Attention Deficit Disorder with Hyperactivity/psychology* ; Cognition ; Humans ; Sleep Apnea, Obstructive

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.
Adult ; Attention Deficit Disorder with Hyperactivity ; epidemiology ; etiology ; physiopathology ; psychology ; Child, Preschool ; Cotinine ; blood ; Female ; Follow-Up Studies ; Humans ; Japan ; epidemiology ; Male ; Maternal Exposure ; adverse effects ; Mothers ; Pregnancy ; Pregnancy Trimester, Third ; Prenatal Exposure Delayed Effects ; epidemiology ; etiology ; Risk ; Sex Factors ; Tobacco Smoking ; adverse effects ; epidemiology

OBJECTIVE: To study the clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention deficit hyperactivity disorder (ADHD). METHODS: Sixty children each with inattentive, hyperactive/impulsive or combined type ADHD were enrolled. According to the intervention measure, they were randomly divided into 4 groups: control, psychological and behavioral intervention, biofeedback treatment and comprehensive treatment (psychological and behavioral intervention + biofeedback). Attention concentration time and impulse/hyperactivity and hyperactivity index scores of the Conners Parent Symptom Questionnaire (PSQ) were evaluated after 4 months of treatment. RESULTS: The attention concentration time increased in all types children with ADHD after psychological and behavioral intervention, biofeedback treatment or comprehensive treatment (P<0.05). In children with inattentive ADHD, hyperactive/impulsive ADHD or combined-type ADHD, biofeedback or comprehensive treatment reduced the impulse/hyperactivity index score (P<0.05). In children with inattentive or combined-type ADHD, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05). In children with hyperactive/impulsive ADHD, biofeedback treatment, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05). CONCLUSIONS In children with ADHD, psychological and behavioral intervention combined with biofeedback treatment can improve the attention concentration and impulsive/hyperactive and hyperactive symptoms. The treatment strategies are slightly different for children with different types of ADHD.
Attention Deficit Disorder with Hyperactivity ; Biofeedback, Psychology ; Child, Preschool ; Humans ; Parents ; Surveys and Questionnaires

The neurocircuitries that constitute the cortico-striato-thalamo-cortical (CSTC) circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder (ADHD), but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders (DBD). Research based on "cool" and "hot" executive functional theory and the dual pathway models, which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains - abstract thinking (cool) and emotional trait (hot) - trigger the mechanism of onset of ADHD.
Animals ; Attention Deficit Disorder with Hyperactivity ; complications ; pathology ; psychology ; Attention Deficit and Disruptive Behavior Disorders ; complications ; pathology ; psychology ; Brain ; physiopathology ; Cerebral Cortex ; physiopathology ; Corpus Striatum ; physiopathology ; Emotions ; Humans ; Inhibition (Psychology) ; Neuropsychological Tests ; Thalamus ; physiopathology

OBJECTIVETo investigate the effect of baicalin on the behavioral characteristics of rats with attention deficit hyperactivity disorder (ADHD), and to provide a basis for further research on baicalin in the treatment of ADHD.

METHODSA total of 40 SHR rats were randomly divided into model group, methylphenidate hydrochloride (MPH) group, and low-, medium-, and high-dose baicalin groups, with 8 rats in each group. Eight WKY rats were selected as normal control group. The rats in the MPH group (0.07 mg/mL) and the low- (3.33 mg/mL), medium- (6.67 mg/mL), and high-dose (10 mg/mL) baicalin groups were given the corresponding drugs (1.5 mL/100 g) by gavage twice a day, and those in the normal control group and the model group were given an equal volume of normal saline by gavage twice a day. The course of treatment was 4 weeks for all groups. The open field test was performed to observe total moving distance and average moving speed on day 0 of experiment and at 7, 14, 21, and 28 days after gavage and to evaluate the control effects of drugs on hyperactivity and impulsive behavior. The Morris water maze test was used to observe the latency, time spent in the target quadrant, and number of platform crossings and to evaluate the effects of drugs on attention.

RESULTSThe open field test showed that the model group and the drug treatment groups had a significantly longer total moving distance and a significantly higher average moving speed than the normal control group on day 0 (P<0.05). On day 7, the MPH group had significant reductions in total moving distance and average moving speed compared with the model group (P<0.05). On day 14, the MPH group and the high-dose baicalin group had significant reductions in total moving distance and average moving speed compared with the model group (P<0.05). The data on days 21 and 28 showed that compared with the model group, the low-, medium-, and high-dose baicalin groups had gradual reductions in total moving distance and average moving speed (P<0.05). The water maze test showed that compared with the model group, the MPH group and the medium- and high-dose baicalin groups had a significantly longer time spent in the target quadrant (P<0.05), and the MPH group and the high-dose baicalin group had a significantly higher proportion of the moving distance in the target quadrant in total moving distance (P<0.05). The high-dose baicalin group had the highest number of platform crossings among all groups (P<0.05).

CONCLUSIONSBoth baicalin and MPH can regulate the motor ability and learning and memory abilities of SHR rats with ADHD and thus control the core symptoms of ADHD, i.e., hyperactivity, impulsive behavior, and inattention. Baicalin exerts its effect in a dose-dependent manner, and high-dose baicalin has the most significant effect, but compared with MPH, it needs a longer time to play its therapeutic effect.

Animals ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; psychology ; Behavior, Animal ; drug effects ; Dose-Response Relationship, Drug ; Flavonoids ; therapeutic use ; Male ; Maze Learning ; drug effects ; Motor Activity ; drug effects ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY

OBJECTIVETo investigate the cognitive characteristics in early school-age children with attention deficit hyperactivity disorder (ADHD) using event-related potential (ERP) and Achenbach Child Behavior Checklist (CBCL), as well as the correlation between ERP and behavioral problems.

METHODSA total of 22 children aged 6-7 years with ADHD and 19 healthy children matched by age were enrolled. Continue Performance Test-AX (CPT-AX) was performed for ERP test. The amplitude and latency of N2 and P3 of Go and Nogo were compared. The CBCL was completed by the parents, and the correlation between behavioral factors and ERP was analyzed.

RESULTSThe ADHD group had a significantly higher number of ERP omissions than the normal control group (10±8 vs 5±4; P<0.05), while the reaction time and number of commission errors showed no significant differences between the two groups (P>0.05). The ADHD group showed a significantly lower Go-N2 amplitude than the normal control group (-8±5 μV vs -10±4 μV; P<0.05). In the ADHD group, the detection rates of hyperactivity, attack, and discipline violation were 27%, 27% and 9% respectively. The scores on attack and discipline violation subscales were negatively correlated with the Go-N2 amplitude of ERP (r=-0.43 and -0.48 respectively; P<0.05), while the score on hyperactivity subscale was positively correlated with the latency of Go-P3 (r=0.50, P<0.05).

CONCLUSIONSThe early school-age children with ADHD show the tendency to the impairment of attention/executive function, but the inhibition function defect has not been noted. In early school-age children with ADHD, the behavioral problems such as hyperactivity, attack, and discipline violation are associated with ERP.

Attention Deficit Disorder with Hyperactivity ; physiopathology ; psychology ; Child ; Child Behavior Disorders ; etiology ; Evoked Potentials ; physiology ; Humans

OBJECTIVETo investigate the characteristics of attention in school-age children with mild autism spectrum disorder (ASD), and to provide a basis for clinical treatment.

METHODSA total of 20 school-age children with mild ASD were enrolled, and the intermediate visual and auditory continuous performance test (IVA-CPT) was used to assess their attention. A total of 20 children with attention deficit hyperactivity disorder (ADHD) and 40 healthy children were enrolled as controls.

RESULTSCompared with the normal control group, the ASD group showed significantly lower scores of full scale attention quotient, full scale response control quotient, visual/auditory full scale response control quotient, visual/auditory prudence quotient, auditory perseverance quotient, visual consistency quotient, visual/auditory vigilance quotient, visual attention quotient, visual speed quotient, number of correct visual/auditory reactions, and visual mean reaction time of the second and third phases (P<0.05). Compared with the ADHD group, the ASD group showed significantly higher scores of full scale response control quotient and auditory consistency quotient (P<0.05), as well as significantly lower scores of visual vigilance quotient and visual speed quotient (P<0.05).

CONCLUSIONSSchool-age children with mild ASD have attention deficit mainly manifested as the defect in the ability to focus attention, which is similar to the defect in children with ADHD, but ASD children have a lower degree of attention control impairment compared with children with ADHD. The defect in the ability to focus visual attention is more severe than that in the ability to focus auditory attention, while there is no significant difference between the defects in visual and auditory attention control.

Adolescent ; Attention ; Attention Deficit Disorder with Hyperactivity ; psychology ; Autism Spectrum Disorder ; psychology ; Child ; Female ; Humans ; Male

OBJECTIVETo evaluate the effects of school entrance age on cognition and behaviors in children with attention deficit hyperactivity disorder (ADHD) using mathematical event-related potential (ERP), behavioral test, and Conners Parent Symptom Questionnaire (PSQ).

METHODSFifty-eight ADHD children aged 7-12 years were enrolled and classified into older age and younger age groups according to the school entrance age (n=29 each). The children in the older age group were admitted at an age of 6 years and 6 months to 6 years and 11 months, and those in the younger age group were admitted at an age of 6 years to 6 years and 5 months. The ERP with a mathematical task was used to detect the difference in brain electrical activity between the two groups, and the behavioral test results were compared. The children's parents were asked to complete the PSQ, and the scores on each subscale were compared.

RESULTSThe ERP detection showed that the older age group had a significantly higher P2 amplitude for wrong answers than the younger age group (10.9±5.0 μv vs 8.5±3.6 μv; P<0.05). The younger age group had a significantly shorter time of response to wrong answers than the older age group (619±340 ms vs 870±418 ms; P<0.05). The scores on the subscales of learning problems and impulse-hyperactivity of PSQ were significantly higher in the younger age group than in the older age group (P<0.05).

CONCLUSIONSSchool entrance age can affect cognition and behaviors in children with ADHD, and the ADHD children with a younger school entrance age have an obvious defect in executive function, especially the function of error detection, which leads to the prominent problems in impulse-hyperactivity and learning.

Age Factors ; Attention Deficit Disorder with Hyperactivity ; physiopathology ; psychology ; Child ; Child Behavior ; Evoked Potentials ; physiology ; Female ; Humans ; Male

PURPOSE: The purpose of this study was to identify predictors influencing relational self and negative thinking on coping among teachers working with students with attention deficit hyperactivity disorder (ADHD). METHODS: A cross sectional study design was conducted with 212 teachers in six elementary schools located in D and C cities. Data were analyzed using t test, one way ANOVA, Pearson's correlation coefficients, and stepwise regression analysis with SPSS 18.0. RESULTS: The significant predictive factor for the active coping type was perceived support in relational self. Empathy care was as a significant factor for the passive coping type. Relationship avoidance and agency were significant predictive factors for negative coping with ADHD students. Active and passive coping had significant negative correlations with social worry. Significant factors for positive coping were attendance at ADHD workshops and number of years of teaching. CONCLUSION: Results suggest that it is important to focus on teachers having a positive aspect in the classroom, using new strategies, and understanding their own inner factors of perceived support and empathy care in order to provide positive coping and enhance relationships with ADHD students. To further enhance positive coping and perceived support and to reduce social worry, teachers should use community resources, especially psychiatric health nurses.
Adaptation, Psychological ; Anxiety ; Attention Deficit Disorder with Hyperactivity* ; Education ; Empathy ; Humans ; Self Psychology ; Thinking

PURPOSE: This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea. METHODS: Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis. RESULTS: Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. CONCLUSION: Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.
Attention ; Attention Deficit Disorder with Hyperactivity/*therapy ; Child ; *Cognitive Therapy ; Databases, Factual ; Humans ; Psychomotor Agitation ; Republic of Korea ; Self-Control/psychology ; Social Skills