Receiver operating characteristic curve analysis of the Weiss Functional Impairment Rating Scale-Parent Report for screening children with ADHD: Looking beyond symptoms in ADHD diagnosis.

AIM: The current study aimed at examining the ability of the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) to discriminate between children with ADHD and controls in functional impairment and identifying optimal cutoff scores for the WFIRS-P subscales and total scale. METHODS: Parents of 51 children with ADHD (90.2% male; grades 1-6) and 51 gender/grade matched controls (90.2% male; grades 1-6) completed the WFIRS-P. Receiver operating characteristic (ROC) curve analysis was used to examine the ability of the WFIRS-P to differentiate children with ADHD from controls and to determine optimal cutoff scores of the WFIRS-P. RESULTS: Area under the curve (AUC) was 0.98 for the WFIRS-P total scale, indicating excellent ability to differentiate children with ADHD from controls. The score of 0.45 with 0.88 for sensitivity and 0.96 for specificity was determined as the optimal cutoff score for the total scale of the WFIRS-P. AUC was 0.73 to 0.97 for the WFIRS-P subscales, suggesting good to excellent ability for discriminating between children with ADHD and controls. Among the subscales, the family subscale score of 0.42 with 0.92 for sensitivity and 0.96 for specificity showed the highest discriminating power. The self-concept and life skills subscales had low sensitivity, suggesting Iranian mothers do not identify problems with self-concept or difficulty with life skills as particularly problematic in ADHD. CONCLUSIONS: The WFIRS-P is a sensitive and specific measure of the functional impairment associated with ADHD in Iranian children. Our sample was predominantly male, limiting the generalizability of results to females.

Adult ADHD Treatment Based on Combination of Dialectical Behavior Therapy (DBT) and Transcranial Direct Current Stimulation (tDCS) as Measured by Subjective and Objective Scales.

Almost 30% of ADHD adults do not respond to standard pharmaceuticals. Transcranial direct current stimulation (tDCS) is a method for modulation of cortical excitability. On the other hand, dialectical behavioral therapy (DBT) is a cognitive-behavioral approach that might be utilized for adults with ADHD. The effects of integration of these interventions are only beginning to be explored. In the present work, we used both subjective and objective measures to investigate the effects of tDCS, DBT, and the integration of the two in treating adult ADHD symptoms. A total of 80 adults with ADHD (63 females, 17 males) participated in the study and were grouped into control, DBT, tDCS, and combined groups. Based on the observed results, the combination of DBT and tDCS was significantly effective in improving the mentioned variables compared to administration of each method in isolation. The results are discussed in terms of neurophysiological and psychological aspects of treatment methods.

Study of Functional Impairment in Students of Elementary and Secondary Public Schools in Iran.

OBJECTIVE: The current study aimed to investigate the frequency of impairment in different functional domains of life and the relationship between sex and age and functional impairment in school-based samples of Iranian children and adolescents. METHOD: A sample of 270 children (ages 6-11) enrolled in two public elementary schools and a sample of 386 adolescents (ages 12-17) enrolled in four public secondary schools were selected by multistage sampling. The Persian version of the parent report form and self-report form of the Weiss Functional Impairment Rating Scale (WFIRS-P and WFIRS-S) were used for evaluating functional impairment in children and adolescents, respectively. Two-way analyses of variance (two-way ANOVAs) were conducted to explore the main effects and the interaction effect of sex and age on functional impairment. RESULTS: 11.9% of children and 29.5% of adolescents showed impairment in at least two functional domains of life. The most frequent impaired domain was life skills (22.6% of children and 30.3% of adolescents). While no significant sex and age effect was found during childhood, male adolescents showed more impairment in externalizing domains and female adolescents showed more internalizing difficulties. In addition, older adolescents showed more functional impairment relative to younger adolescents. CONCLUSIONS: Detailed knowledge of the relationship between sex and age and functional impairment could be a starting point to target the major psychosocial elements of these challenges.

OBJECTIF: La présente étude visait à investiguer la fréquence de la déficience dans différents domaines fonctionnels de la vie et la relation entre le sexe et l'âge et la déficience fonctionnelle dans des échantillons recrutés en milieu scolaire d'enfants et adolescents iraniens. MÉTHODE: Un échantillon de 270 enfants (de 6 à 11 ans) inscrits dans deux écoles primaires publiques et un échantillon de 386 adolescents (de 12 à 17 ans) inscrits dans 4 écoles secondaires publiques ont été choisis par un échantillonnage à plusieurs degrés. La version persane du formulaire du rapport des parents et du formulaire d'auto-déclaration de la Weiss Functional Impairment Rating Scale (WFIRS-P et WFIRS-S) a servi à évaluer la déficience fonctionnelle chez les enfants et les adolescents, respectivement. L'analyse de la variance à deux facteurs (ANOVA à deux facteurs) a été menée pour explorer les principaux effets et l'effet d'interaction du sexe et de l'âge sur la déficience fonctionnelle. RÉSULTATS: 11,9 % des enfants et 29,5 % des adolescents révélaient une déficience dans au moins deux domaines fonctionnels de la vie. Le domaine le plus fréquemment déficient était celui des compétences essentielles (22,6 % des enfants et 30,3 % des adolescents). Bien qu'aucun effet significatif du sexe et de l'âge n'ait été constaté durant l'enfance, les adolescents de sexe masculin affichaient plus de déficience dans les domaines externalisants et les adolescentes de sexe féminin montraient plus de difficultés d'internalisation. En outre, les adolescents plus âgés affichaient plus de déficience fonctionnelle relativement aux adolescents plus jeunes. CONCLUSIONS: Une connaissance détaillée de la relation entre le sexe et l'âge et la déficience fonctionnelle pourrait constituer un point de départ pour cibler les éléments psychosociaux majeurs de ces difficultés.

Health-related quality of life in Iranian adolescents: a psychometric evaluation of the self-report form of the PedsQL 4.0 and an investigation of gender and age differences.

BACKGROUND: Research on the psychometric properties of the Persian self-report form of the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0) in adolescents has several gaps (e.g., convergent validity) that limit its clinical application and therefore the cross-cultural impact of this measure. This study aimed at investigating the psychometric properties of the PedsQL 4.0 and the effects of gender and age on quality of life in Iranian adolescents. METHOD: The PedsQL 4.0 was administered to 326 adolescents (12-17 years). A subsample of 115 adolescents completed the scale two weeks after the first assessment. Confirmatory Factor Analysis (CFA), correlation of the PedsQL 4.0 with the Weiss Functional Impairment Rating Scale-Self-report (WFIRS-S), and Item Response Theory (IRT) analysis were conducted to examine validity. Cronbach's alpha, McDonald's Omega, and Intra class correlation (ICC) were calculated as well to examine reliability. Gender and age effects were also evaluated. RESULTS: Internal consistency and test-retest reliability of the total PedsQL 4.0 scale was .92 and .87, respectively. The PedsQL 4.0 scores showed negative moderate to strong correlations with the WFIRS-S total scale. The four-factor model of the PedsQL 4.0 was not fully supported by the CFA-the root mean square error of approximation and the comparative fit index showed a mediocre and poor fit, respectively. IRT analysis indicated that all items of the PedsQL 4.0 fit with the scale and most of them showed good discrimination. The items and total scale provided more information in the lower levels of the latent trait. Males showed significantly higher scores than females in physical and emotional functioning, psychosocial health, and total scale. Adolescents with lower ages showed better quality of life than those with higher ages in all scores of the PedsQL 4.0. CONCLUSION: The PedsQL 4.0 showed good psychometric properties with regard to internal consistency, test-retest reliability, and convergent validity in Iranian adolescents, which supports its use in clinical settings among Persian-speaking adolescents. However, factor structure according to our CFA indicates that future work should address how to improve fit. In addition, studies that include PedsQL 4.0 should consider gender and age effects were reported.

Attention and behavioral control skills in Iranian school children.

This study assessed quality of life, emotional and behavioral problems, prosocial behavior, and functional impairment in a sample of Iranian children based on their attention and behavioral control skills. The sample consisted of 280 male and female children aged between 6 and 12 years old who were divided into strong, moderate, and weak groups based on parental ratings of attention and behavioral control skills on the strengths and weaknesses of ADHD symptom and normal behavior rating scale (SWAN). In addition, parents completed the pediatric quality of life inventory version 4.0 generic core scales (PedsQL 4.0), the strengths and difficulties questionnaire, and the Weiss functional impairment rating scale-parent report (WFIRS-P). The strong group generally showed better quality of life than the weak group. The strong group was better than the moderate group, and the moderate group was better than the weak group on school functioning. The weak group had more conduct problems and hyperactivity/inattention and less prosocial behavior than the moderate group and the strong group. The moderate group had more hyperactivity/inattention than the strong group. The weak group showed more impairment than the moderate group and the strong group on all subscales and the total scale of the WFIRS-P. The quality of life, behavioral problems, prosocial behavior, and functional impairment can be different in children based on their attention and behavioral control skills.

Psychometric Properties of the Persian Version of the Weiss Functional Impairment Rating Scale-Self-Report Form in Iranian Adolescents.

OBJECTIVE: The Weiss Functional Impairment Rating Scale-Self-Report Form (WFIRS-S) was developed as a measure of functional impairment in adolescents and adults with ADHD. This study reports the psychometric properties of the Persian version of the WFIRS-S in a sample of normal Iranian adolescents. METHOD: Internal consistency and factor structure of the WFIRS-S were tested on a sample of 386 students (Grades 7-12). The test-retest reliability and the convergent validity of the WFIRS-S were evaluated by using two different subsamples including 50 and 100 students, respectively. RESULTS: The Cronbach's alpha values were between .72 and .94 for the WFIRS-S subdomains and total scale. The test-retest reliability was .80 for the total scale. The WFIRS-S subdomains had moderate to high significant correlations with the Pediatric Quality of Life total scale. CONCLUSION: The Persian version of the WFIRS-S has acceptable psychometric properties and could be used as a functional impairment assessment for adolescents.

Descriptive and psychometric properties of the Persian version of the Weiss functional impairment rating scale: parent report form in Iranian children.

BACKGROUND: This study evaluates the descriptive and psychometric properties of the Persian version of the Weiss Functional Impairment Rating Scale-Parent Report Form (WFIRS-P) in a normal sample of Iranian children. METHOD: Parents of 282 students (grades 1-6) completed the WFIRS-P. Means and standard deviations were computed for the total scale, each domain, and each item of the WFIRS-P. Internal consistency, interdomain correlations, and test-retest reliability were used to assess the reliability of the scale. RESULTS: Among the WFIRS-P domains, life skills had the highest rated impairment (M = 0.50, SD = 0.37) and risky activities had the lowest. Internal consistency (α = .88) and test-retest reliability (r = 0.77) were strong for the WFIRS-P total scale. The correlation between the WFIRS-P domains and the total scale ranged from 0.52 to 0.81. CONCLUSIONS: Results suggest that the Persian version of the WFIRS-P is a useful and psychometrically reliable measure for assessing functional skills in children.

Child abuse in group of children with attention deficit-hyperactivity disorder in comparison with normal children.

BACKGROUND: Children suffer from attention deficit hyperactivity disorder (ADHD) are very difficult to handle. It can be very frustrating and needs an outstanding tolerance. Behavioral difficulties in ADHD children may increase the risk of child abuse for them. The aim of this research was to compare child abuse, and neglect between ADHD group and normal children. METHODS: In this cross-sectional study, 30 ADHD students (10 girls and 20 boys) were selected from regional mental behavior disorder clinics and matched with 30 normal students. Data were collected using Child Abuse Self Report Scale. Descriptive statistics, one-way multivariate analysis of variance (MANOVA) and Least Significant Difference (LSD) was performed by using SPSS software. RESULT: The result of the research showed that almost 60% of participants had experienced neglect and 35% psychological abuse. Neglect and psychological abuse are more frequent than other maltreatments. Neglect, psychological and physical abuses are significantly higher in the ADHD group. CONCLUSION: The findings showed that the rates of neglect and psychological abuse are higher in the ADHD group. Therefore, it can be suggested that the society and families should be trained to deal better with ADHD children.

Operationalizing Cognitive Science and Technologies' Research and Development; the "Brain and Cognition Study Group (BCSG)" Initiative from Shiraz, Iran.

Recent advances in brain and cognitive science studies have revolutionized concepts in neural dynamics, regulating mechanisms, coding systems and information processing networks which govern our function and behavior. Hidden aspects of neurological and psychiatric diseases are being understood and hopes for their treatment are emerging. Although the two comprehensive mega-projects on brain mapping are in place in the United States and Europe; the proportion of science contributed by the developing countries should not be downsized. With the granted supports from the Cognitive Sciences and Technologies Council (CSTC), Iran can take its role in research on brain and cognition further. The idea of research and development in Cognitive Sciences and Technologies (CST) is being disseminated across the country by CSTC. Towards this goal, the first Shiraz interdisciplinary meeting on CST was held on 9 January 2014 in Namazi hospital, Shiraz. CST research priorities, infrastructure development, education and promotion were among the main topics discussed during this interactive meeting. The steering committee of the first CST meeting in Shiraz decided to frame future research works within the "Brain and Cognition Study Group-Shiraz" (BCSG-Shiraz). The study group comprises scientific leaders from various allied disciplines including neuroscience, neurosurgery, neurology, psychiatry, psychology, radiology, physiology, bioengineering, biophysics, applied physics and telecommunication. As the headquarter for CST in the southern Iran, BCSG-Shiraz is determined to advocate "brain and cognition" awareness, education and research in close collaboration with CSTC. Together with CSTC, Shiraz Neuroscience Research center (SNRC) will take the initiative to cross boundaries in interdisciplinary works and multi-centric research projects within the study group.

Comparing Iconic Memory in Children with and without Attention Deficit Hyperactivity Disorder.

OBJECTIVE: Children with attention deficit hyperactivity disorder (ADHD) do not process most information due to inattention and loss of the opportunity to save and retrieve information. Therefore, these children experience memory impairment. Although visual memory has been previously studied in children with ADHD, iconic memory in these children has been less evaluated. We aimed to study the possibility of iconic memory impairment in children with ADHD, and compare the results with that of children without ADHD. METHODS: The experimental group of this study were 6-9 year-old children who referred to the Imam Hosein Clinic and were diagnosed as having ADHD by a psychiatrist during 2011-2012 (n = 30).The subjects were interviewed clinically by a psychologist; and in order to diagnose ADHD, their parents and teachers were asked to complete the child symptom inventory-4 (CSI-4). The comparison group were 6-9 year-old children without ADHD who studied in 1st and 2nd educational district of Yazd (n = 30). Subjects' iconic memory was assessed using an iconic memory task. Repeated measure ANOVA was used for data analysis. RESULTS: Based on the iconic memory test, the mean score of ADHD children was significantly lower than that of children without ADHD (P < 0.001). Moreover, the performance of the experimental group differed significantly when the duration of the presentation differed from 50 ms to 100 ms as compared to the control group (P < 0.001). The number of correct answers increased in the experimental group as the duration of presentation increased. However, children with ADHD scored less than children without ADHD at 50 ms as well as 100 ms. The means of ADHD children increased as the duration of the presentation increased from 50 ms to 100 ms to 300 ms (P < 0.001). CONCLUSION: Visual memory is weaker in children with ADHD, and they have weaker performance than normal children in both visual and auditory symbols at presentation durations of 50 and 100 ms. The performance of ADHD children improves as the stimulation time increases.