Language of ADHD in Adults on Social Media.

Objective: We computationally analyze the language of social media users diagnosed with ADHD to understand what they talk about, and how their language is correlated with users' characteristics such as personality and temporal orientation. Method: We analyzed approximately 1.3 million tweets written by 1,399 Twitter users with self-reported diagnoses of ADHD, comparing their posts with those used by a control set matched by age, gender, and period of activity. Results: Users with ADHD are found to be less agreeable, more open, to post more often, and to use more negations, hedging, and swear words. Posts are suggestive of themes of emotional dysregulation, self-criticism, substance abuse, and exhaustion. A machine learning model can predict which of these Twitter users has ADHD with an out-of-sample AUC of .836. Conclusion: Based on this emerging technology, conjectures of future uses of social media by researchers and clinicians to better understand the naturalistic manifestations and sequelae of ADHD.

Transcranial direct current brain stimulation decreases impulsivity in ADHD.

BACKGROUND: Impulsivity is a core deficit in attention deficit hyperactivity disorder (ADHD). Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits and could enhance DLPFC activity, leading to improved impulse control in ADHD. OBJECTIVE: Hypothesis: We predicted 2.0 mA anodal stimulation (tDCS) versus sham stimulation applied over the left DLPFC would improve Conners Continuous Performance Task (CPT) scores. Our secondary hypothesis predicted that stop signal task (SST) reaction time (SSRT) would decrease with tDCS (versus sham). METHODS: Thirty-seven participants completed two periods of three tDCS (or sham) sessions two weeks apart in a within-subject, double-blind, counterbalanced order. Participants performed a fractal N-back training task concurrent with tDCS (or sham) stimulation. Participants completed the CPT and SST at the beginning of treatment (baseline), at the end of the treatment, and at a 3-day post-stimulation follow-up. RESULTS: There was a significant stimulation condition by session interaction for CPT false positive scores (χ2 = 15.44, p < 0.001) driven by a decrease in false positive errors from baseline to end of treatment in the tDCS group (ß = -0.36, 95% Confidence Interval (CI) -0.54 to -0.18, p < 0.001). This effect did not persist at follow-up (ß = -0.13, p > 0.05). There was no significant stimulation condition by session interaction effect on CPT true positive errors or response time (ps > 0.05). No significant change in SSRT performance was observed (p > 0.05). CONCLUSION: These findings suggest that stimulation of the left DLPFC with tDCS can improve impulsivity symptoms in ADHD, supporting the therapeutic potential for tDCS in adult ADHD patients.

Assessment and monitoring of treatment response in adult ADHD patients: current perspectives.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to "get by" before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians' practice needs in order to track treatment progress and optimize treatments for adults with ADHD.

Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness.

The current chart review study examined the relationship between self-reported cognitive distortions, attention-deficit/hyperactivity disorder (ADHD) symptoms, and co-occurring symptoms of depression and anxiety in a clinical sample of adults diagnosed with ADHD. Thirty subjects completed inventories measuring cognitive distortions, ADHD, anxiety, depression, and hopelessness as part of the standard diagnostic evaluation protocol used in a university-based outpatient clinic specializing in adult ADHD. A series of correlational analyses were conducted to assess the relationship between self-reported cognitive distortions, ADHD, anxiety, depression, and hopelessness. Results indicated a significant, positive correlation between self-reported cognitive distortions and ADHD. Responses to individual items on the measure of cognitive distortions were tabulated to identify the prevalence of specific cognitive distortion categories, with Perfectionism emerging as the most frequently endorsed. Further clinical implications of these findings are discussed.

Culturally competent strategies for assessing and treating ADHD in African American adults.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with symptoms of inattention, hyperactivity, and impulsivity. When ADHD persists into adulthood, patients often experience occupational and social impairments and may present with mood, anxiety, or substance use disorders. Despite the deleterious effects of ADHD, many adults, especially minority patients, remain undiagnosed and untreated.

Health care systems issues and disparities in ADHD care for African American adults.

The diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) may be overlooked among African Americans. Barriers within the medical profession pose challenges, including biases among health care professionals and a lack of specialty services. Educating medical professionals in cultural competence, as well as educating community gateway contacts (such as clergy and educators) about ADHD, should improve the diagnosis and treatment of African American adults who have ADHD. More specialists are needed in underserved areas.

A model for parental ADHD: help-seeking and readiness to change.

Attention deficit/hyperactivity disorder (ADHD) is a lifespan developmental syndrome that is associated with significant impairments. Although there is strong evidence that ADHD persists into adulthood for a majority of individuals, adults with ADHD are identified and treated at much lower rates than are children with ADHD. Considering the heritability of ADHD, there is an increased likelihood that at least one parent of a child with ADHD will also have ADHD, or exhibit prominent features of the disorder. Parental ADHD also affects help-seeking behavior regarding treatment, as well as follow through on treatment recommendations. There is a paucity of data on parental ADHD and help-seeking among underserved populations. The goal of this paper is to review parental ADHD among underserved groups in terms of factors affecting help-seeking behavior and readiness to engage in care. A model for conceptualizing and addressing issues of readiness for change for parents with ADHD is also proposed.

Adults with ADHD: who are we missing?

Attention deficit hyperactivity disorder (ADHD) has long been identified as a common disorder of childhood. There is increasing recognition that adults also are affected by this disorder. Many adults, however, are often undiagnosed or misdiagnosed until their child is diagnosed with the disorder. Improved recognition and treatment for parental ADHD needs to occur given the genetic and environmental etiologies of the disorder. This paper examines three areas where there is a dearth of data in extant literature: parental ADHD culture and ethnicity; parenting and undiagnosed ADHD; and professional care and ADHD, and focuses on parents from ethnic minority cultures.

Cultural proficiency: a Hispanic woman with ADHD--a case example.

BACKGROUND: Guidelines for assessment, diagnosis, and treatment of ADHD have been drawn from research focused primarily on Caucasian males generating, in part, the need to redress health disparities. Diagnostic criteria may therefore be limited, especially regarding gender differences and other associated cultural, familial, socio-environmental, and individual influences. OBJECTIVE: To examine how one woman with ADHD managed social, academic, interpersonal, and familial roles and to discuss the need for culturally proficient practice and treatment frameworks that are gender-sensitive to diagnosis and treatment. METHOD: A case example of a 29-year-old Hispanic woman. FINDINGS: There is a gap in early diagnosis and treatment for some woman and individuals from ethnic minority and diverse groups. CONCLUSION: Cultural competence in practice and research are critical to mitigate the disparities in accurate and timely diagnosis and treatment of adult ADHD among the American population.

Research forum on psychological treatment of adults with ADHD.

BACKGROUND: A literature search found five empirical studies of psychological treatment for adults with ADHD, out of 1,419 articles on ADHD in adults. Practice guidelines to date all recommend multimodal intervention, given that a significant number of patients cannot tolerate, do not respond to, or fail to reach optimal outcomes with medication alone. METHOD: This article provides a literature review and the recommendations of a forum of experts in the psychological treatment of adults with ADHD. RESULTS: Empirical studies of brief, structured, and short-term psychological interventions for adults with ADHD to date demonstrate moderate to large effect sizes. Methodological challenges include selection of control groups, broad-based measures of outcome, and the need for larger samples. CONCLUSION: Psychological treatment may play a critical role in the management of adults with ADHD who are motivated and developmentally ready to acquire new skills as symptoms remit.

Current status of cognitive-behavioral therapy as a psychosocial treatment for adult attention-deficit/hyperactivity disorder.

A convergence of research has established that attention-deficit/hyperactivity disorder (ADHD) is a valid clinical syndrome affecting individuals of all ages. ADHD is associated with significant impairment in many important life domains that often requires clinical intervention. Although medications are a well-researched and effective first-line treatment option, many adult patients with ADHD continue to experience significant functional impairment despite the symptom improvement afforded by pharmacotherapy. Consequently, adjunctive psychosocial treatments often are indicated for adults with ADHD. The aim of this paper is to review the status of cognitive-behavioral therapy (CBT) as an effective psychosocial treatment (when combined with pharmacotherapy) for adult ADHD. This review includes a brief discussion of the CBT conceptualization of ADHD, a summary of clinical outcome studies of psychosocial treatments for adult ADHD, directions for future research, and a discussion of the various possible mechanisms of change involved in CBT for adult ADHD.

A combined treatment approach for adults with ADHD--results of an open study of 43 patients.

OBJECTIVE: Increasing numbers of adults are seeking treatment for ADHD. Pharmacotherapy is well established as the first line treatment for adult ADHD, although medications alone may be insufficient treatment for the myriad problems experienced by these patients. Few studies have examined the clinical outcomes of a combination of pharmacotherapy and psychotherapy for this clinical population. The purpose of the present study is to examine the potential effectiveness of the combination of pharmacotherapy and cognitive-behavior therapy modified to treat adult patients diagnosed with ADHD. METHOD: Forty-three adults who underwent a structured diagnostic assessment for ADHD complete 6 months of combined treatment. Treatment outcome is assessed by comparing pre- and posttreatment measures of ADHD symptoms, comorbid symptoms, and ratings of overall functioning. RESULTS/CONCLUSION: Results indicate that combined treatment is associated with significant improvements on all clinical measures. Limitations of the study design and directions for future research are discussed.