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1.
Pharmacol Biochem Behav ; 241: 173802, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38866372

RESUMO

The reinforcing efficacy, or behavior-strengthening effect, of a substance is a critical determinant of substance use typically quantified by measuring behavioral allocation to the substance under schedules of reinforcement with escalating response requirements. Although responses on these tasks are often used to indicate stable reinforcing effects or trait-level abuse potential for an individual, task designs often demonstrate within-person variability across varying degrees of a constraint within experimental procedures. As a result, quantifying behavioral allocation is an effective approach for measuring the impact of contextual and psychosocial factors on substance reward. We review studies using laboratory self-administration, behavioral economic purchase tasks, and ambulatory assessments to quantify the impact of various contextual and psychosocial factors on behavioral allocation toward consumption of a substance. We selected these assessment approaches because they cover the translational spectrum from experimental control to ecological relevance, with consistent support across these approaches representing greater confidence in the effect. Conceptually, we organized factors that influence substance value into two broad categories: factors that influence the cost/benefit ratio of the substance (social context, stress and affect, cue exposure), and factors that influence the cost/benefit ratio of an alternative (alternative non-drug reinforcers, alternative drug reinforcers, and opportunity costs). We conclude with an overview of future research directions and considerations for clinical application.


Assuntos
Reforço Psicológico , Recompensa , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Autoadministração , Sinais (Psicologia) , Análise Custo-Benefício
2.
Subst Use Misuse ; 59(8): 1141-1149, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38555872

RESUMO

Background: Relations among attention-deficit/hyperactivity disorder (ADHD), sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use. Methods: College students who drink alcohol with (n = 51) and without (n = 50) ADHD completed an assessment that included a diagnostic interview assessing ADHD, and questionnaire measures of sleep quality, substance use, and associated consequences. Analyses utilized a series of hierarchical linear regression models and explored these aims for cannabis use in a subset of participants (n = 52 participants that used cannabis). Results: College students who drink alcohol with ADHD reported significantly worse sleep quality and more alcohol-related consequences, relative to those without ADHD. When ADHD and sleep quality were included in the model, ADHD-but not sleep quality-was independently associated with alcohol consequences, but not cannabis consequences. There were no moderating effects of ADHD on the associations between sleep and substance-related consequences. Conclusions: Students who drank alcohol with ADHD may be particularly vulnerable to experiencing poor sleep and consequences from their substance use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Uso da Maconha , Estudantes , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Masculino , Feminino , Estudantes/psicologia , Adulto Jovem , Estudos Transversais , Universidades , Uso da Maconha/epidemiologia , Uso da Maconha/psicologia , Sono , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Adulto , Transtornos do Sono-Vigília/epidemiologia , Consumo de Álcool na Faculdade/psicologia , Inquéritos e Questionários
3.
Psychol Addict Behav ; 38(4): 437-450, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38271078

RESUMO

OBJECTIVE: Behavioral economic theory suggests that alcohol risk is related to elevated alcohol reinforcing efficacy (demand) combined with diminished availability of reinforcing substance-free activities, but little research has examined these reward-related processes at the daily level in association with comorbid conditions that might influence behavioral patterns and reward. Young people with attention-deficit/hyperactivity disorder (ADHD) report high levels of risky drinking, and this risk may be due in part to elevated demand for alcohol and diminished engagement in enjoyable and valued substance-free activities. METHOD: College student drinkers (N = 101; 48.5% female; 68.3% White; 18-22 years old) with (n = 51) and without (n = 50) ADHD completed 14 consecutive daily diaries (diary entry n = 1,414). We conducted a series of multilevel path models to examine (a) the associations among ADHD and average daily alcohol demand, substance-free enjoyment, and response contingent positive reinforcement (RCPR) for goal-directed behaviors; (b) the associations among concurrent daily alcohol demand, substance-free reinforcement, and RCPR for goal-directed behaviors and daily alcohol use and alcohol-related negative consequences; and (c) the moderating effect of ADHD on these within-day associations. RESULTS: ADHD was significantly associated with more daily alcohol-related negative consequences and less daily substance-free enjoyment and RCPR. Regardless of ADHD status, there were significant associations among behavioral economic risk factors and alcohol use and negative consequences, though effects differed within and between persons. There were no moderating effects of ADHD on within-person associations. CONCLUSIONS: Results expose areas of impairment specific to drinkers with ADHD and advance theory on ADHD and hazardous drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Consumo de Álcool na Faculdade , Transtorno do Deficit de Atenção com Hiperatividade , Economia Comportamental , Reforço Psicológico , Estudantes , Humanos , Feminino , Masculino , Adolescente , Adulto Jovem , Consumo de Álcool na Faculdade/psicologia , Estudantes/psicologia , Universidades , Transtornos Relacionados ao Uso de Álcool , Comorbidade
4.
Res Child Adolesc Psychopathol ; 50(7): 853-866, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35064466

RESUMO

Symptoms of ADHD and anxiety often co-occur, yet we are limited in our understanding of which children with ADHD symptoms are more likely to develop anxiety symptoms in adolescence. This longitudinal study examined the role of behavioral inhibition (BI) and peer relationships (i.e., peer support and peer victimization) in relation to childhood ADHD and adolescent anxiety symptoms in a community sample, which was oversampled for reactivity. Data were drawn from a larger longitudinal study (N = 291) examining trajectories of BI. For the current analyses, we used behavioral observations of BI at ages 2 and 3, parent report of their child's ADHD symptoms at age 7, child report of peer support and peer victimization at age 12, and adolescent report of anxiety symptoms at age 15. Using structural equation modeling, results indicated that BI and peer support moderated the relation between ADHD and anxiety symptoms, such that ADHD symptoms predicted later anxiety symptoms only for youth who displayed low BI in toddlerhood and reported experiencing lower levels of peer support in early adolescence. Findings highlight the role of early temperament and peer relationships on the relation between childhood ADHD and adolescent anxiety symptoms, and underscore the importance of evaluating multiple risk factors when examining the development of psychopathology.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Temperamento , Adolescente , Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Pré-Escolar , Humanos , Estudos Longitudinais , Fatores de Proteção , Temperamento/fisiologia
5.
Alcohol Alcohol ; 57(4): 452-459, 2022 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34632479

RESUMO

AIMS: Contemporary theories of attention-deficit/hyperactivity disorder (ADHD) and alcohol use disorder (AUD) emphasize core dysfunctions in reward-related processes and behaviors as pathognomonic characteristics. However, to date, it is unclear which domains of reward functioning are unique to ADHD versus AUD symptom dimensions, and which represent underlying shared correlates. METHODS: The current study employed secondary data analyses from a large community sample of emerging adults (N = 602; 57.3% female) and novel transdiagnostic modeling (i.e. bi-factor confirmatory factor analyses and structural equation modeling) of ADHD, AUD and shared symptom dimensions to identify unique and common reward-related dimensions: environmental suppressors, reward probability, hedonic capacity, proportionate substance-related reinforcement and delay discounting. RESULTS: The presence of environmental suppressors was the only reward-related construct that correlated with the underlying ADHD-AUD shared dimension. The AUD symptom dimension was uniquely associated with proportionate substance-related reinforcement, whereas the ADHD symptom dimension was uniquely associated with limited reward probability. No significant associations were found for delay discounting or hedonic capacity. CONCLUSIONS: These novel findings highlight specific aspects of reward-related functioning in ADHD, AUD and shared symptom dimensions. In so doing, this work meaningfully advances theoretical conceptualizations of these two commonly co-occurring presentations and suggests future directions for research on transdiagnostic correlates. Future longitudinal studies should include clinical samples with diagnoses of AUD and ADHD to further identify underlying correlates over time.


Assuntos
Alcoolismo , Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Consumo de Bebidas Alcoólicas , Alcoolismo/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Análise Fatorial , Feminino , Humanos , Masculino , Recompensa
6.
Res Child Adolesc Psychopathol ; 50(2): 211-224, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-32778993

RESUMO

Maternal emotional functioning and emotion socialization practices can facilitate or hinder children's emotional development, and youth with symptoms of attention-deficit/hyperactivity disorder (ADHD) are at increased risk for emotion lability. However, little is known about the independent and interactive effects of maternal emotion dysregulation and adolescent ADHD symptoms on maternal emotion socialization and adolescent emotion lability over time. Using secondary data analyses of a longitudinal community sample of youth and their mothers (Nbaseline = 247; 43.7% female), the current study examined direct and indirect effects of maternal emotion dysregulation on adolescent emotion lability via supportive and non-supportive emotion socialization practices as mediators, and the extent to which adolescent ADHD symptoms moderated these longitudinal pathways. Mothers reported on all study constructs. Results showed that non-supportive parenting responses to adolescents' negative emotional expressions partially mediated the association between maternal emotion dysregulation and adolescent emotion lability, and the effect was stronger at higher levels of youth ADHD symptom severity. Results suggest that parent- and youth-level characteristics interact to confer risk for non-supportive emotion socialization practices and adolescent emotion lability. This research contributes uniquely to theory and research on ADHD and emotional functioning across adolescence. Future research should extend this work by utilizing multi-modal assessment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Socialização , Adolescente , Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Emoções/fisiologia , Feminino , Humanos , Masculino , Poder Familiar/psicologia
7.
Depress Anxiety ; 38(12): 1225-1233, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34762765

RESUMO

BACKGROUND: Depression is a highly prevalent, debilitating disorder that runs in families. Yet, empirical support for bidirectional mechanisms linking mother-adolescent depression symptoms remains limited. This study examined longitudinal bidirectional relations among emotion regulation (ER) constructs and depressive symptoms among mother-adolescent dyads over time. Pathways for girls and boys were explored separately, given extant research on sex differences in the intergenerational transmission of depression. METHODS: Adolescent (n = 232; M = 15.02 years, SD = 0.95; 44% female)-mother dyads, drawn from a longitudinal study on the development of risky behaviors, completed annual assessments of depressive symptoms and facets of ER over 4 years. Panel modeling examined lagged and cross-lagged effects of mother-adolescent depressive symptoms and ER constructs over time, in a multigroup model of boys and girls. RESULTS: Among girls, higher baseline maternal depression scores predicted increased adolescent ER difficulties (std. est. = -.42, p < .001) in turn, predicting increased adolescent depressive symptoms (std. est. = -.33, p = .002) and subsequent maternal ER difficulties (std. est. = .39, p = .002). The indirect effect of maternal depressive symptoms→adolescent ER→adolescent depressive symptoms→maternal ER was significant (ind. eff. = .10, 95% confidence interval [>.001, .19]) for girls, but not boys. CONCLUSION: Implications for interrupting intergenerational cycles of depressive symptoms and emotion dysregulation are discussed.


Assuntos
Regulação Emocional , Mães , Adolescente , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Relações Mãe-Filho/psicologia , Mães/psicologia , Tempo
8.
Behav Ther ; 52(5): 1198-1212, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34452673

RESUMO

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.


Assuntos
Consumo de Álcool na Faculdade , Transtorno do Deficit de Atenção com Hiperatividade , Feminino , Objetivos , Humanos , Masculino , Motivação , Estudantes
9.
Psychol Addict Behav ; 35(7): 803-816, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33600197

RESUMO

Objective: College is a high-risk period for the initiation and escalation of problem alcohol use. College students with attention-deficit/hyperactivity disorder (ADHD) are at particularly high risk for experiencing alcohol-related negative consequences relative to typically developing peers. Despite this, the best therapeutic approach for addressing alcohol problems in college students with ADHD has not been identified. Behavioral activation (BA) may augment the effects of gold-standard College drinking interventions [i.e., brief motivational intervention (BMI)] for students with ADHD who are engaging in problem drinking. Method: 113 college students with ADHD (Mean age = 19.87, SD = 1.44; 49.1% male) were randomized to either BMI + BA or BMI plus supportive counseling (BMI + SC). Both groups received ADHD psychoeducation delivered in MI style. Outcomes were assessed using the Brief Young Adult Alcohol Consequences Questionnaire, Daily Drinking Questionnaire, Barkley Functional Impairment Scale, and Beck Depression Inventory. Results: There were no significant differences in outcomes for the sample as a whole; in both conditions, participants showed significant reductions in their alcohol-related negative consequences, alcohol use, and depressive symptoms at 1- and 3-month follow-ups. Exploratory moderation analyses revealed that participants with elevated depressive symptoms at baseline evidenced greater reductions in alcohol-related negative consequences in the BMI + BA condition compared to BMI + SC at the 3-month follow-up. Those low in depressive symptoms evidenced greater reductions of alcohol-related negative consequences in BMI + SC compared to BMI + BA. Conclusions: For college students with ADHD who reported elevated baseline depressive symptoms, the inclusion of BA with BMI resulted in significantly greater decreases in alcohol-related negative consequences, compared to BMI + SC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Consumo de Álcool na Faculdade , Alcoolismo , Transtorno do Deficit de Atenção com Hiperatividade , Entrevista Motivacional , Adulto , Feminino , Humanos , Masculino , Estudantes , Adulto Jovem
10.
J Atten Disord ; 25(12): 1699-1711, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-32506994

RESUMO

Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents' negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother-adolescent negative relationship quality may be one mechanism that explains the development of depressive symptoms in adolescent boys with elevated ADHD symptoms.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Amigos , Adolescente , Depressão/diagnóstico , Feminino , Humanos , Masculino , Mães , Instituições Acadêmicas
11.
J Atten Disord ; 25(7): 954-964, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-31416370

RESUMO

Objective: ADHD and depression co-occur at higher than chance levels in adolescence, but moderators of this association are not well understood. Consistent with a developmental-transactional framework, one such moderator may be maternal emotion regulation (ER) difficulties. Using latent growth curve modeling, the current study examined the independent and interactive effects of adolescent ADHD symptoms and maternal ER difficulties on the trajectory of depressive symptoms across adolescence. Method: This study included a community sample of 247 adolescents (Mage = 13.06 years) assessed annually over a 6-year period. Results: Findings suggested that youth with greater ADHD symptoms whose mothers evidenced more ER difficulties demonstrated steeper increases in depressive symptoms over time relative to their peers with lower ADHD symptoms or whose mothers reported fewer ER difficulties. Conclusion: This work highlights the importance of maternal ER difficulties in predicting the trajectory of depressive symptoms among adolescents with ADHD symptomatology.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Regulação Emocional , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Mães
12.
Suicide Life Threat Behav ; 50(6): 1198-1204, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32770790

RESUMO

OBJECTIVE: The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. METHOD: Participants were 217 college students with elevated depressive symptoms (Mage  = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). RESULTS: In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation. CONCLUSION: Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Feminino , Humanos , Relações Interpessoais , Masculino , Teoria Psicológica , Fatores de Risco , Estudantes , Ideação Suicida , Adulto Jovem
13.
J Atten Disord ; 24(4): 509-523, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-28162039

RESUMO

Objective: The primary objective of this study was to evaluate the prevalence of multiple types of sleep problems in young adolescents with ADHD. Method: Adolescents comprehensively diagnosed with ADHD (N = 262) and their caregivers completed well-validated measures of sleep problems and daytime sleepiness. Participants also completed measures related to medication use, comorbidities, and other factors that could predict sleep problems. Results: Daytime sleepiness was by far the most common sleep problem, with 37% of adolescents meeting the clinical threshold according to parent report and 42% according to adolescent report. In contrast, prevalence rates for specific nighttime sleep problems ranged from 1.5% to 7.6%. Time spent in bed, bedtime resistance, ADHD inattentive symptoms, and Sluggish Cognitive Tempo (SCT) symptoms were significant in the final model predicting daytime sleepiness. Conclusion: Adolescents with ADHD commonly experience problems with daytime sleepiness that may significantly affect their functioning, but this may not be directly attributable to specific sleep problems.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos do Sono-Vigília , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comorbidade , Humanos , Prevalência , Sono , Transtornos do Sono-Vigília/epidemiologia , Sonolência
14.
J Atten Disord ; 22(5): 497-505, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-27056848

RESUMO

OBJECTIVE: ADHD is associated with elevated rates of comorbid depressive disorders, yet the nature and development of this comorbidity remain understudied. We hypothesized that a longer period of prior ADHD treatment, being less likely to engage in maladaptive cognitive/behavioral coping strategies, and less severe ADHD symptoms would predict greater likelihood of lifetime resilience to depression. METHOD: Seventy-seven adults with ADHD completed diagnostic interviews, clinician-administered symptom rating scales, a stressful life events measure, and self-report questionnaires. We used logistic regression analyses to identify factors associated with resilience to depression. RESULTS: Adults with more extensive ADHD treatment histories were more likely to be resilient to depression. Those who were less likely to report ruminative thinking patterns and cognitive-behavioral avoidance were also more resilient. Severity of current or childhood ADHD symptoms and recent negative life events did not predict resilience. CONCLUSION: Results identify protective factors that may promote the resiliency to ADHD-depression comorbidity.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Depressivo/psicologia , Resiliência Psicológica , Adaptação Psicológica , Adolescente , Adulto , Idoso , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Inquéritos e Questionários , Adulto Jovem
15.
Sch Psychol Q ; 33(3): 390-398, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28857587

RESUMO

Many students with attention-deficit/hyperactivity disorder (ADHD) exhibit deficits in motivation to pursue long-term goals. Students with ADHD have particular difficulty with motivation to complete homework-related tasks and often fail to complete assignments. Although these problems are common and may impact academic performance, no homework-motivation measures have been validated for use with students with ADHD. The primary goal of the present study was to evaluate the factor structure and predictive validity of a homework-motivation measure based upon the expectancy-value theory of achievement motivation. A sample of 285 middle school students with ADHD completed the measure, and confirmatory factor analysis was used to evaluate the proposed factor structure and associations with parent and teacher ratings of homework performance. A 2-factor structure emerged, and model fit was excellent. Further, student-rated ability-expectancy beliefs demonstrated significant associations with parent-rated homework problems and performance and with teacher-rated homework performance and percentage of assignments turned in above and beyond ADHD symptoms. Future directions for studying the importance of motivation in students with ADHD are provided, with particular attention to the role that reward sensitivity may play in motivation. (PsycINFO Database Record


Assuntos
Desempenho Acadêmico/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/reabilitação , Motivação/fisiologia , Psicometria/normas , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria/instrumentação , Reprodutibilidade dos Testes
16.
J Atten Disord ; 22(4): 323-333, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-26637840

RESUMO

OBJECTIVE: The primary aim of this study was to evaluate longitudinal pathways to impairment as outlined in the cognitive-behavioral model of ADHD in a sample of 59 college students diagnosed with ADHD. METHOD: Serial mediation models were used to test whether underachievement, defined as prior year GPA, would longitudinally predict self-reported impairment at the end of the next school year, through negative self-concept and associated changes in symptoms of anxiety and depression, while controlling for baseline impairment and changes in ADHD symptoms. RESULTS: Findings supported the cognitive-behavioral model of ADHD. The association between prior year GPA and overall impairment at the end of the year was fully mediated through self-concept and symptoms of depression. CONCLUSION: These results help explain why impairment often persists even when ADHD symptoms remit and suggests that internalizing symptoms may be an important target for intervention in college students with ADHD.


Assuntos
Ansiedade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Cognição/fisiologia , Depressão/etiologia , Estudantes/psicologia , Baixo Rendimento Escolar , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Feminino , Humanos , Masculino , Modelos Psicológicos , Escalas de Graduação Psiquiátrica , Autoimagem , Autorrelato , Adulto Jovem
17.
Assessment ; 25(1): 99-111, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27313185

RESUMO

The primary goals of this study were to evaluate the dimensionality of the Penny et al. Sluggish Cognitive Tempo Scale and to compare model fits for parent- and youth self-report versions. Participants were 262 young adolescents (ages 10-15) comprehensively diagnosed with attention-deficit/hyperactivity disorder. Both confirmatory factor analysis (CFA) and bifactor modeling were used to determine if the proposed three-factor structure previously identified through exploratory factor analysis could be confirmed. Results showed that although the three-factor CFA had better fit statistics than a one- or two-factor CFA, the bifactor model was the best-fitting model for both parent report and self-report. This implies that Sluggish Cognitive Tempo Scale is best conceptualized as having an underlying general factor, with three specific factors that may represent different etiologies. Importantly, results also showed low-to-moderate correlations between raters and equivalent or better fit statistics for self-report in comparison with parent report.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Atenção , Cognição , Escalas de Graduação Psiquiátrica/normas , Autorrelato/normas , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Análise Fatorial , Feminino , Humanos , Entrevista Psicológica , Masculino , Pais , Psicometria , Instituições Acadêmicas , Estados Unidos
18.
J Consult Clin Psychol ; 86(1): 39-55, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29172596

RESUMO

OBJECTIVE: To evaluate the effectiveness of 2 brief school-based interventions targeting the homework problems of adolescents with attention-deficit/hyperactivity disorder (ADHD)-the Homework, Organization, and Planning Skills (HOPS) intervention and the Completing Homework by Improving Efficiency and Focus (CHIEF) intervention, as implemented by school mental health providers during the school day. A secondary goal was to use moderator analyses to identify student characteristics that may differentially predict intervention response. METHOD: Two-hundred and eighty middle school students with ADHD were randomized to the HOPS or CHIEF interventions or to waitlist, and parent and teacher ratings were collected pre, post, and at a 6-month follow-up. RESULTS: Both interventions were implemented with fidelity by school mental health providers. Participants were pulled from elective periods and sessions averaged less than 20 min. Participants in HOPS and CHIEF demonstrated significantly greater improvements in comparison with waitlist on parent ratings of homework problems and organizational skills and effect sizes were large. HOPS participants also demonstrated moderate effect size improvements on materials management and organized action behaviors according to teachers. HOPS participants made significantly greater improvements in parent- and teacher-rated use of organized actions in comparison with CHIEF, but not on measures of homework problems. Moderation analyses revealed that participants with more severe psychopathology and behavioral dysregulation did significantly better with the HOPS intervention as compared to the CHIEF intervention. CONCLUSIONS: Brief school-based interventions implemented by school providers can be effective. This type of service delivery model may facilitate overcoming the oft cited research-to-practice gap. (PsycINFO Database Record


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/reabilitação , Terapia Comportamental/métodos , Serviços de Saúde Mental , Serviços de Saúde Escolar , Instituições Acadêmicas , Estudantes , Criança , Feminino , Humanos , Masculino , Lacunas da Prática Profissional
19.
School Ment Health ; 9(2): 143-156, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28983327

RESUMO

Children and adolescents with ADHD often have difficulties with organization, time management, and planning (OTMP) skills, and these skills are a common target of intervention. A limited array of tools for measuring these abilities in youth is available, and one of the most prominent measures is the Children's Organizational Skills Scale (COSS). Although the COSS fills an important need, a replication of the COSS factor structure outside of initial measure development has not been conducted in any population. Given that the COSS is frequently used in ADHD research, the current study evaluated the factor structure of the parent-rated COSS in a sample (N = 619) of adolescents with ADHD. Results indicated that the original factor structure could be replicated, although the use of item parcels appeared to affect model fit statistics. An alternative bi-factor model was also tested that did not require the use of parcels, with results suggesting similar model fit in comparison to the original factor structure. Exploratory validity tests indicated that the domain-general factor of the bi-factor model appears related to broad executive functioning abilities.

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