Insomnia, Alcohol Consumption and ADHD Symptoms in Adults

Introduction Substance use disorders and insomnia are common in the general population, and particularly among adults with attention-deficit/hyperactivity disorder (ADHD). Here we investigated the relationship between insomnia, alcohol consumption and ADHD symptoms. Methods: Adults with an ADHD diagnosis (n = 235, 41.3% males) and controls (n = 184, 38% males) completed a questionnaire assessing insomnia (Bergen Insomnia Scale), alcohol consumption (Alcohol Use Disorders Identification Test), and current ADHD symptoms (Adult ADHD Self-report Scale). The majority of the sample (95%) gave additional information about childhood ADHD symptoms (Wender Utah Rating Scale), and information about lifetime occurrence of an internalizing disorder was included as part of background information. Results: Compared to controls, the ADHD group reported a higher frequency of insomnia, a higher quantity of consumed alcohol and a higher frequency of internalizing disorders. Current and childhood ADHD symptoms were more severe in those with than without insomnia. Scores on ADHD symptom scales were explained by the presence of insomnia and internalizing disorders, while the contribution from alcohol consumption was restricted to the control group. Discussion: The high functional impact of insomnia, alcohol misuse and internalizing disorders is well known. The present study contributed by focusing on their relations to ADHD symptoms, and by showing that strong relations were not restricted to adults with a clinical ADHD diagnosis. By this, the results put a critical light on a categorical delineation between adults with an ADHD diagnosis and population selected controls, and call for further studies including dimensional metrics of ADHD symptoms and co-occurring problems.publishedVersio

Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD

Objective To validate the Adult ADHD Self‐Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) in a well‐characterized sample of adult attention‐deficit/hyperactivity disorder (ADHD) patients and population controls. Methods Both the ASRS and the WURS were administered to clinically diagnosed adult ADHD patients (n = 646) and to population controls (n = 908). We performed principal component analyses (PCA) and calculated receiver operating curves (ROC) including area under the curve (AUC) for the full WURS and ASRS, as well as for the PCA generated factors and the ASRS short screener. Results We found an AUC of 0.956 (95% CI: 0.946–0.965) for the WURS, and 0.904 (95% CI: 0.888–0.921) for the ASRS. The ASRS short screener had an AUC of 0.903 (95%CI: 0.886–0.920). Combining the two full scales gave an AUC of 0.964 (95% CI: 0.955–0.973). We replicated the two‐factor structure of the ASRS and found a three‐factor model for the WURS. Conclusion The WURS and the ASRS both have high diagnostic accuracy. The short ASRS screener performed equally well as the full ASRS, whereas the WURS had the best discriminatory properties. The increased diagnostic accuracy may be due to the wider symptom range of the WURS and/or the retrospective childhood frame of symptoms.publishedVersio

Attention Network Test in adults with ADHD - the impact of affective fluctuations

Background: The Attention Network Test (ANT) generates measures of different aspects of attention/executive function. In the present study we investigated whether adults with ADHD performed different from controls on measures of accuracy, variability and vigilance as well as the control network. Secondly, we studied subgroups of adults with ADHD, expecting impairment on measures of the alerting and control networks in a subgroup with additional symptoms of affective fluctuations. Methods: A group of 114 adults (ADHD n = 58; controls n = 56) performed the ANT and completed the Adult ADHD Rating Scale (ASRS) and the Mood Disorder Questionnaire (MDQ). The latter was used to define affective fluctuations. Results: The sex distribution was similar in the two groups, but the ADHD group was significantly older (p = .005) and their score on a test of intellectual function (WASI) significantly lower than in the control group (p = .007). The two groups were not significantly different on measures of the three attention networks, but the ADHD group was generally less accurate (p = .001) and showed a higher variability through the task (p = .033). The significance was only retained for the accuracy measure when age and IQ scores were controlled for. Within the ADHD group, individuals reporting affective fluctuations (n = 22) were slower (p = .015) and obtained a lower score on the alerting network (p = .018) and a higher score on the conflict network (p = .023) than those without these symptoms. The significance was retained for the alerting network (p = .011), but not the conflict network (p = .061) when we controlled for the total ASRS and IQ scores. Discussion: Adults with ADHD were characterized by impairment on accuracy and variability measures calculated from the ANT. Within the ADHD group, adults reporting affective fluctuations seemed to be more alert (i.e., less impacted by alerting cues), but slower and more distracted by conflicting stimuli than the subgroup without such fluctuations. The results suggest that the two ADHD subgroups are characterized by distinct patterns of attentional problems, and that the symptoms assessed by MDQ contribute to the cognitive heterogeneity characterizing groups of individuals with ADHD

Goal management training improves executive control in adults with ADHD: an open trial employing attention network theory to examine effects on attention

Background Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) typically experience poorer attentional control. According to the attention network theory, attentional control relies on three interacting networks of alerting, orienting, and executive control. In ADHD, it is mainly the alerting and executive control networks that are suggested and found to be compromised. Methods In the current study, we investigated if a group-based metacognitive remediation program (Goal Management Training [GMT]) in adults with ADHD would enhance attentional control using an experimental measure of the attention network theory. We expected that GMT would specifically enhance the executive control and alerting networks. Results Data from post- and follow up-assessments of 21 adults (age: 39.05 [11.93]) with ADHD who had completed GMT were included. Linear mixed-effects modeling revealed significant improvements in the functioning of the executive control network for the majority of the participants, although a small subset of participants showed a negative development following the intervention. Results also showed an improvement in the orienting network at follow up, but no change in the alerting network. Conclusion The results may indicate that improvements in the functioning of the executive control network are central to the positive effects of GMT reported in disorders characterized by impaired attentional control.publishedVersio

Polaron physics and crossover transition in magnetite probed by pressure-dependent infrared spectroscopy

The optical properties of magnetite at room temperature were studied by infrared reflectivity measurements as a function of pressure up to 8 GPa. The optical conductivity spectrum consists of a Drude term, two sharp phonon modes, a far-infrared band at around 600 cm$^{-1}$, and a pronounced mid-infrared absorption band. With increasing pressure both absorption bands shift to lower frequencies and the phonon modes harden in a linear fashion. Based on the shape of the MIR band, the temperature dependence of the dc transport data, and the occurrence of the far-infrared band in the optical conductivity spectrum the polaronic coupling strength in magnetite at room temperature should be classified as intermediate. For the lower-energy phonon mode an abrupt increase of the linear pressure coefficient occurs at around 6 GPa, which could be attributed to minor alterations of the charge distribution among the different Fe sites.Comment: 7 pages, 7 figure

A randomized controlled trial comparing different sites of high-velocity low amplitude thrust on sensorimotor integration parameters

Increasing evidence suggests that a high-velocity, low-amplitude (HVLA) thrust directed at a dysfunctional vertebral segment in people with subclinical spinal pain alters various neurophysiological measures, including somatosensory evoked potentials (SEPs). We hypothesized that an HVLA thrust applied to a clinician chosen vertebral segment based on clinical indicators of vertebral dysfunction, in short, segment considered as "relevant" would significantly reduce the N30 amplitude compared to an HVLA thrust applied to a predetermined vertebral segment not based on clinical indicators of vertebral dysfunction or segment considered as "non-relevant". In this double-blinded, active-controlled, parallel-design study, 96 adults with recurrent mild neck pain, ache, or stiffness were randomly allocated to receiving a single thrust directed at either a segment considered as "relevant" or a segment considered as "non-relevant" in their upper cervical spine. SEPs of median nerve stimulation were recorded before and immediately after a single HVLA application delivered using an adjusting instrument (Activator). A linear mixed model was used to assess changes in the N30 amplitude. A significant interaction between the site of thrust delivery and session was found (F1,840 = 9.89, p &lt; 0.002). Pairwise comparisons showed a significant immediate decrease in the N30 complex amplitude after the application of HVLA thrust to a segment considered "relevant" (- 16.76 ± 28.32%, p = 0.005). In contrast, no significant change was observed in the group that received HVLA thrust over a segment considered "non-relevant" (p = 0.757). Cervical HVLA thrust applied to the segment considered as "relevant" altered sensorimotor parameters, while cervical HVLA thrust over the segment considered as "non-relevant" did not. This finding supports the hypothesis that spinal site targeting of HVLA interventions is important when measuring neurophysiological responses. Further studies are needed to explore the potential clinical relevance of these findings.</p

Мотивационная политика предприятия как основа новой философии управления

В современной концепции управления ключевое место отводится человеку. Именно люди, характеризующиеся не только специальным образованием и профессиональными навыками, но и яркой индивидуальностью, способны генерировать новые идеи и решать непростые задачи в высококонкурентной и динамичной бизнес-среде. Такова закономерность в развитии экономических отношений и совершенствовании менеджмента организаций. Акценты в управлении компанией смещаются к идеологическим (культурным, духовным) ценностям предприятия, носителем которых является его персонал, конкретные сотрудники, способные в этих условиях обеспечивать эффективную работу в высококонкурентной среде

Gene-Environment Interactions in Attention-Deficit/Hyperactivity Disorder Symptom Dimensions:The Role of Unhealthy Food Habits

Background: Dietary habits were investigated as environmental risk factors for Attention-Deficit/Hyperactivity Disorder (ADHD). However, no previous studies explored the effects of dietary factors on modifying the role of genetic factors on ADHD. Methods: Based on a Swedish population-based twin study with 1518 twin pairs aged 20-47 years, we tested whether the importance of genetic and environmental effects on ADHD varied as a function of dietary habits. Self-reported dietary habits and ADHD symptoms were collected. Twin methods were used to test the degree to which high-sugar and unhealthy food intake moderated the genetic and environmental influences on ADHD symptoms. Results: In middle-aged adults, genetic influences on inattention symptoms were statistically significantly higher among individuals with higher levels of high-sugar (45%, 95%CI: 25-54%) and unhealthy food intake (51%, 95%CI: 31-60%), compared with those with lower levels of consumption of high-sugar (36%, 95%CI: 25-47%) and unhealthy foods (30%, 95%CI: 20-41%). Similar patterns were also found for the associations between hyperactivity/impulsivity and high-sugar/unhealthy food intake, even though the moderation effects were not statistically significant. Conclusion The present study suggests that genetic factors play a more prominent role in individual differences of ADHD symptoms in the presence of the high consumption of sugar and unhealthy foods. Future longitudinal studies with multiple assessments of ADHD and dietary habits are needed to replicate our findings.</p

The Effects of Four Weeks of Chiropractic Spinal Adjustments on Blood Biomarkers in Adults with Chronic Stroke:Secondary Outcomes of a Randomized Controlled Trial

Certain blood biomarkers are associated with neural protection and neural plasticity in healthy people and individuals with prior brain injury. To date, no studies have evaluated the effects chiropractic care on serum brain-derived neurotrophic factor (BDNF), insulin-like growth factor-II (IGF-II) and glial cell-derived neurotrophic factor (GDNF) in people with stroke. This manuscript reports pre-specified, exploratory, secondary outcomes from a previously completed parallel group randomized controlled trial. We evaluated differences between four weeks of chiropractic spinal adjustments combined with the usual physical therapy (chiro + PT) and sham chiropractic with physical therapy (sham + PT) on resting serum BDNF, IGF-II and GDNF in 63 adults with chronic stroke. Blood samples were assessed at baseline, four weeks (post-intervention), and eight weeks (follow-up). Data were analyzed using a linear multivariate mixed effects model. Within both groups there was a significant decrease in the mean log-concentration of BDNF and IGF-II at each follow-up, and significant increase log-concentration of GDNF at eight-weeks’ follow-up. However, no significant between-group differences in any of the blood biomarkers at each time-point were found. Further research is required to explore which factors influence changes in serum BDNF, IGF-II and GDNF following chiropractic spinal adjustments and physical therapy

Innovative approaches in investigating inter-beat intervals: Graph theoretical method suggests altered autonomic functioning in adolescents with ADHD

Cardiac inter-beat intervals (IBIs) are considered to reflect autonomic functioning and self-regulatory abilities and are often investigated by traditional time- and frequency domain analyses. These analyses investigate IBI fluctuations across relatively long time series. The similarity graph algorithm is a nonlinear method that analyzes segments of IBI time series (i.e., time windows)—possibly being more sensitive to transient and spontaneous IBI fluctuations. We hypothesized that the similarity graph algorithm would detect differences between Attention-Deficit/Hyperactivity Disorder (ADHD) and control groups. Resting electrocardiogram (ECG) recordings were collected in 10–18-year-olds with ADHD (n = 37) and controls (n = 36). IBIs were converted to graphs that were subsequently investigated for similarity. We varied the criterion for defining IBIs as similar, assessing which setting best distinguished ADHD and control groups. Using this setting, we applied the similarity graph algorithm to time windows of 2–5, 6–13 and 12–25 s, respectively. We also performed traditional IBI analyses. Independent samples t tests assessed group differences. Results showed that a 1.5% criterion of similarity and a time window of 2–5 s best distinguished adolescents with ADHD and controls. The similarity graph algorithm showed a higher number of edges, maximum edges and cliques, and lower edges10+10/edges2+2 in the ADHD group compared to controls. The results suggested more similar IBIs in the ADHD group compared to the controls, possibly due to altered vagal activity and less effective regulation of heart rate. Traditional analyses did not detect any group differences. Consequently, the similarity graph algorithm might complement traditional IBI analyses as a marker of psychopathology.publishedVersio