterizing the ADHD condition and in understanding its correlates and causes. However, the translation of these scientific insights into clinical benefits has been limited. In this review, we provide a selective and focused survey of the scientific field of ADHD, providing our personal perspectives on what constitutes the scientific consensus, important new leads to be highlighted, and the key outstanding questions to be addressed going forward. We cover two broad domains – clinical characterization and, risk factors, causal processes and neuro‐biological pathways. Part one focuses on the developmental course of ADHD, co‐occurring characteristics and conditions, and the functional impact of living with ADHD – including impairment, quality of life, and stigma. In part two, we explore genetic and environmental influences and putative mediating brain processes. In the final section, we reflect on the future of the ADHD construct in the light of cross‐cutting scientific themes and recent conceptual reformulations that cast ADHD traits as part of a broader spectrum of neurodivergence.
Read the Commentary on this article at doi: 10.1111/jcpp.13758.
Before assigning full etiologic validity to a psycopathologic disorder, disease theory suggests that a causal dysfunction in a mechanism within the affect individuals must be identified. Existing ...theories on attention-deficit/hyperactivity disorder (ADHD) suggest such dysfunctions in cognitive, neuropsychological, or motivational processes in the child. To date, researchers have tested these theories by comparing groups with DSM-defined ADHD to children without ADHD. Using executive functioning as an illustration of an issue that exists across all such theories, this article describes substantial overlaps in the group performance data. Thus only a subgroup may have executive deficits. Noted are other supportive data suggesting multiple pathways to ADHD. The article explores implications and recommends that future theory and research give more consideration to the probability that only a subset of behaviorally defined children will have a deficit in a given neurocognitive mechanism believed to contribute to the disorder. Creation of a provisional set of criteria in DSM-V for defining an “executive deficit type” could stimulate research to validate the first etiologic subtype of ADHD and spur the development of more sophisticated causal models, which in the longer term may give clinicians ways to target and tailor treatments.
Attention-deficit/hyperactivity disorder (ADHD) is a behavioral syndrome that arises in early childhood, often co-occurs with conduct disorder and leads, developmentally, to antisocial behavior and ...substance abuse. Models from cognitive and affective neuroscience have been invoked in an effort to understand the development of ADHD, leading to a broad array of interrelated theories and hypothesized mechanisms. In this paper, we highlight core mechanisms that may cut across several theories and constructs, and thus provide some leverage for further study and conceptualization from a neuroscience perspective. We emphasize the joint operations of frontostriatal and frontocerebellar neural loops in detecting and predicting what and when important events in the environment will occur and their interaction with frontoamygdala loops in assigning emotional significance to these events. We note that weaknesses in the development of these basic operations could lead to decrement in the development of cognitive and affective control and other mental operations mediated by prefrontal cortex during development. In turn, such decrement could lead to many of the phenotypic cognitive and neuropsychological features seen in children with ADHD.
Background: Prenatal problems are among theorized etiologies for child disruptive behavior problems. A key question concerns whether etiological contributors are shared across the broad range of ...disruptive psychopathology or are partially or largely distinct. Method: We examined prenatal smoking exposure and low birth weight as risk factors for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) in a population-based longitudinal design from ages 6 to 17 years. Multiple informants were used, with emphasis on parent and teacher report for ADHD, parent-and self-report interview for ODD, and self-report interview for CD, in keeping with evidence about the most valid sources of information for these respective syndromes. Results: The association of prenatal smoking exposure with ADHD was highly confounded by family variables. In contrast, low birth weight independently predicted ADHD, even with family variables statistically controlled. The opposite pattern appeared for ODD and CD. Prenatal smoking exposure but not low birth weight predicted ODD independent of potential confounding variables. Prenatal smoking exposure also predicted CD. The effect on CD was via its effect on ODD. Conclusion: Prenatal smoking exposure may contribute to ODD and via that route to later CD, but does not have a specific association with ADHD in this sample. Findings have implications for distinct etiological contributors to these often comorbid aspects of the disruptive behavior domain. (Contains 4 tables.)
Executive Function in Adolescents with ADHD Martel, Michelle; Nikolas, Molly; Nigg, Joel T
Journal of the American Academy of Child and Adolescent Psychiatry,
11/2007, Letnik:
46, Številka:
11
Journal Article
Recenzirano
A study is conducted to determine the specificity of executive function weakness in attention-deficit/hyperactivity disorder (ADHD) during adolescence. Results suggest that executive function ...weakness in ADHD is specifically associated with symptoms of inattention-disorganization.
Although a role for family and parent factors in the
development of behavioral problems in
childhood is often acknowledged, the roles of specific
parental characteristics in relation to
specific ...child actions need further elucidation. We
studied parental “Big Five” personality
traits and psychiatric diagnoses in relation to their
children's antisocial diagnoses and
naturalistically observed antisocial behaviors, in boys
with and without the diagnosis of
Attention-Deficit Hyperactivity Disorder (ADHD). First,
regardless of comorbid antisocial
diagnosis, boys with ADHD, more often than comparison
boys, had mothers with a major
depressive episode and/or marked anxiety symptoms
in the past year, and fathers with a
childhood history of ADHD. Second, compared to the
nondiagnosed group, boys with
comorbid ADHD+Oppositional Defiant or Conduct Disorder
(ODD/CD) had fathers
with lower Agreeableness, higher Neuroticism, and more
likelihood of having Generalized
Anxiety Disorder. Third, regarding linkages between
parental characteristics and child
externalizing behaviors, higher rates of child overt
antisocial behaviors observed in a
naturalistic summer program were associated primarily
with maternal characteristics,
including higher Neuroticism, lower Conscientiousness,
presence of Major Depression, and
absence of Generalized Anxiety Disorder. The association
of maternal Neuroticism with
child aggression was larger in the ADHD than in the
comparison group. In contrast, higher
rates of observed child covert antisocial behaviors
were associated solely with paternal
characteristics, including history of substance abuse
and higher Openness. Results provide
external validation in parent data for a distinction
between overt and covert antisocial
behaviors and support inclusion of parent personality
traits in family studies. The interaction
of maternal Neuroticism and child ADHD in predicting
child aggression is interpreted in
regard to a conceptualization of child by parent
“fit.” Abbreviations: ADHD: Attention-Deficit
Hyperactivity Disorder; CBCL: Child Behavior
Checklist; CD: Conduct Disorder; DBD: Disruptive Behaviors
Checklist; DIS-3-R:
Diagnostic Interview Schedule for DSM-III-R; MMPI:
Minnesota Multiphasic
Personality Inventory; NEO-FFI: Neuroticism, Extraversion,
Openness Five Factor
Inventory; ODD: Oppositional Defiant Disorder; WURS:
Wender Utah Rating Scale.
Attention-deficit hyperactivity disorder (ADHD) is a heritable disorder, prevalent from childhood through adulthood. Although the noradrenergic (NA) system is thought to mediate a portion of the ...pathophysiology of ADHD, genes in this pathway have not been investigated as frequently as those in the dopaminergic system. Previous association studies of one candidate gene in the NA system, ADRA2A, showed inconsistent results with regard to an MspI polymorphism. In the current study, two nearby single-nucleotide polymorphisms, which define HhaI and DraI restriction fragment length polymorphisms, were also genotyped and were in significant linkage disequilibrium with the MspI RFLP. Transmission disequilibrium tests (TDTs) in a sample of 177 nuclear families showed significant association and linkage of the DraI polymorphism with the ADHD combined subtype (P=0.03), and the quantitative TDT showed association of this polymorphism with the inattentive (P=0.003) and hyperactive-impulsive (P=0.015) symptom dimensions. The haplotype that contained the less common allele of the DraI polymorphism likewise showed a strong relationship with the inattentive (P=0.001) and hyperactive-impulsive (P=0.004) symptom dimensions. This study supports the hypothesis that an allele of the ADRA2A gene is associated and linked with the ADHD combined subtype and suggests that the DraI polymorphism of ADRA2A is linked to a causative polymorphism.
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