Alexithymia, emotion processing and social anxiety in adults with ADHD.

OBJECTIVE: given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). SUBJECTS AND METHODS: 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German "Experience of Emotions Scalerdquor; (SEE) to measure emotion processing. RESULTS: 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. DISCUSSION/CONCLUSION: our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.

Cognitive impairment in patients with a schizoaffective disorder: a comparison with bipolar patients in euthymia.

OBJECTIVES: Several studies have shown persistent neurocognitive impairment in patients with a bipolar affective disorder (BD) even in euthymia as well as in patients with a schizoaffective disorder (SAD). The aim of our study was to compare the neuropsychological performance between these two groups. Confounding variables were controlled to enhance our understanding of cognitive dysfunction in both BD and SAD. METHODS: Several domains of neurocognitive function, executive function, memory, attention, concentration and perceptuomotor function were examined in 28 euthymic SAD patients and 32 BD patients by using a neuropsychological test battery. The Hamilton Depression Rating Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to evaluate the patients' clinical status. Data analysis was performed by using a multivariate analysis of covariance (ANCOVA/MANCOVA). RESULTS: Euthymic SAD patients showed greater cognitive impairment than euthymic BD patients in the tested domains including declarative memory and attention. Putative significant group differences concerning cognitive flexibility vanished when controlled for demographic and clinical variables. Age and medication were robust predictors to cognitive performance of both SAD and BD patients. CONCLUSIONS: Our results point out the worse cognitive outcome of SAD compared to BD patients in remission. Remarkably, the variance is higher for some of the test results between the groups than within each group, this being discussed in light of the contradictive concept of SAD.

Self concept, action control and ADHD symptoms under methylphenidate treatment in adults with ADHD.

INTRODUCTION: Self-efficacy of adults with ADHD might be changed unfavourably under methylphenidate treatment. Therefore, we sought to investigate the initial situation and changes under this medication, regarding features related to self-efficacy (self concept, locus of control and action control). METHODS: 3 self-rating scales (FSKN, IPC, and HAKEMP-90/ACS-90) were applied to 24 adults with ADHD combined type, before and after 5 months of methylphenidate treatment. RESULTS: No negative changes with respect to ADHD symptoms or any questionnaire were found under medication. In fact, both ADHD symptom domains, 5 out of 10 self concept subscale scores, and all 3 action control subscale scores changed favourably. Regression analysis revealed that only facets of self concept, but not of locus of control or of action control, predicted the patients' response to stimulant medication (i.e., a reduction of ADHD symptoms). DISCUSSION: Positive changes of self-concept and action control features under methylphenidate treatment in this study may encourage therapists to treat adults with ADHD with stimulants, thus not being at risk to decrease their patients' self-efficacy. In combined pharmacological/psychotherapeutic approaches, self-concept scales could be used to predict treatment outcome, and in order to monitor interactions between ADHD symptom reduction and self concept.