The Needs and Experiences of Adolescents With ADHD Related to a Digital Intervention: A Qualiative Exploratory Study

Formål: Det foreligger et behov for å utvikle skalerbare og tilgjengelige intervensjoner for ungdommer med ADHD. Digitale intervensjoner kan være et lovende format for å øke tilgangen til evidentbasert psykologisk behandling for denne gruppen. Implementeringen av en digital intervensjon krever innspill fra målgruppen. Få studier har imidlertid tatt brukerbehovene i betraktning. Denne studien har som formål å utforske behovene og erfaringene til ungdommer med ADHD relatert til en digital intervensjon for denne målgruppen. Funnene vil bidra til utviklingen av en brukersentrert digital psykisk helse-intervensjon ledet av et større forskningsprosjekt ved Haukeland Universitetssykehus. Metode: Kvalitative intervjuer ble gjennomført med åtte ungdommer med ADHD. Refleksiv tematisk analyse ble brukt for å identifisere, tolke og rapportere mønstre fra de kvalitative intervjuene. Resultater: Fem hovedtemaer ble generert: et økt behov for innsikt og aksept, en balanse mellom å motta hjelp og være selvstendig, håndtere energitopper og -daler, potensielle barrierer for behandling og forestilling av en ideell app. Konklusjon: Studien understreker betydningen av å gi informasjon, fasilitere for interaksjon, fremme autonomi, ta i bruk fysisk aktivitet, samt tilrettelegge for etterlevelse i intervensjonen. Funnene diskuteres i lys av selvbestemmelsesteorien, Eriksons psykososiale teori og retningslinjer for behandling av ADHD. Implikasjoner av funnene blir fremhevet.Hovedoppgave psykologprogrammetPROPSY317PRPSY

Coping Strategies in College-Aged Women across the Attention Spectrum

Attention Deficit Hyperactivity Disorder is a highly studied condition that has garnered increasing attention across the past 30 years. Within the population of adults with ADHD, women with ADHD may be an underidentified, underserved, and understudied group. The term “Coping Strategies” is used to describe the various behaviors an individual might engage in to help deal with the hard and stressful parts of life. For those dealing with ADHD, coping strategies can be an important aspect of dealing with their symptoms. The current study surveyed a sample of college-age women, with the goal of learning how their placement on the attention spectrum might relate to their endorsement of certain coping strategies. Results are shown for the entire sample and for those who qualified for adult ADHD based on the scoring guidelines of the ASRS-v1.1. Results showed that the more ADHD symptoms participants endorsed, the more coping strategies they also reported trying. The top and bottom five coping strategies that were endorsed by participants in this study are described. The majority of participants reported that they discovered their coping strategies by themselves and through observing others. Research on the coping strategies that ADHD individuals find the most helpful could help make it easier for them to manage their symptoms

Attention Deficit Hyperactivity Disorder and Bronfenbrenner\u27s Ecology of Human Development

Attention Deficit Hyperactivity Disorder (ADHD) and the norms associated with this condition in the United States have evolved over time. Culturally established beliefs control how the disorder is defined and treated. This study will explore the idea that ADHD is a socially constructed disorder that impacts multiple levels of society. These levels include the child, the family, the school, the medical community, and the advertising agencies. Social construction theory will be used to establish a framework for this study. Urie Bronfenbrenner’s (1977) system theory describing the ecology of human development will also be used to investigate the impact that different levels of society possibly have on the growth and development of ADHD and how this disorder has become institutionalized in our society with suggested norms and routine treatments

Parents’ Perspectives on a Smartwatch Intervention for Children with ADHD: Rapid Deployment and Feasibility Evaluation of a Pilot Intervention to Support Distance Learning During COVID-19

Distance learning in response to the COVID-19 pandemic presented tremendous challenges for many families. Parents were expected to support children’s learning, often while also working from home. Students with Attention Deficit Hyperactivity Disorder (ADHD) are at particularly high risk for setbacks due to difficulties with organization and increased risk of not participating in scheduled online learning. This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. We implemented a 6-week pilot study of a Digital Health Intervention (DHI) with ten families. The DHI included a smartwatch and a smartphone. Google calendars were synchronized across devices to guide children through daily schedules. After the sixth week, we conducted parent interviews to understand the use of smartwatches and the impact on children’s functioning, and we collected physiological data directly from the smartwatch. Our results demonstrated that children successfully adopted the use of the smartwatch, and parents believed the intervention was helpful, especially in supporting the development of organizational skills in their children. Overall, we illustrate how even simple DHIs, such as using smartwatches to promote daily organization and task completion, have the potential to support children and families, particularly during periods of distance learning. We include practical suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction

The Effects Social Media Has on Depressive and Neuro Developmental Disorders

Social media has played a huge role in society today and is one of the most common activities in everyday life for people of all ages. Due to the long amount of time that most users spend on social media daily, some trends seem to grow and become very visible over time that have a negative impact on mental health but also on neuro developmental disorders. Neurodevelopmental disorders are identified through a list of symptoms and characteristics that show a problem in how the brain is developing. Due to social media still being very new in this generation and with its huge advancements and changes in fast periods of time few studies focus on comparing the symptoms of obsessive social media use to neuro developmental disorders. This study aims to link the common characteristics and symptoms of obsessive social media use to ADHD and ADD to see if it is possible to show that they are common enough to have a hard time differentiating. Part of the goal will also be to show the maladaptive behavior that develops from social media use and how over time it can change the brain’s neuroplasticity in a way where memory retention is affected, and focus is negatively impacted. In this dissertation there will be a quantitative method of research that will build a base of research to help show these statements to be accurate and allow for future research to build upon this method for further understanding

Exploring the gut-brain axis in Attention-Deficit Hyperactivity Disorder

There is a bidirectional interaction between the gut and the brain, termed the gut-brain axis (GBA), involving e.g. the gut microbiota, and connecting the peripheral intestinal elements to the central nervous system (CNS). The GBA is increasingly recognized as a vital factor in the development and prognosis of neurological and psychiatric disorders. Of particular interest in this thesis is the signaling from gut microbiota to brain and back which is enabled through neural, endocrine, immune, and humoral pathways. Studies in germ-free and antibiotic-treated animal models have created a significant body of knowledge on the GBA and its role in regulating behavior. There are fewer studies using human subjects or with human materials. This thesis is focused on both clinical and biological aspects of GBA in attention-deficit hyperactivity disorder (ADHD). ADHD is a common childhood-onset psychiatric and neurodevelopmental disorder, which is characterized by having problems with paying attention and/or excessive activity and impulsivity, along with impairments on daily function and emotion regulation. ADHD is highly heritable and has high comorbidity with other psychiatric disorders and a higher-than-normal co-occurrence with some inflammatory disorders (e.g. asthma, eczema, rhinitis, celiac disease). However, ADHD is diagnosed primarily based on clinical observations of behaviors. Biomarkers for diagnosis and approaches for new therapy are lacking and the pathophysiology is poorly understood. This thesis consists of five studies attempting to explore some aspects of the GBA in neurodevelopmental and psychiatric disorders, with a focus on ADHD, utilizing a nationwide population-based cohort, a case-control design, a randomized controlled trial (RCT) and an in vitro model. It covers different aspects of the GBA, including gut microbiota and related antibiotic exposure, probiotic and prebiotic intervention, derived metabolites, inflammatory mediators, as well as the associations with clinical observations. Specifically, in Study I, we investigated whether exposure to antibiotic drugs, in utero and first two years after birth was associated with a risk for childhood-onset psychiatric disorders. Using Finnish nationwide registers, we found that antibiotic exposure was associated with a 10–50% increased risk for development of sleep disorders, ADHD, conduct disorders, mood disorders and anxiety disorders, which were accompanied by an increased risk for psychotropic drug use in childhood. The association with prenatal antibiotic exposure was neither explained completely by confounding factors related to family, nor by factors related to maternal infections. In Study II, we used a case-control design to study plasma levels of four inflammatory mediators: C-reactive protein (CRP), serum amyloid A (SAA), soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular cell adhesion molecule 1 (sVCAM-1) in ADHD and their associations with medication and clinical symptoms. We found that ADHD patients had higher levels of sICAM-1 and sVCAM-1 than healthy controls, especially in children currently on ADHD medication. Among adult participants with ADHD, sICAM-1 levels were positively associated with comorbid autism symptoms, and CRP levels were associated with GI symptoms and emotion dysregulation. In Study III, a double-blind RCT was conducted to determine whether a synbiotic (Synbiotic 2000), consisting of a mixture of three lactic acid bacteria and four fibers had effects on symptoms, daily functioning, and comorbid traits in ADHD patients. We found that Synbiotic 2000, compared to placebo, significantly reduced typical restricted, repetitive and stereotyped behaviors of autism symptoms in children, and alleviated problems with goal-directed behavior of emotion regulation in adults. The effects on autism symptoms and problems with emotion regulation were stronger in the subgroup with higher sVCAM-1 levels. In Study IV, using data from the same RCT as in study III, we investigated the effects of Synbiotic 2000 on plasma levels of immune activity markers and short-chain fatty acids (SCFAs) in ADHD. Adults with ADHD had at baseline higher levels of pro-inflammatory vascular adhesion molecules (sICAM-1, sVCAM-1) and lower levels of the anti-inflammatory interleukin (IL)-10 compared to controls. Synbiotic 2000, compared to placebo treatment, was associated with reduced the levels of IL-12/IL-23p40 in children on ADHD medication, and suggestively associated with reduced sICAM-1 levels and increased propionic acid levels in children. Moreover, in adult patients we found lower baseline levels compared to controls of formic acid and propionic acid. No obvious effects of Synbiotic 2000 were found on plasma levels of SCFAs. However, we found IL-10 levels correlating positively with formic acid and acetic acid at baseline for both children and adults with ADHD. In child patients, sVCAM-1 correlated negatively with acetic acid and propionic acid while sICAM-1 correlated negatively with acetic acid. In adult patients, a negative correlation was observed between sVCAM-1 and formic acid at baseline. In Study V, an in vitro model was used to explore the effects of three SCFAs: acetate, propionate and butyrate, on cell growth and cell death of early stage human neural progenitor cells (hNPCs). We found that acetate, propionate and butyrate at low μM levels, relevant to physiological levels, significantly increased the proliferation of hNPCs and induced more cells to undergo mitosis, while the SCFAs at high mM levels had toxic effects on hNPCs. In support of this, the SCFA exposure to hNPCs changed the expression of genes involved in neurogenesis, proliferation and apoptosis. These studies provide support of a role of components influenced by the GBA, including gut microbiota, immune activity markers and bacterial metabolites in clinical and biological aspects of ADHD. Finally, these studies contribute to a better understanding of the GBA in ADHD

The Self-perceptions of Adolescents with Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD), which affects 3 -- 6% of school- aged children, is considered one of the most common behavioral disorders of childhood. Of those, up to 70% will continue to have symptoms into adolescence. Adolescence is a critical transitional period on the route to adulthood that has the building of self-identity as its chief developmental task. Adults with positive self-perceptions tend to be more productive members of society. Most of the studies directed at understanding the self-perceptions of those with ADHD have been done with children and those studies have yielded mixed results. There are practically no studies about the self-perceptions of adolescents with ADHD. The purpose of this study was to examine the self-perceptions of adolescents with ADHD. This was an investigative, triangulated, cross-section study based on Symbolic Interaction Theory that examined the self-perceptions of students with ADHD (n=21) in senior high school. These students were matched by grade and gender to peers without ADHD (n=23). Triangulation was accomplished using quantitative and qualitative data collection methods. Quantitative data was collected using the Harter Self-Perception Profile for Adolescents and was analyzed using the paired t test and Spearman correlations. Qualitative data was gathered using phenomenologically focused interviews and was analyzed using methods suggested by van Kaam and Munhall. The outcome revealed that both methods yielded similar results. Teens with ADHD had significantly poorer global self-perceptions (p=.02) than their peers. In addition the students with ADHD had a significantly poorer perception (p=.04) of their social acceptance. Correlations revealed that perceptions of close friendship (rs=.55, p=.01) were significantly related to perceptions of global self-worth for the teens with ADHD. The qualitative data revealed that the social interactions of teens with ADHD center on solitary pursuits such as video games or Internet chat rooms or they are marginally involved with peers. In addition, the teens with ADHD perceived themselves in terms of their disorder. Inattention had a strong negative influence in shaping the self-perceptions of the teens ADHD. The results of this study can guide nurses and other health professionals in formulating plans of care that can help teens with ADHD reach adulthood with healthy self-perceptions

Positive practice positive outcomes: a handbook for professionals in the criminal justice system working with offenders with learning disabilities (2011 ed.)

Updated version of the handbook by the same name published by CSIP in 2007. "This handbook is intended as an introduction to working with offenders with learning disabilities. This group includes police suspects and defendants in court. It covers the essential information to help staff identify and understand this group of people. It also covers relevant legislation that outlines the duties and obligations of criminal justice staff, and also health and social care staff, with regards to offenders with learning disabilities." - page 4

Focal Spot, Summer/Fall 2007

https://digitalcommons.wustl.edu/focal_spot_archives/1106/thumbnail.jp