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Department/Unit:Child and Adolescent Psychiatry

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Is Increased Response Time Variability Related to Deficient Emotional Self-Regulation in Children With ADHD?

Elmaghrabi, Shereen; Nahmias, Maria Julia; Adamo, Nicoletta; Di Martino, Adriana; Somandepalli, Krishna; Patel, Varun; McLaughlin, Andrea; De Sanctis, Virginia; Castellanos, Francisco X
OBJECTIVE:Elevated response time intrasubject variability (RT-ISV) characterizes ADHD. Deficient emotional self-regulation (DESR), defined by summating Child Behavior Checklist Anxious/Depressed, Aggressive, and Attention subscale scores, has been associated with worse outcome in ADHD. To determine if DESR is differentially associated with elevated RT-ISV, we examined RT-ISV in children with ADHD with and without DESR and in typically developing children (TDC). METHOD/METHODS:We contrasted RT-ISV during a 6-min Eriksen Flanker Task in 31 children with ADHD without DESR, 34 with ADHD with DESR, and 65 TDC. RESULTS:Regardless of DESR, children with ADHD showed significantly greater RT-ISV than TDC ( p < .001). The ADHD subgroups, defined by presence or absence of DESR, did not differ from each other. CONCLUSION/CONCLUSIONS:Increased RT-ISV characterizes ADHD regardless of comorbid DESR. Alongside similar findings in children and adults with ADHD, these results suggest that RT-ISV is related to cognitive rather than emotional dysregulation in ADHD.
PMID: 30047295
ISSN: 1557-1246
CID: 3216502

Assessment of the impact of shared brain imaging data on the scientific literature

Milham, Michael P; Craddock, R Cameron; Son, Jake J; Fleischmann, Michael; Clucas, Jon; Xu, Helen; Koo, Bonhwang; Krishnakumar, Anirudh; Biswal, Bharat B; Castellanos, F Xavier; Colcombe, Stan; Di Martino, Adriana; Zuo, Xi-Nian; Klein, Arno
Data sharing is increasingly recommended as a means of accelerating science by facilitating collaboration, transparency, and reproducibility. While few oppose data sharing philosophically, a range of barriers deter most researchers from implementing it in practice. To justify the significant effort required for sharing data, funding agencies, institutions, and investigators need clear evidence of benefit. Here, using the International Neuroimaging Data-sharing Initiative, we present a case study that provides direct evidence of the impact of open sharing on brain imaging data use and resulting peer-reviewed publications. We demonstrate that openly shared data can increase the scale of scientific studies conducted by data contributors, and can recruit scientists from a broader range of disciplines. These findings dispel the myth that scientific findings using shared data cannot be published in high-impact journals, suggest the transformative power of data sharing for accelerating science, and underscore the need for implementing data sharing universally.
PMCID:6053414
PMID: 30026557
ISSN: 2041-1723
CID: 3201922

Long-Term Effects from a School-Based Trial Comparing Interpersonal Psychotherapy-Adolescent Skills Training to Group Counseling

Young, Jami F; Jones, Jason D; Sbrilli, Marissa D; Benas, Jessica S; Spiro, Carolyn N; Haimm, Caroline A; Gallop, Robert; Mufson, Laura; Gillham, Jane E
Adolescence represents a vulnerable developmental period for depression and an opportune time for prevention efforts. In this study, 186 adolescents with elevated depressive symptoms (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were randomized to receive either Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST; n = 95) delivered by research clinicians or group counseling (GC; n = 91) delivered by school counselors. We previously reported the short-term outcomes of this school-based randomized controlled trial: IPT-AST youth experienced significantly greater improvements in depressive symptoms and overall functioning through 6-month follow-up. Here, we present the long-term outcomes through 24 months postintervention. We examined differences in rates of change in depressive symptoms and overall functioning and differences in rates of depression diagnoses. Youth in both conditions showed significant improvements in depressive symptoms and overall functioning from baseline to 24-month follow-up, demonstrating the efficacy of school-based depression prevention programs. However, the two groups did not differ in overall rates of change or in rates of depression diagnoses from baseline to 24-month follow-up. Although IPT-AST demonstrated advantages over GC in the short term, these effects dissipated over long-term follow-up. Specifically, from 6- to 24-month follow-up, GC youth showed continued decreases in depressive symptoms, whereas IPT-AST youth showed a nonsignificant increase in symptoms. GC youth remained relatively stable in overall functioning, whereas IPT-AST youth experienced a small but statistically significant worsening in functioning. This study highlights the potential of school-based depression prevention efforts and the need for further research.
PMID: 29979882
ISSN: 1537-4424
CID: 3317382

Adult ADHD: Psychosocial Treatment Components and Efficacy Status

Gallagher, Richard; Feder, Michael A.
Psychosocial treatments for attention-deficit/hyperactivity dis- order (ADHD) in adults and emerging adults have developed to address core symptoms of ADHD (hyperactivity, impulsivity, and inattention) and associated functional impairments. These psychosocial treatments have been developed to enhance the effect of medication treatments. Evidence-based psychosocial treatments teach patients skills in organization, time management, and planning by using a cognitive-behavioral framework. The latest version of these programs also teaches mindfulness skills, so patients learn to think critically before acting impulsively. Cognitive components to address maladaptive thoughts found in ADHD and associated patterns found in comorbid anxiety and depression facilitate mental health. Research indicates that these skill-based programs lead to significant changes including reductions in core symptoms, improved executive functioning, and reduced functional impairments. This article reviews the findings from meta-analyses and details treatment targets and treatment components contained in efficacious interventions.
ISI:000458412200006
ISSN: 0048-5713
CID: 3694492

Review of Cardiovascular Effects of ADHD Medications [Review]

Levin, Charles J.; Goodman, David W.; Adler, Lenard A.
The prevalence of attention-deficit/hyperactivity disorder (ADHD) among adults is approximately 4.4%, and more than 1.5 million Americans are prescribed stimulants for the treatment of ADHD. Stimulants (such as methylphenidate and amphetamine compounds), along with the nonstimulant atomoxetine, are widely prescribed for ADHD, and more Americans are continuing to use these medications throughout their adult lives. Given the action of these drugs on the cardiovascular system, health care professionals have asked whether chronic use of these substances substantively increase the risk for cardiovascular disease (CVD). A comprehensive body of research suggests that this may not be the case. All adult patients should be monitored for changes in blood pressure and pulse during treatment with ADHD medications; furthermore, people at risk for CVD or with existing CVD should be evaluated at baseline in conjunction with appropriate medical personnel, and ongoing treatment should be collaborative with such medical colleagues.
ISI:000458412200004
ISSN: 0048-5713
CID: 3694502

Emotional Dysregulation in Adult ADHD

Adler, Lenard A.; Silverstein, Michael J.
Adult attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that persists into adulthood in about one-half of all patients. Although the current Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnostic formulation limits ADHD symptoms to those of inattention and hyperactivity-impulsivity, there has been a substantial amount of research supporting symptoms of emotional dysregulation (ED) as being either a part of the ADHD syndrome or co-traveling symptoms. This article reviews the description of emotional dysregulation, how emotional dysregulation fits in the diagnostic schemata of ADHD, methods of assessment of emotional dysregulation, and treatment of emotional dysregulation.
ISI:000458412200003
ISSN: 0048-5713
CID: 3694512

Adult ADHD [Editorial]

Adler, Lenard A.
ISI:000458412200002
ISSN: 0048-5713
CID: 3694522

Groupwise 3D Nonlinear Registration of OCT Image Series for Analyzing Dynamic Lamina Cribrosa Changes [Meeting Abstract]

Hong, Sungmin; Ravier, Mathilde; Ishikawa, Hiroshi; Girot, Charly; Tauber, Jenna; Wollstein, Gadi; Schuman, Joel S.; Fishbaugh, James; Gerig, Guido
ISI:000442912505005
ISSN: 0146-0404
CID: 3333512

Stability Analysis of Lamina Cribrosa Structure in Repeated Optical Coherence Tomography Scans [Meeting Abstract]

Fishbaugh, James; Hong, Sungmin; Ishikawa, Hiroshi; Ravier, Mathilde; Wollstein, Gadi; Schuman, Joel S.; Gerig, Guido
ISI:000442912506101
ISSN: 0146-0404
CID: 3333502

Prenatal exposure to disaster-related traumatic stress and developmental trajectories of temperament in early childhood: Superstorm Sandy pregnancy study

Zhang, Wei; Rajendran, Khushmand; Ham, Jacob; Finik, Jackie; Buthmann, Jessica; Davey, Kei; Pehme, Patricia M; Dana, Kathryn; Pritchett, Alexandra; Laws, Holly; Nomura, Yoko
BACKGROUND:Little is known about the impact of prenatal maternal stress (PNMS) on the developmental trajectory of temperament and few studies have been able to incorporate a natural disaster as a quasi-experimental stressor. The current study investigated PNMS related to Superstorm Sandy ('Sandy'), a hurricane that struck the New York metropolitan area in October 2012, in terms of objective exposure during pregnancy, subjective stress reaction as assessed by maternal symptoms of post-traumatic stress, and their impact on the developmental changes in temperament during early childhood. METHOD:A subsample of 318 mother-child dyads was drawn from the Stress in Pregnancy Study. Temperament was measured at 6, 12, 18, and 24 months of age. RESULTS:Objective exposure was associated with greater High-Intensity Pleasure, Approach, Perceptual Sensitivity and Fearfulness, but lower Cuddliness and Duration of Orientation at 6 months. Objective exposure and its interaction with subjective stress reaction predicted developmental changes in temperament. In particular, objective exposure was linked to greater increases in Activity Level but decreases in High-Intensity Pleasure, Approach, and Fearfulness. The combination of objective exposure and subjective stress reaction was also associated with greater increases in Activity Level. LIMITATIONS:Temperament was measured solely via maternal report. Trimester-specific effects of Sandy on temperament were not examined. CONCLUSION:This is the first study to examine the effects of prenatal maternal exposure to a natural disaster on trajectories of early childhood temperament. Findings suggest that both objective stress exposure and subjective stress reaction in-utero predict developmental trajectories of temperament in early childhood.
PMCID:5963732
PMID: 29614461
ISSN: 1573-2517
CID: 5401252