The Impact of Social Determinants of Health on the Efficacy of School-Based Interventions for Adolescents with ADHD

Adolescents with Attention-deficit/hyperactivity disorder (ADHD) often experience impairment in academic functioning in the school and home environment. Because of this, many school- and clinic-based interventions have been developed to target these problems. Initially, clinic-based interventions were mainly used; however, these interventions were associated with many barriers to care, such as lack of transportation, financial resources, and time. Therefore, school-based interventions were developed to address these barriers. However, there has been minimal research evaluating the role of social determinants of health on the efficacy of school-based interventions. In a sample of 222 adolescents with ADHD randomly assigned to receive either a skills-based treatment or contingency management-based treatment, the present study explored the overall and differential impact of social determinants of health, namely income, maternal education, single parent status, and race, on intervention efficacy. Findings revealed a main effect of single parent status, race, and income on school grades and parent and teacher ratings of academic functioning, but no differential effects of these social determinants of health. Further, this study found that social determinants of health matter for school-based interventions and should be acknowledged as integral parts of improving and maintaining the quality of treatment for adolescents with ADHD

MODERATORS OF RESPONSE TO INTERVENTION FOR COLLEGE STUDENTS WITH ADHD: INTEGRATING PERSONAL AND CONTEXTUAL FACTORS

College students with attention deficit/hyperactivity disorder (ADHD) are at increased risk for educational, interpersonal, and comorbid mental health difficulties. Although growing evidence suggests that psychosocial interventions can effectively improve ADHD symptoms and functioning in college students with ADHD, there is almost no research investigating individual differences in intervention response. Numerous factors ranging from participant characteristics, as well as social and contextual factors could lead some people to respond more positively than others. Understanding individual differences in intervention response may help to better target intervention efforts and to determine where intervention refinement is needed. This study evaluates whether personal and contextual variables are associated with differential treatment response to a cognitive-behavioral treatment program for college students diagnosed with ADHD. Specifically, this study evaluated moderators of a range of outcomes, including executive functioning, interpersonal functioning, and ADHD symptom concern. Findings from this study suggest that factors at both the person-level and micro-system level have an impact on the efficacy of CBT intervention for college students with ADHD. Interestingly, person-level factors, including medication status and comorbidity status had a robust impact on aspects of executive functioning, whereas broader contextual factors, such as living situation and employment were mostly related to relationship functioning and symptom concern. The results from this study can be used to further refine effective interventions for college students with ADHD

The tangled web of non-canonical Wnt signalling in neural migration

In all multicellular animals, successful embryogenesis is dependent on the ability of cells to detect the status of the local environment and respond appropriately. The nature of the extracellular environment is communicated to the intracellular compartment by ligand/receptor interactions at the cell surface. The Wnt canonical and non-canonical signalling pathways are found in the most primitive metazoans, and they play an essential role in the most fundamental developmental processes in all multicellular organisms. Vertebrates have expanded the number of Wnts and Frizzled receptors and have additionally evolved novel Wnt receptor families (Ryk, Ror). The multiplicity of potential interactions between Wnts, their receptors and downstream effectors has exponentially increased the complexity of the signal transduction network. Signalling through each of the Wnt pathways, as well as crosstalk between them, plays a critical role in the establishment of the complex architecture of the vertebrate central nervous system. In this review, we explore the signalling networks triggered by non-canonical Wnt/receptor interactions, focussing on the emerging roles of the non-conventional Wnt receptors Ryk and Ror. We describe the role of these pathways in neural tube formation and axon guidance where Wnt signalling controls tissue polarity, coordinated cell migration and axon guidance via remodelling of the cytoskeleton