Stigma in attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of the empirical research in the field of ADHD with regard to stigma was performed. The findings of investigations in this field were clustered in different categories, including stigma in children with ADHD, stigma in adults with ADHD, stigma in relatives or in people close to a patient with ADHD, and the influence of stigma on authorities’ attitudes toward patients with ADHD. Variables identified to contribute to stigma in ADHD are public’s uncertainty concerning the reliability/validity of an ADHD diagnosis and the related diagnostic assessment, public’s perceived dangerousness of individuals with ADHD, socio-demographical factors as age, gender, and ethnicity of the respondent or the target individual with ADHD, stigmatization of ADHD treatment, for example public’s skepticism toward ADHD medication and disclosure of diagnostic status as well as medication status of the individual with ADHD. The contribution of stigma associated with ADHD can be conceptualized as an underestimated risk factor, affecting treatment adherence, treatment efficacy, symptom aggravation, life satisfaction, and mentally well-being of individuals affected by ADHD. Public as well as health professionals’ concepts about ADHD are highly diverse, setting individuals with an ADHD diagnosis at greater risk to get stigmatized

Financial decision-making in adults with ADHD

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) in adulthood is associated with problems in multiple domains of everyday life, including financial decision-making (FDM). Research on FDM in adults with ADHD is, however, limited and FDM has never been examined in an objective standardized manner in these patients. The aim of the present study is to explore FDM abilities of adults with ADHD, using both subjective and standardized objective measures. METHOD: Adults with ADHD (n = 45) and healthy controls (n = 51) completed a comprehensive test battery, including an evaluation of their personal financial situation, a neuropsychological assessment and standardized tests and questionnaires measuring various aspects of FDM. RESULTS: Adults with ADHD reported to have a significantly poorer financial situation than healthy controls, including having less income, more often debts and less often a savings account. Furthermore, adults with ADHD showed significantly lower scores than healthy controls in standardized tests measuring financial competence and capacity (i.e., understanding bank statements/protocols and evaluating financial problems) as well as in a test measuring decision making with implications for the future. Furthermore, compared with healthy controls, adults with ADHD reported more often to buy on impulse and to use an avoidant or spontaneous decision-making style. A mediating effect of numeracy was found for 2 measures of FDM (i.e., financial competence and capacity); however, group differences on these measures remained statistically significant. CONCLUSIONS: Adults with ADHD have difficulties with several aspects of FDM. These difficulties may at least partly explain the poorer financial situation of adults with ADHD. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Utility of an attention-based performance validity test for the detection of feigned cognitive dysfunction after acquired brain injury

Introduction: The Groningen Effort Test (GET) is a recently developed performance validity test (PVT) for the identification of noncredible performance in a neuropsychological assessment of attention abilities. Because the majority of already established PVTs are based on memory functions, the GET has the potential to make a valuable contribution to validity testing.Method: The current study examined the utility of the GET in the detection of feigned cognitive dysfunction after acquired brain injury (ABI) and its incremental validity over already established PVTs, namely the Test of Memory Malingering (TOMM), the Dot Counting Test (DCT), and the b Test. Three hundred and forty-eight participants took part in this study, including 58 patients with ABI (stroke or traumatic brain injury), 43 healthy individuals instructed to show normal behavior, and 247 healthy individuals instructed to feign cognitive dysfunction after ABI.Results: With excellent overall classification accuracy, the GET performed close to the level of the TOMM, and superior to the b Test and DCT. Data analyses further revealed that the GET provides additional diagnostic accuracy compared to the b Test and the DCT in the detection of feigned cognitive dysfunction, but has no incremental validity over the TOMM. For each of the four PVTs in this study, diagnostic sensitivity was independent of the simulation strategy used.Conclusions: It is concluded that the GET is an attention-based PVT with promising test characteristics and high diagnostic accuracy in the detection of noncredible cognitive performance using a simulation design. Given the results can be replicated in studies using known-groups methodology, it may be a useful tool for clinical practice to complement neuropsychological assessments of patients with ABI

Mindfulness-based stress reduction in Parkinson’s disease: a systematic review

Background: Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken place for a number of conditions there remains limited information on its impact on individuals with Parkinson’s disease (PD). Methods: Medline, Central, Embase, Amed, CINAHAL were searched in March 2016. These databases were searched using a combination of MeSH subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed based on questions from the Cochrane Collaboration risk of bias tool. Results: Two interventions and three papers with a total of 66 participants were included. The interventions were undertaken in Belgium (n = 27) and the USA (n = 39). One study reported significantly increased grey matter density (GMD) in the brains of the MBSR group compared to the usual care group. Significant improvements were reported in one study for a number of outcomes including PD outcomes, depression, mindfulness, and quality of life indicators. Only one intervention was of reasonable quality and both interventions failed to control for potential confounders in the analysis. Adverse events and reasons for drop-outs were not reported. There was also no reporting on the costs/benefits of the intervention or how they affected health service utilisation. Conclusion: This systematic review found limited and inconclusive evidence of the effectiveness of MBSR for PD patients. Both of the included interventions claimed positive effects for PD patients but significant outcomes were often contradicted by other results. Further trials with larger sample sizes, control groups and longer follow-ups are needed before the evidence for MBSR in PD can be conclusively judged

Anterior temporal atrophy and posterior progression in patients with Parkinson’s disease.

Background: Parkinson's disease (PD) is characterized by specific motor and nonmotor impairments. This suggests that PD is characterized by disease-specific regional cortical atrophy. Given the change of symptoms over time, a concurrent increase in regional atrophy may further be assumed to reflect the dynamic process of disease progression. Methods: In this study we retrospectively collected T1-weighted MRI scans from previous studies performed in our center, enabling the comparison of gray matter atrophy in 77 PD patients with 87 controls using voxel-based morphometry (VBM). This large VBM analysis provided the opportunity to investigate cortical atrophy in relation with disease progression. Results: We found significant PD-related reductions of gray matter density bilaterally in the anterior temporal cortex, the left inferior frontal and left extrastriate visual cortex, independent from normal aging. The anterior temporal cortex did not show major progression, whereas particularly the posterior parts of the lateral temporal cortex and adjacent extrastriate visual cortex occurred at a later stage of disease. Conclusions: Temporal pole atrophy as an early sign of PD is consistent with the PD pathology classification of Braak. The initial anterior temporal atrophy with spread to occipitotemporal and posterior parietal regions may subserve 'emotion-based' sensorimotor transformations and deficits in the visual domain, respectively, which may be regarded as premotor symptoms. © 2014 S. Karger AG, Basel

ZDHHC11 and ZDHHC11B are critical novel components of the oncogenic MYC-miR-150-MYB network in Burkitt lymphoma

Leukemia accepted article preview online, 23 March 2017. doi:10.1038/leu.2017.9

Executive Functioning in Daily Life in Parkinson's Disease: Initiative, Planning and Multi-Task Performance

Impairments in executive functioning are frequently observed in Parkinson's disease (PD). However, executive functioning needed in daily life is difficult to measure. Considering this difficulty the Cognitive Effort Test (CET) was recently developed. In this multi-task test the goals are specified but participants are free in their approach. This study applies the CET in PD patients and investigates whether initiative, planning and multi-tasking are associated with aspects of executive functions and psychomotor speed. Thirty-six PD patients with a mild to moderate disease severity and thirty-four healthy participants were included in this study. PD patients planned and demonstrated more sequential task execution, which was associated with a decreased psychomotor speed. Furthermore, patients with a moderate PD planned to execute fewer tasks at the same time than patients with a mild PD. No differences were found between these groups for multi-tasking. In conclusion, PD patients planned and executed the tasks of the CET sequentially rather than in parallel presumably reflecting a compensation strategy for a decreased psychomotor speed. Furthermore, patients with moderate PD appeared to take their impairments into consideration when planning how to engage the tasks of the test. This compensation could not be detected in patients with mild PD