International Journal of Environmental Research and Public Health

Research

20 pages, 1001 KiB

Open AccessArticle

Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study

by Miriam Becke, Lara Tucha, Marah Butzbach, Steffen Aschenbrenner, Matthias Weisbrod, Oliver Tucha and Anselm B. M. Fuermaier

Int. J. Environ. Res. Public Health 2023, 20(5), 4070; https://doi.org/10.3390/ijerph20054070 - 24 Feb 2023

Cited by 1 | Viewed by 2470

Abstract

The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery [...] Read more.

The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test’s utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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8 pages, 316 KiB

Open AccessArticle

ADHD Prevalence among Outpatients with Severe Opioid Use Disorder on Daily Intravenous Diamorphine and/or Oral Opioid Maintenance Treatment

by Henrik Rohner, Nikolas Gaspar, Helena Rosen, Tim Ebert, Laura Luisa Kilarski, Felix Schrader, Moaz Al Istwani, Anna Julia Lenz, Christoph Dilg, Andrea Welskop, Tatjana Goldmann, Ulrike Schmidt and Alexandra Philipsen

Int. J. Environ. Res. Public Health 2023, 20(3), 2534; https://doi.org/10.3390/ijerph20032534 - 31 Jan 2023

Cited by 4 | Viewed by 1798

Abstract

(1) Background: Attention deficit hyperactivity disorder (ADHD) is a common comorbid condition in opioid use disorder (OUD) and is associated with a more severe course of substance use. Patients with severe OUD who have not responded to oral opioid maintenance treatment can be [...] Read more.

(1) Background: Attention deficit hyperactivity disorder (ADHD) is a common comorbid condition in opioid use disorder (OUD) and is associated with a more severe course of substance use. Patients with severe OUD who have not responded to oral opioid maintenance treatment can be treated with intravenous diamorphine up to three times per day. Here, we investigated the prevalence of ADHD among patients undergoing either daily diamorphine maintenance treatment or daily oral opioid maintenance treatment. (2) Methods: We assessed all participants with the WURS-k and the ADHD-SR. The Diagnostic Interview for ADHD in Adults (DIVA) was performed with all participants who met the cut-off in the WURS-k and/or ADHD-SR. (3) Results: The overall prevalence of ADHD was 17.9%. Prevalence of ADHD among patients undergoing daily diamorphine maintenance treatment was 14.3%. Prevalence of ADHD among patients undergoing daily oral opioid maintenance treatment was 20.3%. The combined presentation of ADHD was the most prevalent condition. In urine samples of participants with comorbid ADHD, heroin was detected the most and cocaine the least frequently. (4) Conclusions: Almost one out of five patients with OUD suffered from comorbid ADHD. In 83.3%, ADHD had not been diagnosed prior to participation in this study. Thus, patients with SUD could benefit from being routinely screened for ADHD. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

17 pages, 375 KiB

Open AccessArticle

Let’s Talk about Sex… and ADHD: Findings from an Anonymous Online Survey

by Susan Young, Larry J. Klassen, Shayne D. Reitmeier, Jake D. Matheson and Gisli H. Gudjonsson

Int. J. Environ. Res. Public Health 2023, 20(3), 2037; https://doi.org/10.3390/ijerph20032037 - 22 Jan 2023

Cited by 1 | Viewed by 5007

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity. A dearth of studies have investigated psychosexuality in this population, often with few (predominantly male) participants. We recruited individuals with and without ADHD via an anonymous online survey distributed electronically [...] Read more.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity. A dearth of studies have investigated psychosexuality in this population, often with few (predominantly male) participants. We recruited individuals with and without ADHD via an anonymous online survey distributed electronically by ADHD support organizations and social media. We investigated sexual history; interests and practices; and relationships. Of 1392 respondents, we classified an ‘ADHD’ group (n = 541; 30.5% male) and compared them to individuals of similar ages without ADHD, (‘Other’ group; n = 851; 37.6% male). The ADHD group (both males and females) had a significantly higher preference for same-sex or either-sex partners; and higher rates of electronic sexual exchanges, masturbation, and sexually transmitted diseases. They were more adventurous in sexual interests and practices and substantially less satisfied with their partners, both sexually and generally. Within the ADHD group, significant sex differences emerged: females had younger onset of sexual activities, used contraception less frequently, had more sexual partners and practiced more infidelity. Sexual interests differed between the sexes, but females more commonly acted on them, whereas males did not. Findings suggest both sexes engage in risky sexual behaviors, perhaps driven by impulsivity, but risk is substantially greater for females with ADHD. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

14 pages, 951 KiB

Open AccessArticle

Stability of Attention Performance of Adults with ADHD over Time: Evidence from Repeated Neuropsychological Assessments in One-Month Intervals

by Nana Guo, Janneke Koerts, Lara Tucha, Isabel Fetter, Christina Biela, Miriam König, Magdalena Bossert, Carsten Diener, Steffen Aschenbrenner, Matthias Weisbrod, Oliver Tucha and Anselm B. M. Fuermaier

Int. J. Environ. Res. Public Health 2022, 19(22), 15234; https://doi.org/10.3390/ijerph192215234 - 18 Nov 2022

Cited by 4 | Viewed by 2400

Abstract

Neuropsychological assessments of attention are valuable sources of information in the clinical evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). However, it is unclear whether the attention performance of adults with ADHD is stable or fluctuates over time, which is of great importance in [...] Read more.

Neuropsychological assessments of attention are valuable sources of information in the clinical evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). However, it is unclear whether the attention performance of adults with ADHD is stable or fluctuates over time, which is of great importance in the interpretation of clinical assessments. This study aimed to explore the stability of attention performance of adults with ADHD in repeated assessments at one-month intervals. Twenty-one adults diagnosed with ADHD took part in this study by completing selective attention and vigilance tests three times, each one month apart. Test scores of participants were compared with and interpreted based on test norms. A considerable proportion of ‘below average’ performance scores were observed in most of the variables of selective attention and vigilance in all three assessments. Further, selective attention and vigilance performance scores did not differ significantly between the three repeated assessments. Finally, the majority of participants received consistent test score interpretations across the three repeated assessments. This study confirms previous research and highlights abnormal selective attention and vigilance performance in adults with ADHD. Further, this study preliminarily demonstrates relatively stable attention performance across repeated assessments, which has the potential to support clinical assessment, treatment planning, and evaluation. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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17 pages, 1277 KiB

Open AccessArticle

It Takes Time: Vigilance and Sustained Attention Assessment in Adults with ADHD

by Anselm B. M. Fuermaier, Lara Tucha, Nana Guo, Christian Mette, Bernhard W. Müller, Norbert Scherbaum and Oliver Tucha

Int. J. Environ. Res. Public Health 2022, 19(9), 5216; https://doi.org/10.3390/ijerph19095216 - 25 Apr 2022

Cited by 11 | Viewed by 4832

Abstract

Objectives: The present study compares the utility of eight different tests of vigilance and sustained attention in the neuropsychological examination of adults with Attention-deficit/hyperactivity disorder (ADHD). Methods: Thirty-one adults diagnosed with ADHD performed eight tests for vigilance and sustained attention, spread [...] Read more.

Objectives: The present study compares the utility of eight different tests of vigilance and sustained attention in the neuropsychological examination of adults with Attention-deficit/hyperactivity disorder (ADHD). Methods: Thirty-one adults diagnosed with ADHD performed eight tests for vigilance and sustained attention, spread over three assessment days. Results: Adults with ADHD showed cognitive impairments in most tests and test variables, even though their sensitivity differed greatly. No specific type of test variable stands out to be the most sensitive, and no evidence for a differential deterioration of performance over time was observed. Conclusion: This study underscores the role of vigilance and sustained attention tests in the assessment of adult ADHD. It is further concluded that summary scores over the entire test duration are sufficient, but that all variables of a test should be considered. Finally, we hypothesize that reassessment on a different day may benefit a more accurate clinical assessment of adults with ADHD, in order to adequately take intraindividual fluctuations and limitations regarding test reliability into account. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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Review

Jump to: Research, Other

18 pages, 518 KiB

Open AccessReview

Time Perception in Adult ADHD: Findings from a Decade—A Review

by Christian Mette

Int. J. Environ. Res. Public Health 2023, 20(4), 3098; https://doi.org/10.3390/ijerph20043098 - 10 Feb 2023

Cited by 2 | Viewed by 5308

Abstract

Time perception is impaired in adult ADHD. Since the term time perception subsumes different constructs, including time estimation, time reproduction, time production, and duration discrimination, it remains open whether certain domains are more affected than other domains in adult ADHD. The aim of [...] Read more.

Time perception is impaired in adult ADHD. Since the term time perception subsumes different constructs, including time estimation, time reproduction, time production, and duration discrimination, it remains open whether certain domains are more affected than other domains in adult ADHD. The aim of this explorative review is to present the current state of research on time perception in adult ADHD by analysing studies from the past 10 years. A review of the literature addressing adult ADHD time perception, time estimation, and time reproduction was performed. The search strategy was conducted by using the databases “PubMed”, “Medline”, and “PSYNDEX”. The results of the present review indicate that the number of studies on time perception in adult ADHD is very scarce. Moreover, the main investigated domains of time perception in the past decade were time estimation, time reproduction and time management. Whereas some of the found studies were able to demonstrate a distinct deficit in time estimation, time reproduction and time management other studies were unable to demonstrate a clear association between ADHD and time estimation and time reproduction deficits. However, the diagnostic protocols, study design, and methodology varied between studies. Further studies on time estimation and time reproduction need to be carried out. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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Other

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10 pages, 572 KiB

Open AccessBrief Report

Prevalence of ADHD in a Sample of Heroin Addicts Receiving Agonist Treatment—Study Conducted in a Public Addiction Service

by Pasqualina Rocco

Int. J. Environ. Res. Public Health 2023, 20(3), 2602; https://doi.org/10.3390/ijerph20032602 - 31 Jan 2023

Cited by 1 | Viewed by 1849

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder that can persist into adulthood. The co-occurrence of ADHD and substance use disorders is very frequent and has received considerable attention in recent clinical/scientific investigations. However, few studies have investigated the prevalence of ADHD in [...] Read more.

Attention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder that can persist into adulthood. The co-occurrence of ADHD and substance use disorders is very frequent and has received considerable attention in recent clinical/scientific investigations. However, few studies have investigated the prevalence of ADHD in heroin addicts. This study aimed to investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in a sample of heroin addicts treated with opioid agonists and to report this clinical experience in a public service for addiction. Outpatients over 18 years old and being treated with opioid agonists for heroin addiction were enrolled. Each patient took part in a psychiatric examination and completed an ASRS (Adult ADHD Self-Report Scale) self-assessment. Subjects with positive results were called in for another psychiatric visit, and the Brown ADD scale was used as a second-level test for ADHD; furthermore, the Mini International Neuropsychiatric Interview (MINI) and Hypomania/Mania Checklist (HCL-32) were used for differential diagnoses and to assess comorbidities. In total, 111 patients were enrolled. All were followed up by the psychiatrist, who is also the author of this report and the person who formulated the diagnoses. The prevalence of ADHD in this sample was 18%. Among the 20 patients diagnosed with ADHD, 5 (25%) were female and 15 (75%) were male. The most frequent psychiatric comorbidity was major depression, found in 11 patients (55%), of which 4 presented with hypomania (bipolar disorder). In this sample, making diagnoses was very difficult. Frequently, multiple comorbidities further complicated these cases. In conclusion, the results of this study are consistent with the literature: There seems to be a significant prevalence of ADHD even among heroin addicts, and often, the diagnosis is difficult to make. We also do not know the exact effect of opioid agonist therapy on ADHD symptoms. Hypotheses have been put forward, but studies are needed. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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11 pages, 3907 KiB

Open AccessSystematic Review

Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Substance Use Disorder (SUD) Populations: Meta-Analysis

by Henrik Rohner, Nikolas Gaspar, Alexandra Philipsen and Marcel Schulze

Int. J. Environ. Res. Public Health 2023, 20(2), 1275; https://doi.org/10.3390/ijerph20021275 - 10 Jan 2023

Cited by 9 | Viewed by 6393

Abstract

(1) Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of age-inappropriate levels of inattention and/or hyperactivity/impulsivity that results in functional impairment at work, education, or hobbies and affects family life, social contacts, and self-confidence. ADHD is a comorbid condition [...] Read more.

(1) Background: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of age-inappropriate levels of inattention and/or hyperactivity/impulsivity that results in functional impairment at work, education, or hobbies and affects family life, social contacts, and self-confidence. ADHD is a comorbid condition associated with a prognosis of severe substance use disorder (SUD) and the early onset of such. The aim of this meta-analysis was to obtain the best estimate of the prevalence of ADHD in SUD populations. (2) Methods: A literature research was conducted using PUBMED^® and Web of Science^®. The following search terms were used: [ADHD], [prevalence], and [substance use disorder]. RStudio^® was used for meta-analysis methods. (3) Results: In total, 31 studies were included. We estimate the prevalence of ADHD among SUD patients at 21%. Full article

(This article belongs to the Special Issue Assessment of ADHD and Its Related Symptoms)

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