Self-perception of self-regulatory skills in children with attention-deficit/hyperactivity disorder aged 8-10years

Several studies have reported a characteristic "positive illusory bias” in the self-evaluation of children with ADHD. However, results are controversial. The aim of the present study was to investigate whether children with ADHD aged 8 to 10years can rate their self-regulatory skills accurately when assessed with an age appropriate instrument. Twenty-seven children with ADHD and 27 matched normal control children completed the Self-rating Scale of Self-regulatory Function (SelfReg), a new rating scale that has been specifically designed for this age group. As expected, children with ADHD rated themselves significantly more dysfunctional than control children. In most domains, self-ratings of children with ADHD did not diverge from parent and teacher ratings to a greater extent than self-ratings of control children, although overall results indicated a moderate tendency toward a positive bias. When a cluster analysis based on discrepancies between children's and adults' evaluations was carried out, three groups with different self-rating patterns emerged: A "positive bias” group containing exclusively children with ADHD, a "negative bias” group containing both children with ADHD and control children, and the largest group of accurate self-raters which also included children from both diagnostic groups. It is concluded that overly positive self-judgments are not a ubiquitous finding in ADHD, but may be confined to a specific subgroup of children whose specific characteristics remain to be determine

The impact of instruction and response cost on the modulation of response-style in children with ADHD

BACKGROUND: The present study investigated the impact of divergent instructions and response cost on strategic cognitive control in children with ADHD. METHODS: Children with ADHD (N = 34), combined subtype, and control children (N = 34) performed a series of self-paced computerized visual search tasks. The tasks varied by verbal instructions: after a baseline task, children were either instructed to work as fast as possible (speed instruction) or as accurately as possible (accuracy instruction). In addition, tasks were performed with and without response cost. RESULTS: Both groups modulated latencies and errors according to instructions in a comparable way, except for latency in the accuracy - instruction without response cost, where control children showed a larger increase of response time. Response cost did not affect the modulation of response style in children with ADHD to a larger extent than in controls. However, with instructions group differences related to target criteria became clearly more accentuated compared to baseline but disappeared when response cost was added. CONCLUSIONS: Delay aversion theory and motivational or state regulation models may account for different aspects of the results. Modifications related to task presentation, such as the emphasis put on different details in the verbal instruction, may lead to divergent results when comparing performances of children with ADHD and control children on a self-paced task

Slow cortical potential neurofeedback in attention deficit hyperactivity disorder: is there neurophysiological evidence for specific effects?

This study compared changes in quantitative EEG (QEEG) and CNV (contingent negative variation) of children suffering from ADHD treated by SCP (slow cortical potential) neurofeedback (NF) with the effects of group therapy (GT) to separate specific from non-specific neurophysiological effects of NF. Twenty-six children (age: 11.1±1.15years) diagnosed as having ADHD were assigned to NF (N=14) or GT (N=12) training groups. QEEG measures at rest, CNV and behavioral ratings were acquired before and after the trainings and statistically analyzed. For children with ADHD-combined type in the NF group, treatment effects indicated a tendency toward improvement of selected QEEG markers. We could not find the expected improvement of CNV, but CNV reduction was less pronounced in good NF performers. QEEG changes were associated with some behavioral scales. Analyses of subgroups suggested specific influences of SCP training on brain functions. To conclude, SCP neurofeedback improves only selected attentional brain functions as measurable with QEEG at rest or CNV mapping. Effects of neurofeedback including the advantage of NF over GT seem mediated by both specific and non-specific factor

Neuroimaging of cognitive brain function in paediatric obsessive compulsive disorder: a review of literature and preliminary meta-analysis

Obsessive compulsive disorder (OCD) is a frequent psychiatric disorder with a prevalence of 1-3%, and it places an enormous burden on patients and their relatives. Up to 50% of all cases suffer from onset in childhood or adolescence, and the disorder often takes a chronic course with a poor long-term prognosis. Paediatric OCD, with its high familiality, is often referred to as a distinct OCD subtype that coincides with a developmental period in which the prefrontal cortex exhibits extensive structural and functional maturation. In the present review, we included all studies examining cognitive brain activation in children and/or adolescents with OCD. We conducted extensive literature searches for relevant articles (Pubmed, ScienceDirect) and summarize, tabulate, and discuss their results. For the eight activation studies using functional magnetic resonance imaging, we also performed preliminary meta-analyses to assess the most consistent hypo- and hyperactivation in paediatric OCD patients during cognitive task performance. The review of literature as well as our preliminary meta-analyses of paediatric studies indicated altered functional activation in the same brain regions of affective and cognitive cortico-striatal-thalamic (CST) circuits as for adult OCD patients despite some variations in the direction of activation difference. The still small number of studies that examined brain activation in paediatric OCD patients thereby largely converged with previous findings in adult patients and with the established neurobiological models of CST circuit dysfunction in OC

Das Schulkind mit ADHS

Die Aufmerksamkeitsdefizit- und Hyperaktivitätsstörung (ADHS) ist eine der häufigsten psychischen Störungen im Schulalter. Die Kernsymptome Hyperaktivität, Aufmerksamkeitsstörung und erhöhte Impulsivität treten vor dem 7. Lebensjahr auf und beeinträchtigen deutlich die Alltagsbewältigung (Schule, Familie, Freizeit) des Kindes. Bei 70 % aller Betroffenen treten zudem mindestens eine weitere psychische Störung bzw. Lern- und Leistungsstörungen auf. Die ADHS ist in der Kinder- und Jugendpsychiatrie eines der am meisten beforschten Störungsbilder. In einer Vielzahl genetischer Studien und Bildgebungsstudien (MRT) zeigen Unterschiede zwischen Kindern mit ADHS und gesunden Kindern deutlich, dass ADHS eine neurobiologisch begründete Funktionsstörung ist. Nichtsdestotrotz spielen Umweltbedingungen wie familiäre und schulische Faktoren eine bedeutende Rolle bei der Aufrechterhaltung und Verstärkung der Symptomatik. Die Behandlung erfolgt multimodal, kindzentriert, unter Einbezug der Eltern und wenn möglich der Lehrpersonen. Die Gesellschaft mit ihren spezifischen Anforderungen, auch in der Schule hat sich nicht eingestellt auf Kinder, die anders sind, sehr bewegt und leicht ablenkbar. Diese Kinder haben jedoch auch Ressourcen. Sind sie einmal von einer Sache fasziniert, können sie in diesem Bereich durchaus Durchhaltevermögen und hohe Leistungsbereitschaft zeigen

Einfluss des Lockdowns auf Psyche und Mediengebrauch in der Kinder- und Jugendpsychiatrie

Die COVID-19-Pandemie stellte alle Familien vor noch nie dagewesene Herausforderungen: Kontaktverbote und das Fehlen von Alternativen der Freizeitgestaltung führten dazu, dass digitale Medien einen grösseren Stellenwert erhielten als je zuvor. Kinder und Jugendliche mit psychischen Vorerkrankungen waren von den Auswirkungen der Pandemie in ganz besonderer Weise betroffen und es bestand die Sorge, es könne gerade in einer Population mit Risiko für Sucht oder dysfunktionalem Verhalten zu einem Anstieg von problematischem Internetgebrauch kommen

1Controlled evaluation of a neurofeedback training of slow cortical potentials in children with Attention Deficit/Hyperactivity Disorder (ADHD)

BACKGROUND: Although several promising studies on neurofeedback training in Attention Deficit/Hyperactivity Disorder (ADHD) have been performed in recent years, the specificity of positive treatment effects continues to be challenged. METHODS: To evaluate the specificity of a neurofeedback training of slow cortical potentials, a twofold strategy was pursued: First, the efficacy of neurofeedback training was compared to a group training program for children with ADHD. Secondly, the extent of improvements observed in the neurofeedback group in relation to successful regulation of cortical activation was examined. Parents and teachers rated children's behaviour and executive functions before and after treatment. In addition, children underwent neuropsychological testing before and after training. RESULTS: According to parents' and teachers' ratings, children of the neurofeedback training group improved more than children who had participated in a group therapy program, particularly in attention and cognition related domains. On neuropsychological measures children of both groups showed similar improvements. However, only about half of the neurofeedback group learned to regulate cortical activation during a transfer condition without direct feedback. Behavioural improvements of this subgroup were moderately related to neurofeedback training performance, whereas effective parental support accounted better for some advantages of neurofeedback training compared to group therapy according to parents' and teachers' ratings. CONCLUSION: There is a specific training effect of neurofeedback of slow cortical potentials due to enhanced cortical control. However, non-specific factors, such as parental support, may also contribute to the positive behavioural effects induced by the neurofeedback training

The behavioural profile of children with attention-deficit/hyperactivity disorder and of their siblings

The behavioural profiles in N=69 index children with attention-deficit/hyperactivity disorder (ADHD), N=32 siblings with ADHD, N=35 siblings without ADHD, and N=36 normal controls were compared by the use of standardized parent and teacher rating scales. The four groups were matched by age and IQ. The behavioural profiles of the two ADHD groups were very similar not only in the behavioural domains of ADHD, but also in scales measuring emotional and conduct problems. Siblings without ADHD shared more similarities with normal controls except for more emotional problems. These general trends were stronger in the parent compared to the teacher ratings. These findings indicate that not only ADHD-related but also other behaviours show a strong family aggregation. The informant differences may reflect context dependent differences in child behaviour and contrast effects particularly in parental rating

Time processing in children and adults with ADHD

A time-processing deficit has been proposed as a neuropsychological candidate endophenotype for Attention Deficit Hyperactivity Disorder (ADHD), but its developmental trajectory still needs to be explored. In the present study, children (N=33) and adults (N=22) with ADHD were compared to normal controls on two time-processing tasks. For time reproduction, ADHD-related impairment was found in the full group, but not when adults were analyzed separately. For the discrimination of brief intervals, children and adults with ADHD showed different patterns of deficit. We conclude that in ADHD some time-processing deficits are still present in adults, but may take on age-related different form

Diagnostic Value of Resting Electroencephalogram in Attention-Deficit/Hyperactivity Disorder Across the Lifespan

The resting electroencephalogram (EEG) reflects development and arousal, but whether it can support clinical diagnosis of attention-deficit/hyperactivity disorder (ADHD) remains controversial. Here we examined whether theta power and theta/beta ratio are consistently elevated in ADHD and younger age as proposed. Topographic 48-channel EEG from 32 children (8-16years) and 22 adults (32-55years) with ADHD and matched healthy controls (n=30 children/21 adults) was compared. Following advanced artefact correction, resting EEG was tested for increased theta and theta/beta activity due to ADHD and due to normal immaturity. Discriminant analyses tested classification performance by ADHD and age using these EEG markers as well as EEG artefacts and deviant attentional event-related potentials (ERPs). No consistent theta or theta/beta increases were found with ADHD. Even multivariate analyses indicated only marginal EEG power increases in children with ADHD. Instead, consistent developmental theta decreases were observed, indicating that maturational lags of fewer than 3years would have been detected in children. Discriminant analysis based on proposed simple spectral resting EEG markers was successful for age but not for ADHD (81 vs. 53% accuracy). Including ERP markers and EEG artefacts improved discrimination, although not to diagnostically useful levels. The lack of consistent spectral resting EEG abnormalities in ADHD despite consistent developmental effects casts doubt upon conventional neurometric approaches towards EEG-based ADHD diagnosis, but is consistent with evidence that ADHD is a heterogeneous disorder, where the resting state is not consistently characterised by maturational la