Centro de estudios sobre déficit atencional infantil
PUBLICACIONES
DE CEDAI
ESCALAS CEDAI
PARA EL
DOCENTE
CURSO A
DISTANCIA SOBRE ADHD
Cedai
NOTAS DE INTERES
Asociación civil sin fines de lucro dedicada a la investigación del síndrome de hiperactividad y déficit de atención
Novedades científicas
Current Literature in ADHD
Summarized by Sam Goldstein
Barton, B., & North, K. (2004).
Social skills of children
with Neurofibromatosis Type I.
Developmental Medicine
and Child Neurology, 46, 553-563.
The reported incidence of ADHD in
Neurofibromatosis Type I (NF1) is higher than in the general
population. In this study of 79 children of mixed gender,
39% met diagnostic criteria for ADHD. This study
investigated the social skills of children with NF1 and the
influence of comorbid conditions, such as ADHD. Children
with NF1 had significantly poorer social outcomes
than their unaffected siblings and significantly poorer
social skills in comparison with normative data. The presence
of ADHD was the major risk factor for poor social
functioning. Children with NF1 and ADHD had poor
social skills and social outcomes when compared with
children with NF1 only or children with NF1 and learning
difficulties. Thus, it would appear that it is ADHD and not
NF1 alone that is associated with poor social functioning.
Gerdes, A. C., Hoza, B., & Pelham, W. (2003).
ADHD boys’ relationships with their mothers and fathers: Child,
mother and father perceptions.
Development and Psychopathology, 15, 363-382.
The accuracy of children’s self-perception in family
relationships was evaluated in this study that compared
142 males with ADHD and their parents to 55 controls
and their parents. The authors hypothesized that the children
with ADHD would rate their relationships with their
parents as inflated in comparison to the actual ratings provided
by parents. Mothers and fathers of boys with
ADHD perceived their parent-child relationships more
negatively than did parents of control boys. Ratings provided
by the children, however, did not differ from one another. Boys with ADHD rated their relationships with their parents more highly than did parents. Ratings given by mothers and fathers were not different from each other.
The authors concluded that if children with ADHD are unaware of disruptions in their relationships, then treatment should target skill deficits as well as accuracy of perception.
Larsson, J., Larsson, H., & Lichtenstein, P. (2004).
Genetic and environmental contributions to stability and
change of ADHD symptoms between eight and thirteen
years of age: A longitudinal twin study.
Journal of the American Academy of Child and Adolescent Psychiatry,
43, 1267-1275.
This sample included nearly 1,500 twin pairs born in
Sweden in the mid-1980s. Structural equation modeling
was used to analyze checklist data based on the Diagnostic
and Statistical Manual of Mental Disorders (3rd ed.,
revised) symptoms for ADHD. The authors found a relatively
high stability of ADHD symptoms during a 5-year
period. The continuity was mainly caused by the same
genetic effects operating at both points in time. Change in
symptoms between childhood and adolescence was to a
large extent caused by new genetic effects in early adolescence
and new nonshared environment effects that
became important during the adolescent years. The
authors noted a heritability estimate for ADHD at 74%
for males and 61% for females. This would appear to be
the first longitudinal data from a nonreferred,
nonmedicated sample. The factors associated with resilience in peer-rejected
females with and without ADHD were evaluated in this
study of 91 females with ADHD and 58 female controls
between the ages of 6 and 12.5 years. The authors sought
to determine whether positive relationships with adults
and goal-directed solitary play served as functional substitutes
for peer relationships. Sociometric ratings and
staff popularity ratings for each female were obtained on
multiple occasions. Direct behavioral observations were
also completed for multiple occasions. Outcome measures
included aggressive as well as depressed and anxious
behaviors. Peer rejection was related to higher levels
of aggressive, depressed, and anxious behavior. For
rejected and nonrejected females, popularity with adult
staff members was associated with lower levels of aggressive
behavior, whereas goal-directed solitary play was
associated with lower levels of depressed and anxious
behavior. This effect was greatest for females with ADHD.
Among rejected females, goal-directed solitary play was
the most protective, whereas popularity with adults was
most protective in the nonrejected group. The authors
conclude that engaging in goal-directed solitary play
appears to be a protective factor against the negative internalizing
outcomes of peer rejection for females with
ADHD in particular. The authors suggest that programs
for peer-rejected children should include such protective
factors as teaching solitary play activities in addition to
traditional social skill components.
Riccio, C. A., Wolfe, M. E., Romine, C., Davis, B., &
Sullivan, J. R. (2004).
The Tower of London in neuropsychological
assessment of ADHD in adults.
Archives of Clinical Neuropsychology, 19, 661-671.
Current theories of ADHD have increasingly focused
on executive functions, particularly those related to planning,
strategy, and working memory, as well as the maintenance
of attention in the pursuit of specific goals. It is
suggested that these behaviors are deficient in individuals
with ADHD. The Tower of London is one task used in the
assessment of executive functions. These authors evaluated
102 individuals between the ages of 16 and 33 for the
Tower of London performance, along with other executive
measures. Based on diagnostic considerations, nearly
2% of this sample met the diagnostic criteria for ADHD.
It is interesting that more than half presented with
comorbid conditions, including depression and learning
disability. The results suggested that although the Tower
of London measured aspects of ability likely not tapped
by other executive neuropsychological measures and
therefore may provide additional information concerning
individual functioning, findings between these groups
were equivocal, suggesting that the Tower of London is not
an instrument that adults with ADHD are unable to complete
successfully.
Sawyer, M. G., Rey, J. M., Arney, F. M., Whitham, J. N.,
Clark, J. J., & Baghurst, P. A. (2004).
Relationship between parents’ perceptions of children’s need for professional help.
Journal of the American Academy of Child
and Adolescent Psychiatry, 43, 1355-1363.
The impact of children’s problems on children and parents
and services used during a 6-month period were
examined in a national sample in Australia of nearly 400
children and teens with ADHD symptoms between the
ages of 6 and 17. Only 28% of those with ADHD symptoms
had attended health-or school-based services.
Forty-one percent had attended both health-and school-
based services. Thirty-nine percent had attended only
health-based services, and 20% had attended only school-
based services. Sixty-nine percent of parents attending
health-based services wanted additional help. Parent perceptions
that children required professional help, the children’s
level of functional impairment, the impact of problems
on parents, and comorbid, depressive, or conduct
disorders had significant and independent relationships
with service use. It appears that factors other than children’s
ADHD symptoms have a significant relationship
with service attendance.
Schwartz, G., Amor, L. B., Grizenko, N., Lageix, P.,
Baron, C., Boivin, D., et al. (2004).
Actigraphic monitoring during sleep of children with ADHD and methylphenidate and placebo.
Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1276-1282.
Nightly sleep actigraphic recordings during a double-
blind, placebo-controlled, cross-over clinical study were
obtained on 44 children with ADHD. Significant differences
between conditions were found in several software-
computed parameters, including sleep onset latency,
sleep efficiency, and total sleep time. No significant differences
on any of these measures were found between
the 26 participants who showed a moderate to large global
improvement on methylphenidate over placebo and the
18 participants who showed mild or no clinical improvement.
The authors concluded that twice daily dosing of
methylphenidate induced a slight but significant sleep
disturbance. Motor activity levels during sleep did not differentiate
children who responded to methylphenidate
from those who did not. The authors suggest that the
responders to methylphenidate treatment do not experience
greater sleep disturbance than do the nonresponders
for the doses studied.
Singh, I. (2003).
Boys will be boys: Fathers’ perspectives
on ADHD symptoms, diagnosis and drug treatment.
Harvard Review of Psychiatry, 11, 308-316.
Thirty-nine mothers and 22 fathers of males with
ADHD were interviewed by using a novel, picture-based
method to elicit detailed narratives. The authors suggest
that paternal perspectives on ADHD behavior, diagnosis,
and drug treatment could be largely categorized as skeptical,
characterizing these fathers as reluctant believers or
tolerant nonbelievers. Fathers generally tended to resist
the medical framework in relation to their sons’ behavior.
The author emphasized that an evaluation lacking the perspective
of the child’s father is incomplete and may lead
to failure of proven treatments to work effectively.
Tamm, L., Menon, V., Ringel, J., & Reiss, A. (2004).
Event-related fMRI evidence of frontal temporal involvement
in abhorrent response inhibition and task switching in ADHD.
Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1430-1440.
Response inhibition deficits are characteristic of individuals
with ADHD. This study was designed to develop
an understanding of the neurocorrelates of response inhibition.
Ten adolescent boys with ADHD (combined type)
and 12 typically developing controls completed go–no go
tasks modified to control for novelty processing. The
group with ADHD made significantly more errors of
omission and more errors of commission than the control
group. Compared with the controls, those with ADHD
showed marked abnormalities in brain activation during
response inhibition, including hypoactivation of the anterior
and midcingulate cortex extending to the supplementary
motor area and hyperactivation of the left temporal
gyrus. It would appear that underactivation in the frontal
regions reflects core deficits in response and task
switching abnormalities for individuals with ADHD.
Unnever, G. D., & Cornell, D. G. (2003).
Bullying, self-control and ADHD.
Journal of Interpersonal Violence, 18, 129-147.
These authors examined a group of middle school students
relative to bullying, bully victimization, ADHD,
and student physical characteristics. A population of
more than 1,300 sixth through eighth graders completed a
series of questionnaires. Students reported the frequency
with which they had engaged in or been the target of areas
of bullying behaviors. Students were also asked whether
they had ever taken medication for ADHD. Fourteen percent
of the population reported a past history or current
use of medication to treat ADHD. Prior use of medications
for ADHD significantly and directly predicted bullying
victimization. In a group of youth with self-reported
ADHD, 34% experienced victimization compared to
22% of other students. Obesity, comorbid to ADHD,
increased in the risk of bullying victimization. Thirteen
percent of students with ADHD reported bullying others
compared 8% of other students. Bullying was most
closely related to reports of low self-control, obesity, and
height. The relationship between ADHD and victimization
is not unexpected in light of the fact that many
children with ADHD struggle socially, making them an
easy target for bullies.