ABSTRACT
Objective:To explore the parenting characteristics of children with attention deficit hyperactivity disorder (ADHD) and conduct problems.Methods:This was a cross-sectional study involving 84 ADHD children with conduct problems and 75 ADHD children without conduct problems treated in the Outpatient Department of Children′s Health and Mental Health Center, Shenzhen Children′s Hospital from September 2017 to December 2019, and 54 healthy control children (healthy children in ordinary primary and secondary schools in Shenzhen) were included.The Egna Minnen av Barndoms Uppfostran (EMBU) scale was used to access the parenting styles of participants. ANCOVA was used to compare the different score of all factors in EMBU among these 3 groups and Tukey′s post-hoc comparisons were also performed.All comparisons were corrected for age and sex. Results:Among the factor scores of EMBU scale, ADHD children with conduct problems scored significantly higher on parental and maternal harsh/punishment [Parental (22.10±4.92) scores vs.(19.40±4.01) scores vs.(17.40±2.51) scores; Maternal (15.10±3.54) scores vs.(13.70±2.78) scores vs.(12.40±1.97) scores] and the reject/deny factors [Parental(10.60±2.49)scores vs.(9.40±2.06)scores vs.(8.90±1.61)scores, Maternal(13.90±3.28)scores vs.(12.40±2.64)scores vs.(11.60±2.19)scores] than ADHD children without conduct problems and the healthy control group (all P<0.001). On parental overprotection factors, both ADHD groups scored higher than the healthy control group [(10.30±2.03) scores vs.(9.80±2.13) scores vs.(8.70±1.92) scores, P<0.001], while on maternal over-interference factor, ADHD children with conduct problem scored significantly higher than ADHD children without conduct problems and the healthy controls [(36.00±4.64) scores vs.(34.60±4.38) scores vs.(33.30±4.92) scores, P=0.009]. Conclusions:Parents of ADHD children with conduct problems tend to use more negative parenting skills like punishment, over-interference, rejection and denial.This kind of negative parenting style, to some extent, causes the conduct problems in children with ADHD.
ABSTRACT
Objective:To determine the effects of cognitive-behavioral therapy (CBT) on resting-state brain functional changes in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Participants including 10 adults with ADHD aged 18-65 years,diagnosed with the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 12 age-and gender-matched healthy controls.The ADHD symptoms and executives functions were assessed using the ADHD Rating Scale (ADHD-RS) and Behavior Rating Inventory of Executive Function (BRIEF) respectively and resting-state functional magnetic resonance imaging were acquired before and after 12-session,CBT for ADHD patients.The healthy controls were also scanned.We used the regional homogeneity (ReHo) to capture the changes of regional brain function between pre-and post-CBT in ADHD for measuring the effects of CBT.Results:After CBT,the total scores of ADHD-RS [(43 ± 7) vs.(31 ± 7),P ＜ 0.01],the subscale of inattention and subscale of hyperactivity/impulsivity were decreased in ADHD adults.As for the executive functions,the subs cales of monitor [(15 ± 2) vs.(11 ± 2),P ＜ 0.01] and organization [(19 ± 5) vs.(14 ± 4),P ＜ 0.01] in BRIEF were reduced significantly in adults with ADHD after CBT training.The ReHo was increased in the regions involved in default mode network and fronto-parietal network,i.e.,right parahippocampa gyrus,fight precentral gyms,fight postcentral gyms and left postcentral gyrus (Voxels with P ＜ 0.05 and cluster size ＞3051mm3,which resulted in a corrected threshold of P ＜ 0.01 determined by AlphaSim).Conclusion:These findings support that CBT could selectively modulate the regional brain function in the default mode network and fronto-parietal network which may contribute to the improvement of ADHD symptoms and executive functions.