Narratives of mothers in stepfamily situations: an exploratory investigation

This project explores the topography of stepfamily relationships through the prism of the mother, a view as yet rarely explored. Recorded interviews of eleven mothers were examined using narrative, phenomenological, grounded theory methods, within a Gestalt theoretical framework and refined into first person narratives of their experience as mothers and stepmothers. The overall aim of the research is to develop resources for stepfamily members and inform and educate psychotherapists who work with individuals or couples with stepfamily issues or problems, an area lacking in much information on this at present. The findings indicate that while many social scientists reject biological determinism within stepfamily dynamics, an acceptance of evolutionary theory opens out the analysis to provide greater understanding of the stepfamily landscape. Further, the study shows that some features of stepfamily dynamics have similarities to the workings of psychotherapeutic groups, and vice versa. Therefore stepfamily situations can be a useful metaphor for therapy group interventions and the possibility exists to develop this theory further as an addition to the existing knowledge of group dynamics. Products of the project include a series of workshops, development of exercises that illuminate stepfamily issues and the launch of an organisation StepIn ASAP, Advancing Stepfamily Awareness through Psychotherapy

Services for adults with ADHD:work in progress: Commentary on . . . Specialist adult ADHD clinics in East Anglia

Magon and colleagues highlight a number of relative strengths and weaknesses very reminiscent of those we have seen over the years in the development of similar services for children and adolescents. It is clear that we all have a lot of work to do to improve our approach to the transition from child to adult services. There was clear evidence that adult services can adapt to manage ADHD, but there is also a clear need for increased upskilling of clinicians in the practical management of medication and other treatments. I disagree with Magon and colleagues about the role of primary care and believe that treatment initiation and ongoing monitoring should, for the time being, remain in secondary care and that, because of the volume of work that will come our way, this will need to become a core rather than specialist task. As with other aspects of psychiatric care, there is a clear role for specialist nurses in delivering a significant proportion of the core care

Plugging the attention deficit: perceptual load counters increased distraction in ADHD

Objective: Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities. Method: We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials). Results: The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ηp² = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls. Conclusions: These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

Screening and diagnostic assessment of neurodevelopmental disorders in a male prison

Purpose The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID). Design/methodology/approach The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test. Findings Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study. Originality/value The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD

Hyperactive-Impulsive Symptom Scores and Oppositional Behaviours Reflect Alternate Manifestations of a Single Liability

Attention deficit hyperactivity disorder (ADHD) and oppositional behaviours frequently co-occur, We aimed to study the etiology of this overlap in a general population–based twin sample, assessing the symptom domains of hyperactivity-impulsivity and inattentiveness separately for their overlap with oppositionality. We further aimed to investigate whether rater bias may contribute to the overlap in previous data which used one rater only. Using parent and teacher ratings on hyperactivity-impulsivity, inattentiveness and oppositionality, and actigraph measurements of activity level, for 668 7-9-year-old twin pairs, oppositionality showed a higher overlap with hyperactivity-impulsivity (r=.95) than with inattentiveness (r=.52) and all etiological influences on hyperactivity-impulsivity were shared with those on oppositionality, indicated by a genetic correlation of .95 and a child-specific environmental correlation of .94. Actigraph data did not show an overlap with ratings of oppositionality. In middle childhood, symptoms of hyperactivity-impulsivity and oppositional behaviour may represent the same underlying liability, whereas the inattentive domain is more distinct

Transient expression analysis of allelic variants of a VNTR in the dopamine transporter gene (DAT1)

BACKGROUND: The 10-repeat allele of a variable number tandem repeat (VNTR) polymorphism in the 3'-untranslated region of the dopamine transporter gene (DAT1) has been associated with a range of psychiatric phenotypes, most notably attention-deficit hyperactivity disorder. The mechanism for this association is not yet understood, although several lines of evidence implicate variation in gene expression. In this study we have characterised the genomic structure of the 9- and 10-repeat VNTR alleles, and directly examined the role of the polymorphism in mediating gene expression by measuring comparative in vitro cellular expression using a reporter-gene assay system. RESULTS: Differences in the sequence of the 9- and 10- repeat alleles were confirmed but no polymorphic differences were observed between individuals. There was no difference in expression of reporter gene constructs containing the two alleles. CONCLUSIONS: Our data suggests that this VNTR polymorphism may not have a direct effect on DAT1 expression and that the associations observed with psychiatric phenotypes may be mediated via linkage disequilibrium with other functional polymorphisms

High Heritability for a Composite Index of Children’s Activity Level Measures

Despite the high heritability of children's activity level, which forms part of the core symptom domain of hyperactivity-impulsivity within attention deficit hyperactivity disorder (ADHD), there has only been a limited success with identifying candidate genes involved in its etiology. This may reflect a lack of understanding about the different measures used to define activity level across studies. We aimed to study the genetic and environmental etiology across three measures of activity level: parent and teacher ratings of hyperactivity-impulsivity and actigraph measurements, within a population-based sample of 463 7-9 year old twin pairs. We further examined ways in which the three measures could be combined for future molecular studies. Phenotypic correlations across measures were modest, but a common underlying phenotypic factor was highly heritable (92%); as was a simple aggregation of all three measurements (77%). This suggests that distilling what is common to all three measures may be a good method for generating a quantitative trait suitable for molecular studies of activity level in children. The high heritabilities found are encouraging in this respect

Actigraph data are, reliable, with functional reliability increasing with aggregation

Motion sensor devices such as actigraphs are increasingly used in studies that seek to obtain an objective assessment of activity level. They have many advantages, and are useful additions to research in fields such as sleep assessment, drug efficacy, behavior genetics, and obesity. However, questions still remain over the reliability of data collected using actigraphic assessment. We aimed to apply generalizability theory to actigraph data collected on a large, general-population sample in middle childhood, during 8 cognitive tasks across two body loci, and to examine reliability coefficients on actigraph data aggregated across different numbers of tasks and different numbers of attachment loci. Our analyses show that aggregation greatly increases actigraph data reliability, with reliability coefficients on data collected at one body locus during 1 task (.29) being much lower than that aggregated across data collected on two body loci and during 8 tasks (.66). Further increases in reliability coefficients by aggregating across four loci and 12 tasks were estimated to be modest in prospective analyses, indicating an optimum trade-off between data collection and reliability estimates. We also examined possible instrumental effects on actigraph data and found these to be nonsignificant, further supporting the reliability and validity of actigraph data as a method of activity level assessment