State and Trait Mindfulness as Predictors of Skin Conductance Response to Stress.

Mindfulness is typically understood as non-judgmental, focused attention on the present moment, although it may be conceptualized as a state, a trait, and an outcome of intervention. There is a limited understanding of the physiological effects of state and trait mindfulness, and it has been a challenge to the research community to measure these effects. This study examined whether state and trait mindfulness are associated with reduced stress response activation in healthy young adults. Fifty-four undergraduate participants completed self-ratings of state and trait mindfulness, and continuous measures of psychophysiological reactivity (i.e., skin conductance response) before, during, and after an interview about a recurrent stressor. Results indicated that individuals with greater self-reported state mindfulness had lower sympathetic psychophysiological activation than those with lower state mindfulness. Moreover, those with greater self-reported state mindfulness experienced greater drops in psychophysiological activation following a stressful task. However, differences in psychophysiological activation were not evident when comparing those with higher and lower self-reported trait mindfulness. The findings suggest that state mindfulness, or "being in the moment", rather than trait mindfulness results in less engagement of metabolically costly psychophysiological activation in response to stress. Thus, intentional mindfulness during a stressful event may be important for decreasing sympathetic activation, resulting in lower bodily stress.

The Effectiveness of Mindfulness-Based Therapies for ADHD: A Meta-Analytic Review.

Objective: Mindfulness-based therapies (MBTs) have been shown to be efficacious in treating internally focused psychological disorders (e.g., depression); however, it is still unclear whether MBTs provide improved functioning and symptom relief for individuals with externalizing disorders, including ADHD. To clarify the literature on the effectiveness of MBTs in treating ADHD and to guide future research, an effect-size analysis was conducted. Method: A systematic review of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until December 2014. Results: A total of 10 studies were included in the analysis of inattention and the overall effect size was d = -.66. A total of nine studies were included in the analysis of hyperactivity/impulsivity and the overall effect was calculated at d = -.53. Conclusion: Results of this study highlight the possible benefits of MBTs in reducing symptoms of ADHD.

Using ecological momentary assessments to evaluate extant measures of mind wandering.

Mind wandering is a commonly experienced phenomenon. Although self-report measures are available to assess these attentional lapses, examination of their correspondence with the reported frequency of these episodes in daily life is warranted. Using ecological momentary assessments (EMAs), the present study aimed to validate 3 mind-wandering measures: the Mind-Wandering Questionnaire (MWQ) and the Mind Wandering-Spontaneous (MW-S) and Mind Wandering-Deliberate (MW-D) measures in university students (N = 100). Participants completed a series of questionnaires in an in-lab session. Using time-based EMA sampling, participants received 6 prompts via text message daily for 7 days. Each prompt asked students to report if their current thoughts were about something other than what they were doing using a scale ranging from completely on-task to completely on unrelated concerns. Self-report data collected via EMA indicated that reporting more mind-wandering episodes was associated with higher MWQ and MW-S scores but was not significantly correlated with the MW-D score. Results highlight the utility of EMA in validating measures designed to capture mind-wandering episodes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Symptom covariance accounts for behavioral approach associations across impulse control disorders.

Behavioral approach system (BAS) dysfunction has been identified as a correlate of and a potential mechanism for attention-deficit/hyperactivity disorder (ADHD) and comorbid disorders. This study examined the role of symptom covariation in the relations among BAS dysfunction, ADHD symptoms, and comorbid impulsive personality disorder features. Undergraduates (N = 207) completed measures of BAS functioning, ADHD symptoms, and borderline and antisocial personality disorder symptoms, and associated features (i.e., relational aggression). Hierarchical regression suggested that age, impulsive ADHD symptoms, and relational aggression were associated with BAS functioning. Adding other ADHD symptom dimensions (inattention, hyperactivity) and antisocial and borderline scores to the model did not increase variance accounted for beyond that accounted for by ADHD impulsivity scores. Results highlight a role of symptom covariance in the previously demonstrated relation between BAS, impulsive presentations of ADHD, and comorbid impulsive personality pathology. Implications for etiological models of ADHD and its co-occurrence with other disorders are discussed.

Mindfulness programming for parents and teachers of children with ADHD.

BACKGROUND: Parents and teachers of children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for a range of suboptimal psychosocial outcomes, including mental health difficulties and heightened stress, problems perhaps ameliorated through mindfulness-based programming. OBJECTIVE: To show pilot data from an investigation of the outcomes of a purpose-built mindfulness training for parents and teachers of children with ADHD (N = 26). METHODS: The program represents a purpose-driven modification of the Mindfulness-Based Stress Reduction (MBSR) curriculum. Namely, we reduced participant time commitment and added psychoeducation about ADHD with brief parent training. The measurement protocol included measures of stress, anxiety, depression, and mindfulness. RESULTS: Following the 8-week program, parents and teachers reported reduced perceived stress, reduced self-reported anxiety, and improvements in some facets of mindfulness. CONCLUSION: The work highlights the promise of specialized mindfulness-based interventions in promoting positive psychosocial outcomes in specific at-risk groups, such as the carers of children with ADHD.

Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.

OBJECTIVE: This exploratory study investigated how the timing of female pubertal maturation was associated with the symptoms of ADHD in a non-clinical female undergraduate sample (N = 253). METHOD: Participants (Mage = 20.2 ± 1.7 years) completed a set of self-report rating scales examining pubertal onset and ADHD symptoms and related deficits. RESULTS: Logistic regression analysis indicated that early puberty was associated with elevation in symptoms, including difficulties in attention (odds ratio [OR] = 1.270, p = .019), emotion regulation (OR = 1.070, p = .038), and more risky behavior (OR = 1.035, p = .045). That is, increased symptom endorsement was shown to significantly help classify those who reported having an earlier pubertal onset relative to their peers. CONCLUSION: Findings highlight the potential role of sex hormones during puberty in explaining the gender differences in prevalence rates of ADHD and symptom profiles.

Planum temporale morphology in children with developmental dyslexia.

The planum temporale is a highly lateralized cortical region, located within Wernicke's area, which is thought to be involved in auditory processing, phonological processing, and language. Research has linked abnormal morphology of the planum temporale to developmental dyslexia, although results have varied in large part due to methodological inconsistencies in the literature. This study examined the asymmetry of the planum temporale in 29 children who met criteria for dyslexia and 26 children whose reading was unimpaired. Leftward asymmetry of the planum temporale was found in the total sample and this leftward asymmetry was significantly reduced in children with dyslexia. This reduced leftward asymmetry in children with dyslexia was due to a planum temporale that is larger in the right hemisphere. This study lends support to the idea that planum temporale asymmetry is altered in children with developmental dyslexia.

Are cognitive control and stimulus-driven processes differentially linked to inattention and hyperactivity in preschoolers?

Temperament and attention-deficit/hyperactivity disorder (ADHD) are both typically viewed as biologically based behavioural constructs. There is substantial overlap between ADHD symptoms and specific temperamental traits, such as effortful control, especially in young children. Recent work by Martel and colleagues ( 2009 , 2011 ) suggests that cognitive control temperamental processes are more closely related to inattention symptoms, whereas stimulus-driven temperamental processes are linked to hyperactivity-impulsivity. The present study tested a model of temperament and ADHD symptoms in typically developing preschoolers and those at risk for ADHD using structural equation modelling. Data were from larger study on ADHD in a short-term longitudinal sample with parent/teacher reports and neurocognitive testing. Participants included 214 preschool children (72.9% male) from diverse ethnic/racial backgrounds and a wide range of socioeconomic status from a large metropolitan center. Cognitive control processes, such as effortful control, but not stimulus-driven processes, are related to inattention and hyperactivity. In contrast, stimulus-driven processes, such as emotional reactivity, were related only to hyperactivity symptoms longitudinally. These results suggest that early temperament behaviours and cognitive processes may be indicators of later childhood behavioural difficulties with lasting consequences.

"My child is shy and has no friends: what does parenting have to do with it?".

Accumulating evidence suggests that parents may react differentially to children based on their children's temperament, children's gender, and the interaction of these factors. Furthermore, parents' differential reactions to their children have direct implications for their children's social success. The present study assessed the moderating influence of mothers' and fathers' psychological control on the relationship between shy temperament and peer exclusion in grade five children (n = 153; 57% female), an age during which peer connections are particularly salient. Teachers reported on children's shyness and peer exclusion, and children reported on parents' psychological control. Regression analyses showed fathers' psychological control to be associated with greater peer exclusion for males. Both mothers' and fathers' psychological control were associated with peer exclusion for shy females. Results suggest the importance of parents considering how psychologically controlling behaviors may work in concert with their children's gender and temperament in influencing peer connections during the adolescent transition.

Childhood CBCL bipolar profile and adolescent/young adult personality disorders: a 9-year follow-up.

BACKGROUND: To assess the late adolescent psychiatric outcomes associated with a positive Child Behavior Checklist-Juvenile Bipolar Disorder Phenotype (CBCL-JBD) in children diagnosed with ADHD and followed over a 9-year period. METHODS: Parents of 152 children diagnosed as ADHD (ages 7-11 years) completed the CBCL. Ninety of these parents completed it again 9 years later as part of a comprehensive evaluation of Axis I and II diagnoses as assessed using semi-structured interviews. As previously proposed, the CBCL-JBD phenotype was defined as T-scores of 70 or greater on the Attention Problems, Aggression, and Anxiety/Depression subscales. RESULTS: The CBCL-JBD phenotype was found in 31% of those followed but only 4.9% of the sample continued to meet the phenotype criteria at follow-up. Only two of the sample developed Bipolar Disorder by late adolescence and only one of those had the CBCL-JBD profile in childhood. The proxy did not predict any Axis I disorders. However, the CBCL-JBD proxy was highly predictive of later personality disorders. LIMITATIONS: Only a subgroup of the original childhood sample was followed. Given this sample was confined to children with ADHD, it is not known whether the prediction of personality disorders from CBCL scores would generalize to a wider community or clinical population. CONCLUSIONS: A positive CBCL-JBD phenotype profile in childhood does not predict Axis I Disorders in late adolescence; however, it may be prognostic of the emergence of personality disorders.

Childhood stimulant treatment and teen depression: is there a relationship?

Recent preclinical data have raised the possibility that prepubertal treatment of attention-deficit/hyperactivity disorder (ADHD) with stimulant medication might increase risk for later depression. The current longitudinal study investigated whether children with ADHD who were treated with stimulant medication displayed heightened levels of adolescent depression. Adolescents diagnosed with ADHD during childhood who had received a minimum of 1 year of treatment with stimulant medication were compared to adolescents with a childhood history of ADHD who were never treated with stimulants and a demographically matched comparison group on self-reports of depressive symptoms and diagnoses of depressive disorders. Both subgroups with childhood ADHD reported significantly higher dimensional ratings of depression and categorical rates of depressive disorders relative to the comparison group (all p<0.05), yet those who were and were not medicated did not differ from one another. Results indicate that, while childhood ADHD increases risk for adolescent depression, stimulant treatment for ADHD neither heightens nor protects against such risk.

Fading memories: retrospective recall inaccuracies in ADHD.

OBJECTIVE: This longitudinal study examines the recall accuracy of childhood ADHD symptoms in late adolescence and early adulthood by youth and their parents, compared with reports obtained during childhood. METHOD: Participants (N = 94) are initially evaluated when they are aged between 7 and 11 and reassessed when they are aged between 16 and 22 years. All participants meet full DSM-IV diagnostic criteria for ADHD in childhood. Assessments at baseline and follow-up include clinical interviews and ADHD checklists. RESULTS: Results indicate that both youth and their parents have limited retrospective recall of childhood symptoms. Current ADHD symptoms improve accuracy of recall. Specifically, when current symptoms are endorsed, participants are more likely to recall clinically significant childhood ADHD symptoms. CONCLUSION: These results suggest that late adolescents and young adults with ADHD and their parents have limited ability to accurately recall childhood symptoms, with reporting of past symptoms influenced by reports of severity of current symptoms.

Adolescents with childhood ADHD and comorbid disruptive behavior disorders: aggression, anger, and hostility.

UNLABELLED: This study examined the self-reported expression of overt aggressive behaviors and covert emotional and cognitive processes in adolescents diagnosed with ADHD and comorbid disruptive behavior disorders (DBDs) during childhood. METHODS: Participants were a clinically referred sample of 85 individuals diagnosed with ADHD, initially recruited in the early to mid 1990s when they were 7-11 years of age. At that time, 44 (52%) met criteria for a comorbid diagnosis of ODD and an additional 22 (26%) met criteria for a comorbid diagnosis of CD. Approximately 10 years later, these youth, along with an age-matched comparison sample (n=83), were re-evaluated to assess a wide array of outcomes including physical and verbal aggression, anger, and hostility. RESULTS: Individuals diagnosed with ADHD + CD in childhood reported elevated levels of physical aggression when compared to Controls and the ADHD-only group. Individuals diagnosed with ADHD + ODD had elevated levels of verbal aggression compared to Controls. Additionally, both comorbid groups experienced significantly greater amounts of anger, but not hostility, as compared to Controls. Importantly, the persistence of ADHD symptoms into adolescence accounted for most group differences in verbal aggression and anger at follow-up, but not physical aggression, which was accounted for by childhood CD. CONCLUSION: Adolescents diagnosed with ADHD and comorbid disruptive behavior disorders during childhood report high levels of aggression associated with increased emotionality in the form of anger, but not hostile cognitions. These findings suggest that in addition to inattention and hyperactivity/impulsivity, emotional dysregulation may be an important component of ADHD, particularly as it presents in adolescence.

The impact of childhood ADHD on dropping out of high school in urban adolescents/ young adults.

OBJECTIVE: To examine cognitive and psychosocial factors associated with high school dropout in urban adolescents with and without childhood ADHD. METHOD: In a longitudinal study, 49 adolescents/young adults with childhood ADHD and 44 controls who either dropped out or graduated from high school are included. Risk factors examined as potential correlates of dropout were intelligence, reading skills, socioeconomic status, marijuana use, and paternal contact. RESULTS: Lower IQ, reading ability, socioeconomic status, frequent marijuana use, and limited paternal contact significantly differentiated dropouts from graduates, irrespective of childhood ADHD. Follow-up analyses determined that IQ, marijuana use, and paternal contact independently contribute to the likelihood of dropout. CONCLUSION: Selected cognitive and psychosocial factors appear independently associated with the likelihood of high school dropout irrespective of ADHD. Notably, childhood ADHD did not increase this risk, suggesting that previous reports of increased dropout because of ADHD may become negated in urban areas when matched with similar community controls.

Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder.

Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11 years old were screened for histories of childhood maltreatment, and SUD diagnoses were formulated in accordance with the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Lifetime history of problematic substance use was obtained for each parent at baseline. Childhood maltreatment predicted SUD outcome over and above that accounted for by childhood conduct disorder and problematic parental substance use, two potent predictors of adolescent SUDs.

Stimulant treatment in children with attention-deficit/hyperactivity disorder moderates adolescent academic outcome.

Treatment with psychostimulant medication has been shown to improve scholastic functioning in children with attention-deficit/hyperactivity disorder (ADHD). However, the extent to which long-term academic gains are apparent in those having received such treatment remains elusive. This study examined prospectively the relationship of childhood stimulant treatment to academic functioning during adolescence. Children (n = 169) were initially recruited and diagnosed with ADHD when they were 7-11 years old. A subsample of those with childhood ADHD (n = 90) was reevaluated on average 9.13 (SD = 1.5) years later. Probands who did and did not receive treatment with stimulant medication were compared to each other and to a never-ADHD comparison group (n = 80) on three subtests from the Wechsler Individual Achievement Test-II (WIAT-II), as well as high school grade point average (GPA) and number of retentions in school as derived from school records. Analyses of covariance controlling for severity of childhood ADHD symptoms indicated that probands treated with psychostimulant medication achieved better academic outcomes, as measured by WIAT-II subtests and high school GPA, than those not treated with psychostimulants (p < .05). However, treated probands did not fare as well as the never-ADHD comparison group. Psychostimulant treatment for children with ADHD may benefit long-term adolescent academic performance, although the extent of improvement is likely to vary as a function of multiple factors.

Neuropsychological outcome in adolescents/young adults with childhood ADHD: profiles of persisters, remitters and controls.

BACKGROUND: This study examined neuropsychological functioning in a longitudinal sample of adolescents/young adults with attention deficit/hyperactivity disorder (ADHD) and controls as a function of the persistence of ADHD. We hypothesized that measures of executive processes would parallel adolescent clinical status, with ADHD-persisters, but not remitters, differing significantly from controls. In contrast, persisters and remitters were hypothesized to perform similarly, and different from controls, on tasks requiring less effortful processing. METHODS: Ninety-eight participants diagnosed with ADHD in childhood were reevaluated approximately 10 years later. Eighty-five never-ADHD controls similar in age, IQ, and sex distribution served as a comparison group. Participants were administered a psychiatric interview and neuropsychological test battery. RESULTS: Those with childhood ADHD demonstrated broad neuropsychological deficits relative to controls. When the group with childhood ADHD was subdivided based on adolescent ADHD status, compared to controls, both persisters and remitters showed deficient perceptual sensitivity and response variability, and increased ankle movements recorded by a solid-state actigraph. Only persisters differed from controls on several measures of more effortful executive processes. CONCLUSIONS: Findings provide preliminary support to the hypothesis that ADHD is associated with early-appearing and enduring subcortical dysfunction, while recovery over the course of development is associated with improvements in executive control functions.

The impact of impairment criteria on rates of ADHD diagnoses in preschoolers.

Behaviors characteristic of ADHD are common among preschool children, and as such, their clinical significance is oftentimes difficult to ascertain. Thus a focus on impairment is essential in determining the clinical significance of these behaviors. In order to explore the impact of impairment criteria on rates of diagnoses in inattentive/hyperactive children aged 36 through 60-months-old, we first developed, and psychometrically evaluated, the Children's Problem Checklist (CPC) which was designed to assess psychosocial impairment associated with ADHD in a community sample of preschoolers (n = 394), and found its reliability and validity to be acceptable. We then examined the impact of the inclusion of various CPC-determined impairment criteria, over and above symptom criteria measured by the ADHD-RS-IV, using various cut points ranging from the 75th to 90th percentile of our community sample. This reduced the number of children meeting criteria for ADHD by 46-77%. These findings are discussed in terms of the importance of using impairment criteria, rather than just severity of inattention, impulsivity and hyperactivity, when diagnosing ADHD in preschool children.

Childhood attention-deficit/hyperactivity disorder and the emergence of personality disorders in adolescence: a prospective follow-up study.

OBJECTIVES: Adults with attention-deficit/hyperactivity disorder (ADHD) experience considerable functional impairment. However, the extent to which comorbid Axis II personality disorders contribute to their difficulties and whether such comorbidities are associated with the childhood condition or the persistence of ADHD into adulthood remain unclear. METHOD: This study examined the presence of personality disorders in a longitudinal sample of 96 adolescents diagnosed with ADHD when they were 7 through 11 years old, as compared to a matched, never ADHD-diagnosed, control group (N = 85). Participants were between 16 and 26 years old at follow-up. On the basis of a psychiatric interview, the ADHD group was subdivided into those with and without persistent ADHD. Axis II symptoms were assessed by using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Data were analyzed using logistic regression, and odds ratios (ORs) were generated. The study was conducted from 1994 through 1997. RESULTS: Individuals diagnosed with childhood ADHD are at increased risk for personality disorders in late adolescence, specifically borderline (OR = 13.16), antisocial (OR = 3.03), avoidant (OR = 9.77), and narcissistic (OR = 8.69) personality disorders. Those with persistent ADHD were at higher risk for antisocial (OR = 5.26) and paranoid (OR = 8.47) personality disorders but not the other personality disorders when compared to those in whom ADHD remitted. CONCLUSION: Results suggest that ADHD portends risk for adult personality disorders, but the risk is not uniform across disorders, nor is it uniformly related to child or adult diagnostic status.

Personality characteristics associated with persistent ADHD in late adolescence.

This study focused on the personality characteristics associated with Attention-deficit/Hyperactivity disorder (ADHD) in a longitudinal sample of youth, with a particular focus on differences between those with and without persisting ADHD symptoms. Participants with ADHD (n = 90) were initially evaluated when they were 7-11 years old, and re-assessed at 16-22 years of age. Matched control subjects (n = 80) were recruited at the time of the follow-up evaluation. At follow-up, the Kiddie-SADS-PL, a semi-structured psychiatric interview, and the NEO-PI, a self-report personality inventory, were administered. Data were analyzed using multivariate analyses of variance (MANOVA). Results indicate that childhood ADHD is associated with lower scores on the NEO Conscientiousness subscale in adolescents/young adults--irrespective of the degree of ADHD persistence. In contrast, ratings of Neuroticism and Agreeableness appear to be more closely linked to adolescent status; those with persisting symptoms only exhibited increased Neuroticism and decreased Agreeableness. These results suggest that ADHD, and the degree to which symptoms persist into adolescence, may be closely linked to personality structure.