Daily Behaviors, Worries and Emotions in Children and Adolescents with ADHD and Learning Difficulties during the COVID-19 Pandemic.

The aim of the present study was to investigate the effects of the coronavirus crisis on behavioral and emotional parameters in children and adolescents with ADHD and Learning Difficulties. A total of 101 children, 5-18 years old, were included in the study, 63 (44 boys) of which were diagnosed with ADHD and learning difficulties (ADHD/LD) and 38 were healthy children (19 boys). The CRISIS questionnaire for parents/caregivers was used. The questionnaire was completed during the first national lockdown in Greece and the data referred to two time-points: 3 months before, and the past 2 weeks. A significant deterioration in the "Emotion/Worries (EW)" symptoms was observed during the pandemic in the control group (2.62 ± 0.16 vs. 2.83 ± 0.18, p < 0.001). No such differences were noted in the ADHD group: 3.08 ± 0.25 vs. 3.12 ± 0.29, p = 0.12. Provision of educational and activities support was related to increased EW before the crisis. In ADHD/LD children, higher parental education and child's younger age were related to increased symptoms of EW. In the entire group, previous mental health conditions, increasing stress due to restrictions, and increased COVID-related worries were positively associated with the EW symptoms during the crisis. Less affected relations with friends and less reduction in contact with people outside the home were negatively related with EW during the crisis. The study revealed specific parameters that negatively affected the emotional and behavioral variables of children with ADHD and learning difficulties.

EF Train: development of an executive function training program for preschool and school-aged children with ADHD

Executive functions are involved in the manifestation of ADHD symptoms. These functions have been proven to predict academic achievement and performance promoting school readiness and social functioning, thus training programs are essential. The current study focused on the development of an executive function training program "EF Train" and assessed its effect on the enhancement of three core executive functions, i.e. working memory, inhibitory control and sustained attention. A group of 52 children with ADHD ranging from 4 to 7 years of age were assigned to either a training group who performed 20 sessions of the executive function training program or a control group that received no training. The assessment of executive function improvement was carried out before, immediately after and three months after the completion of the "EF Train". Data analysis revealed that the training program led to significant improvements of the core executive functions, as well as diminished ADHD symptoms. The findings indicate that executive function programs may assist on the attenuation of ADHD symptomatology providing additional non-invasive approaches for executive function improvement

No disponible

Salivary cortisol and alpha-amylase diurnal profiles and stress reactivity in children with Attention Deficit Hyperactivity Disorder.

There is growing evidence for dysregulation of the stress system in individuals with Attention Deficit Hyperactivity Disorder (ADHD). The stress system includes neuroanatomical and functional components that function in concert to maintain homeostasis and its main effectors are the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic/adrenomedullary nervous system (SNS). As stress system activity demonstrates a distinct circadian variation, we aimed to describe simultaneously, diurnal rhythms of both the HPA axis and the SNS in children with ADHD and a comparison group. Moreover, we attempted to investigate stress responses to a physical stressor, venipuncture, in both groups. Sixty-two prepubertal children with ADHD combined (ADHD-C) or inattentive (ADHD-I) type and 40 typically developing children provided saliva samples at six specific time points during a day, as well as before and 10 min after a scheduled morning venipuncture. Salivary cortisol and α- amylase were selected as reliable noninvasive biomarkers for HPA axis and SNS function and were measured in the samples obtained. Results revealed that children with ADHD-C had lower mean cortisol values both 30 min after awakening and at 18:00 h than controls (p = 0.002 and p = 0.018 respectively), as well as lower mean Cortisol Awakening Response (CAR) and Area Under the Curve for "wake to bed" period (AUCi) values of cortisol (p = 0.004 and p = 0.001, respectively). Also, mean CAR and cortisol AUCi were lower in children with ADHD-I than the control group (p = 0.034 and p = 0.038 respectively). Alpha-amylase measurements showed an increase over time (p < 0.001), which was similar in all three groups. Interestingly, α-amylase changes over time were correlated with the corresponding cortisol changes (p < 0.001). Venipuncture, elicited a significant increase only in α-amylase levels and more so in the control group (p = 0.003). These findings suggest a partial hypofunction of the stress system in children with ADHD.

Mothers' parenting stress is associated with salivary cortisol profiles in children with attention deficit hyperactivity disorder.

The aim of this study was to explore the relation between mothers' parenting stress and the functioning of the hypothalamic-pituitary-adrenal axis (HPAA), as expressed by daily salivary cortisol concentrations, in their children diagnosed with attention deficit hyperactivity disorder (ADHD). Seventy-five children aged 6-11 years diagnosed with ADHD predominant hyperactive-impulsive/combined (ADHD-HI/C, N = 49) and inattentive symptoms (ADHD-I, N = 26) and 45 healthy peers and their mothers participated in the study. Μothers completed measures assessing their children's ADHD status, perceived parenting stress (Parenting Stress Index - Short Form, PSI-SF), mothers' symptoms of psychopathology, social support and socioeconomic status. Children's salivary cortisol samples were collected at six different time points on a single day. Mothers of children with ADHD-HI/C reported higher levels of parenting stress than mothers of children with ADHD-I and controls. All PSI-SF subscales showed significant associations with children's cortisol awakening response (CAR) in both ADHD groups, with the exception of the parental distress subscale in the ADHD-I group. In both ADHD groups, the parent-child dysfunctional interaction subscale, the difficult child subscale and the PSI total score were significantly associated with children's CAR. An interrelation is revealed between mothers' high levels of parenting stress and HPAA functioning in children with ADHD. In this population, CAR has been identified as a sensitive peripheral measure of HPAA functioning in children. Lay summaryThis study showed that in families of children diagnosed with ADHD, there is a complex relation between the mothers' high levels of parenting stress and children's atypical hypothalamic-pituitary-adrenal axis functioning.

Catastrophic worries in mothers of adolescents with internalizing disorders.

OBJECTIVES: This study investigates worrying in mothers of adolescents with internalizing disorders, and tests the hypothesis that these mothers will produce a greater number of worries with higher catastrophic content compared to control groups. DESIGN: Differences in worry steps and in catastrophic content of worries were investigated in a cross-sectional, between groups design, employing a clinical internalizing group, a clinical control, and a non-referred control group. METHODS: Twenty-five mothers of adolescents with internalizing disorders, 24 mothers of adolescents with externalizing disorders, and 28 mothers with non-referred adolescents participated in two interviews about their 'real' pre-existing worries and their worries in response to a hypothetical situation. RESULTS: The internalizing group produced both a greater number of worry steps and a higher catastrophic content when they talked about their 'real' worries, compared to both control groups. They also produced a greater number of worry steps in response to a hypothetical situation compared to the other two groups. The number of worry steps and the level of catastrophic content of 'real' worries were associated with adolescent depression and anxiety. Additionally, the number of worry steps and the level of catastrophic content of worries in response to a hypothetical situation were related to adolescent depression. The number of worry steps in 'real' worries and the level of catastrophic content in hypothetical worries were also associated with maternal depressive symptoms. CONCLUSIONS: Mothers of adolescents with internalizing disorders may worry more catastrophically about their children than other mothers.