BACKGROUND & AIMS: OBJECTIVE:Neuropsychological functioning of individuals with attention-deficit/hyperactivity disorder (ADHD) or heavy prenatal alcohol exposure has been well documented independently. This study examined the interaction between both factors on cognitive performance in children. METHOD:As part of a multisite study, 344 children (8-16 y, M = 12.28, SD = 2.52) completed a comprehensive neuropsychological battery. Four subject groups were tested: children with histories of heavy prenatal alcohol exposure (AE) and ADHD (AE+, n = 90), alcohol-exposed without ADHD, (AE-, n = 38), nonexposed with ADHD (ADHD, n = 80), and nonexposed without ADHD (CON, n = 136). RESULTS:Separate 2(AE) × 2(ADHD) MANCOVAs revealed significant main and interactive effects of ADHD and AE on overall WISC-IV, D-KEFS, and CANTAB performance. Individual ANOVAs revealed significant interactions on 2 WISC-IV indices [Verbal Comprehension (VCI), Perceptual Reasoning (PRI)], and four D-KEFS and CANTAB subtests [Design Fluency, Verbal Fluency, Trail Making, Spatial Working Memory]. Follow-up analyses demonstrated no difference between AE+ and AE- groups on these measures. The combined AE+/- group demonstrated more severe impairment than the ADHD group on VCI and PRI, but there were no other differences between clinical groups. CONCLUSIONS:These results support a combined AE+/- group for neuropsychological research and indicate that, in some cases, the neuropsychological effects seen in ADHD are altered by prenatal alcohol exposure. The effects of alcohol exposure on verbal comprehension and perceptual reasoning were greater than those related to having ADHD without alcohol exposure, although both conditions independently resulted in cognitive impairment compared to controls. Clinically, these findings demonstrate task-dependent patterns of impairment across clinical disorders.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:In Chronic Tic Disorders (CTD) associated Attention Deficit Hyperactivity Disorder (ADHD) is very common. Hence, it is important to clarify how both conditions are related to cognitive dysfunctions in patients with CTD+ADHD comorbidity. Recent studies on neuropsychology revealed equivocal results, mostly due to methodological shortcomings like problems in sample composition. Thus better and more detailed information on this topic is needed to improve diagnostic and treatment approaches. METHOD:Three tasks related to different domains of executive functions (the Matching Familiar Figures Test, the Stroop color-word interference task, and a computerized version of the Wisconsin Card Sorting Test) have been performed in two independent samples (altogether n = 138 children) both including four groups of children (CTD-only, CTD+ADHD, ADHD-only, healthy controls) matched for age and IQ. To specify the influence of either tics or ADHD-symptoms on executive functions and to answer the question of their interactive or additive relationship two-way analyses of variance (MANOVA) for the factors CTD (yes,-no) x ADHD (yes,no) were conducted. Eta squared was calculated to reveal the effect sizes for each factor. For a deeper understanding of group differences and to better enable the comparison with data in literature, additional analyses of variance (ANOVA) with posthoc testing were applied. RESULTS:In summary, there was a main effect only for the factor ADHD reflected by decreased performance, while no main effect of the factor CTD could be found. Admittedly, the effects were not uniform in both samples. However, in all three tasks and both samples, uniformly no interaction between the main factors has been observed. CONCLUSIONS:In cases of coexisting CTD+ADHD the factor ADHD shows the main negative impact on neuropsychological performance and this impact seems to be independent of any feature of the coexisting tics (additive model). This supports the notion to primarily treat the ADHD-symptoms in order to increase cognitive self regulatory abilities of these children. Contrarily, tics seem to have little impact on cognitive performance in most cases.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:The world prevalence of ADHD ranges between 5-10%. The prevalence in Israel was generally studied from prescriptions of methylphenidate and not from cohorts of children. METHODS:We assessed the prevalence of ADHD among a cohort of early school age children in the Jewish and Arab populations using DSM-IV criteria and evaluated the difference between teachers' and parental assessment. We also studied in the Jewish population the differences in several social-behavioral parameters between children with and without ADHD. RESULTS:The rate of ADHD among the Jewish children was 9.5% and among the Arab children it was significantly lower - 7.35%. Teachers' evaluation in the Jewish population was 2.3 times higher than parental evaluation but in the Arab population it was closer to that of the parents, being only 12% higher. In addition, there were more regulatory, behavioral and learning problems among the Jewish children with ADHD compared to children without ADHD. CONCLUSIONS:The rates of ADHD in school age children among both Jews and Arabs fall within the average rate in other countries. The high difference between teachers' and parental assessment of ADHD in the Jewish population emphasizes that ADHD diagnosis should rely on the joint behavioral assessment of both. The prevalence of ADHD in Jewish early school age children is slightly higher than in Arab children and the inattentive type is the most common. There is a discrepancy between teachers' and parents' evaluation of children's behavior in the Jewish population, but this discrepancy is less in the Arab population.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Effective implementation of parent training programmes for preschool Attention-Deficit/Hyperactivity Disorder type is constrained by barriers limiting take-up and effective engagement by 'hard to reach' and 'difficult to treat' families. METHOD:We describe an evidence-driven adaptation and piloting of an existing empirically supported preschool ADHD parenting programme to address these problems. RESULTS:The New Forest Parenting programme was changed substantially in terms of length; content and delivery on the basis of information gathered from the literature, from parents and practitioners, further modifications were made after the pilot study. CONCLUSIONS:The adapted-NFPP is currently being assessed for efficacy in a large multicentre randomized controlled trial.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:We explored the reaction of boys with ADHD when they are angry at a friend. Due to their impulsivity and difficulty in focussing their attention, it may be expected that such boys be inclined to resort more frequently to confrontational and harmful strategies of anger regulation and less often to negotiation, reappraisal, or distancing strategies. METHODS:A sample of 23 boys diagnosed with ADHD (without co-morbid Oppositional Defiant Disorder or Conduct Disorder) between eight and thirteen years of age were compared to an age-matched sample of 23 boys with non-clinical behaviour. Strategies of anger regulation were assessed by means of a self-report questionnaire: Strategies of Anger Regulation for Children (SAR-C). RESULTS:The self-report reveals no difference between boys with ADHD and those without in terms of confrontation and harmful strategies. As expected, boys with ADHD reported less frequent use of distancing strategies. They also indicated less frequent negotiation of the event with the friend or re-appraisal thereof. CONCLUSIONS:Results indicate that boys with ADHD tend to report anger regulation strategies that require impulse control less often than their counterparts without ADHD. The groups did not differ in terms of their use of confrontational strategies that involved the acting out of their aggressive anger impulse because boys with ADHD (but without a co-morbid ODD or CD) may not intend to harm their friends in the long run and thus do not consider their behaviour to be aggressive.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The goal of this study was to validate the pilot Adult ADHD Self-Report Scale (pilot ASRS) versus standard clinician ratings on the ADHD Rating Scale (ADHD RS). METHOD:Sixty adult ADHD patients took the self-administered ADHD RS and then raters administered the standard ADHD RS. Internal consistency of symptom scores was assessed by Cronbach's alpha. Agreement of raters was established by intra-class correlation coefficients (ICCs) between scales. RESULTS:Internal consistency was high for both patient and rater-administered versions (Cronbach's alpha 0.88, 0.89, respectively). The ICC between scales for total scores was also high (0.84); ICCs for subset symptom scores were also high (both 0.83). There was acceptable agreement for individual items (% agreement: 43%-72%) and significant kappa coefficients for all items (p < 0.001). CONCLUSIONS:The pilot Adult ADHD Self-Report Scale symptom checklist is a reliable and valid scale for evaluating ADHD for adults and shows a high internal consistency and high concurrent validity with the rater-administered ADHD RS.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The Wender Utah Rating Scale (WURS) is used to retroactively assess ADHD symptoms. This study sought to determine whether the WURS actually functions as an index of dysfunctional personality traits. METHOD:Five hundred twenty-two adult participants completed the WURS and at least one of the following measures: Wechsler Adult Intelligence Scale-III (WAIS-III), Trails Making Test (Forms A and B), Conners' Continuous Performance Test, d2 Test of Attention, and the Personality Assessment Inventory (PAI). RESULTS:The WURS correlated significantly with all PAI clinical and treatment scales; however, of the neuropsychological measures, only the CPT significantly correlated with the WURS score. Multiple regression analyses revealed a significant model that included clinical and treatment scales from the PAI as well as working memory and processing speed indexes from the WAIS-III that accounted for 39% of the variance in WURS scores. CONCLUSION:Performance on the WURS was more related to dysfunctional personality traits than to actual attentional performance in this young adult sample. (J. of Att. Dis. 2009; 13(1) 87-94).

背景与目标：

BACKGROUND & AIMS: :Attention-Deficit and Hyperactivity Disorder (ADHD) is a common child and adolescent psychiatric disorder with a prevalence rate of 3-7%. Formal genetic studies provided an estimated heritability of 0.6-0.8 and an approximately five-fold elevated risk for ADHD in first-degree relatives. Currently, four genome scans have led to the identification of chromosomal regions potentially relevant in ADHD; especially the evidence for linkage to chromosome 5p13 is convincing. Meta-analyses of a large number of candidate gene studies suggest association with gene variants of the dopaminergic receptors DRD4 and DRD5, the serotonergic receptor HTR1B, and the synaptosomal receptor protein (SNAP-25). Hyperactivity has been investigated particularly in animal models, focusing on knockout- and quantitative trait loci (QTL) designs, with promising results for the dopaminergic system. It is likely that several gene polymorphisms with moderate to small effect sizes contribute to the phenotype ADHD; different combinations of such predisposing variants presumably underlie ADHD in different individuals. Therefore, large samples for molecular genetic studies are mandatory to detect these polymorphisms. Accordingly, several of today's findings have to be regarded as preliminary. The understanding of ADHD's neurobiology may be advanced by new technologies, such as SNP-based genome scans performed with gene chips comprising 10,000-1,000,000 SNPs, as well as using more sophisticated animal model designs.

背景与目标： : 注意力缺陷多动障碍 (ADHD) 是一种常见的儿童和青少年精神疾病，患病率为3-7%。正式的遗传研究提供了0.6-0.8的估计遗传力，一级亲属的ADHD风险增加了大约五倍。目前，四次基因组扫描已导致鉴定与ADHD潜在相关的染色体区域; 尤其是与5p13染色体连锁的证据令人信服。对大量候选基因研究的荟萃分析表明，与多巴胺能受体DRD4和DRD5，血清素能受体HTR1B和突触体受体蛋白 (SNAP-25) 的基因变异有关。特别是在动物模型中研究了多动症，重点是敲除和数量性状基因座 (QTL) 设计，并为多巴胺能系统带来了可喜的结果。几种具有中等至小效应大小的基因多态性可能会导致ADHD表型; 这种易感变异的不同组合可能是不同个体ADHD的基础。因此，用于分子遗传学研究的大样本必须检测这些多态性。因此，今天的一些发现必须被视为初步的。对ADHD的神经生物学的理解可以通过新技术来推进，例如使用包含10,000 1,000,000 SNP的基因芯片进行的基于SNP的基因组扫描，以及使用更复杂的动物模型设计。

BACKGROUND & AIMS: :Recent debates in the literature discuss commonalities between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) at multiple levels of putative causal networks. This debate requires systematic comparisons between these disorders that have been studied in isolation in the past, employing potential markers of each disorder to be investigated in tandem. The present study, choose superior local processing, typical to ASD, and increased Intra-Subject Variability (ISV), typical to ADHD, for a head-to-head comparison of the two disorders, while also considering the comorbid cases. It directly examined groups of participants aged 10-13 years with ADHD, ASD with (ASD+) or without (ASD-) comorbid ADHD and a typically developing (TD) group (total N = 85). A visual search task consisting of an array of paired words was designed. The participants needed to find the specific pair of words, where the first word in the pair was the cue word. This visual search task was selected to compare these groups on overall search performance and trial-to-trial variability of search performance (i.e., ISV). Additionally, scanpath analysis was also carried out using Recurrence Quantification Analysis (RQA) and the Multi-Match Model. Results show that only the ASD- group exhibited superior search performance; whereas, only the groups with ADHD symptoms showed increased ISV. These findings point towards a double dissociation between ASD and ADHD, and argue against an overlap between ASD and ADHD.

背景与目标： : 文献中最近的辩论在假定的因果网络的多个层面上讨论了注意力缺陷/多动障碍 (ADHD) 和自闭症谱系障碍 (ASD) 之间的共同点。这场辩论需要对过去隔离研究的这些疾病进行系统的比较，并采用每种疾病的潜在标志物进行串联研究。本研究选择了ASD典型的优越局部处理方法和ADHD典型的增加的受试者内变异性 (ISV)，以对两种疾病进行头对头比较，同时还考虑了合并症病例。它直接检查了年龄在10-13岁之间的ADHD，患有 (ASD) 或不患有 (ASD-) 共患ADHD的ASD和典型发育 (TD) 组 (总N = 85) 的参与者组。设计了一个由成对单词数组组成的视觉搜索任务。参与者需要找到特定的单词对，其中该对中的第一个单词是提示单词。选择此视觉搜索任务是为了比较这些组的整体搜索性能和搜索性能 (即ISV) 的试验间差异。此外，还使用递归量化分析 (RQA) 和多匹配模型进行了scanpath分析。结果表明，只有ASD组表现出优异的搜索性能; 而只有具有ADHD症状的组显示ISV增加。这些发现表明ASD和ADHD之间存在双重分离，并反对ASD和ADHD之间存在重叠。

BACKGROUND & AIMS: OBJECTIVE:Exploring differences in behavioral and academic progress between children displaying substantive ADHD behaviors (M age of 9.4 years) in special schools (n = 38) and in inclusive education (n = 26). The contribution of pedagogical strategies to positive outcomes was also examined. METHOD:Measurements used were the Teachers' Report Form, the Social Emotional Questionnaire, assessments of academic achievement, and the Pedagogical Methods Questionnaire. Mixed-model ANOVAs and Pearson's correlations were used to analyze the data. RESULTS:Significant progress was found regarding disorder-specific problem behavior and in all academic areas, but no interaction effect was found between time and setting. Correlations indicated that positive behavior reinforcement and emotional support are the pedagogical strategies that contributed most to behavioral adaptation. CONCLUSION:Children displaying substantive ADHD behaviors in both groups develop equally well in the areas of behavioral and academic functioning where significant progress was found.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:(a) Evaluate the efficacy and duration of effect of lisdexamfetamine dimesylate (LDX) in adult ADHD. (b) Assess the reliability and validity of the Adult ADHD Medication Smoothness of Effect Scale (AMSES) and Adult ADHD Medication Rebound Scale (AMRS). METHOD:Adults ( N = 40) with ADHD were treated with LDX for up to 12 weeks. The primary efficacy measure was the ADHD Rating Scale (ADHD-RS). The psychometric properties of the AMSES and AMRS are analyzed and compared with the ADHD-RS, ADHD Self-Report Scale (ASRS) v1.1 Symptom Checklist, and Time-Sensitive ADHD Symptom Scale (TASS). RESULTS:ADHD-RS scores were significantly improved with LDX. The AMSES and AMRS had high internal consistency and were correlated with the ADHD-RS, ASRS v1.1 Symptom Checklist, and TASS. CONCLUSION:LDX is effective in treating adult ADHD and has a smooth drug effect throughout the day with limited symptom rebound. The AMSES and AMRS are valid and reliable measures.

背景与目标：

BACKGROUND & AIMS: :Cortical neuronal migration and formation of filamentous actin cytoskeleton, needed for development, normal cell growth and differentiation, are regulated by the cyclin-dependent kinase 5 (Cdk5). Attention deficit hyperactivity disorder (ADHD) is associated with delayed maturation of the brain and hence we hypothesized that cdk5 may have a role in ADHD. Eight functional CDK5 gene variants were analyzed in 848 Indo-Caucasoid individuals including 217 families with ADHD probands and 250 healthy volunteers. Only three variants, rs2069454, rs2069456 and rs2069459, predicted to affect transcription, were found to be bimorphic. Significant difference in rs2069456 "AC" genotype frequency was noticed in the probands, more specifically in the males. Family based analysis revealed over transmission of rs2069454 "C" and rs2069456 "A" to the probands. Quantitative trait analysis exhibited association of haplotypes with inattention, domain specific impulsivity, and behavioral problem, though no significant contribution was noticed on the age of onset of ADHD. Gene variants also showed significant association with cognitive function and co-morbidity. Probands having rs2069459 "TT" showed betterment during follow up. It may be inferred from this pilot study that CDK5 may affect ADHD etiology, possibly by attenuating synaptic neurotransmission and could be a useful target for therapeutic intervention.

背景与目标： : 发育，正常细胞生长和分化所需的皮质神经元迁移和丝状肌动蛋白细胞骨架的形成，由细胞周期蛋白依赖性激酶5 (Cdk5) 调节。注意缺陷多动障碍 (ADHD) 与大脑的延迟成熟有关，因此我们假设cdk5可能在ADHD中起作用。在848个印度-高加索人个体中分析了八个功能性CDK5基因变异，包括217个ADHD先证者家庭和250个健康志愿者。仅发现三个可能影响转录的变体rs2069454，rs2069456和rs2069459是双态的。在先证者中，尤其是在男性中，发现rs2069456 “AC” 基因型频率存在显着差异。基于家庭的分析揭示了rs2069454 “C” 和rs2069456 “A” 向先证者的传输。数量性状分析显示单倍型与注意力不集中，领域特定的冲动性和行为问题相关，尽管在ADHD发病年龄上没有发现明显的贡献。基因变异也显示出与认知功能和合并症的显着关联。rs2069459 “TT” 先证者在随访期间显示出改善。从这项初步研究中可以推断出，CDK5可能会影响ADHD的病因，可能会减弱突触神经传递，并且可能是治疗干预的有用靶标。

BACKGROUND & AIMS: :Cannabis is the most widely used illicit substance in the United States with especially high prevalence of use among those with psychiatric disorders. Few studies have examined the relationship between concurrent cannabis use and treatment outcome among patients receiving treatment for comorbid substance abuse and psychiatric disorders. This study investigated the effects of cannabis use on treatment retention and abstinence from cocaine among cocaine dependent patients with Attention Deficit Hyperactivity Disorder (ADHD). Cocaine dependent patients diagnosed with current ADHD (DSM-IV, N = 92) aged 25 to 51 participated in a randomized clinical trial of methylphenidate for treatment of ADHD and cocaine dependence in an outpatient setting. The majority of patients (69%) used cannabis during treatment. Results suggest that moderate/intermittent cannabis users had greater retention rates compared to abstainers and consistent users (p = .02). This study is the first to examine concurrent cannabis use in cocaine dependent patients diagnosed with ADHD.

背景与目标： : 大麻是美国使用最广泛的非法物质，在精神疾病患者中，大麻的使用率特别高。很少有研究检查同时使用大麻与接受共病药物滥用和精神疾病治疗的患者的治疗结果之间的关系。这项研究调查了使用大麻对可卡因依赖的注意力缺陷多动障碍 (ADHD) 患者的可卡因治疗保留和戒断的影响。25至51岁被诊断为当前ADHD (dsm-iv，N = 92) 的可卡因依赖者参加了哌醋甲酯的随机临床试验，用于在门诊环境中治疗ADHD和可卡因依赖性。大多数患者 (69%) 在治疗期间使用大麻。结果表明，与戒烟者和稳定使用者相比，中度/间歇性大麻使用者的保留率更高 (p = .02)。这项研究是第一个检查诊断为ADHD的可卡因依赖患者同时使用大麻的研究。

BACKGROUND & AIMS: :Motor hyperactivity is one of the most outstanding symptoms of attention deficit hyperactivity disorder (ADHD) which might be caused by a disturbed inhibitory motor control. Using focal transcranial magnetic stimulation (TMS) we tested the cortico-callosal inhibition (duration and latency of the ipsilateral Silent Period, iSP) in 23 children with ADHD (mean age 11+/-2.6 years) before and on treatment with methylphenidate (MPH). iSP latency was age correlated, whereas iSP duration as well as Conners scores were age independent. Analyses of mean differences revealed a significant prolongation of iSP duration (p=0.001), shortening of iSP latency (p=0.027) and reduction of Conners score (p=0.001) under medication. Increase of iSP duration and reduction of Conners score under medication were significantly correlated (t=-9.87, p=0.016). Reduced iSP duration and prolonged iSP latency in ADHD children could be the result of a disturbed transcallosally mediated inhibition, most probable due to a combination of maturation deficits of callosal fiber tracts as well as neuronal synaptical transmission within the neuronal network between ipsilaterally stimulated cortex layer III--the origin of transcallosal motor-cortical fibers--and contralateral layer V, the origin of the pyramidal tract. MPH may indirectly improve the dysbalance between excitatory and inhibitory interneuronal activities of this neuronal network via dopaminergic modulatory effects of the striato-thalamo-cortical loop.

背景与目标： : 运动多动是注意力缺陷多动障碍 (ADHD) 最突出的症状之一，可能是由抑制性运动控制障碍引起的。使用局灶性经颅磁刺激 (TMS)，我们在接受哌醋甲酯 (MPH) 治疗之前和治疗时测试了23名ADHD儿童 (平均年龄11/-2.6岁) 的皮质-call抑制作用 (同侧静默期的持续时间和潜伏期，iSP)。iSP延迟与年龄相关，而iSP持续时间和Conners评分与年龄无关。平均差异分析显示，在药物治疗下，iSP持续时间显着延长 (p = 0.001)，iSP潜伏期缩短 (p = 0.027) 和Conners评分降低 (p = 0.001)。iSP持续时间的增加与药物治疗下Conners评分的降低显著相关 (t =-9.87，p = 0.016)。ADHD儿童的iSP持续时间减少和iSP潜伏期延长可能是跨call介导的抑制干扰的结果，最有可能的原因是，在同侧刺激的皮层III层 (经胼胝体运动皮质纤维的起源) 和对侧V层 (锥体束的起源) 之间的神经元网络内，胼胝体纤维束的成熟缺陷以及神经元突触传递的组合。MPH可能通过纹状体-丘脑-皮质环的多巴胺能调节作用间接改善该神经元网络的兴奋性和抑制性神经元活动之间的失衡。

BACKGROUND & AIMS: UNLABELLED:Attention deficit, impulsivity and hyperactivity are the cardinal features of attention deficit hyperactivity disorder (ADHD) but executive function (EF) disorders, as problems with inhibitory control, working memory and reaction time, besides others EFs, may underlie many of the disturbs associated with the disorder. OBJECTIVE:To examine the reaction time in a computerized test in children with ADHD and normal controls. METHOD:Twenty-three boys (aged 9 to 12) with ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 2000 (DSM-IV) criteria clinical, without comorbidities, Intelligence Quotient (IQ) > or = 89, never treated with stimulant and fifteen normal controls, age matched were investigated during performance on a voluntary attention psychophysical test. RESULTS:Children with ADHD showed reaction time higher than normal controls. CONCLUSION:A slower reaction time occurred in our patients with ADHD. This findings may be related to problems with the attentional system, that could not maintain an adequate capacity of perceptual input processes and/or in motor output processes, to respond consistently during continuous or repetitive activity.

背景与目标：