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Department/Unit:Child and Adolescent Psychiatry

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Adult ADHD [Editorial]

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

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

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

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

Intellectual Disabilities in Juvenile Justice: The Case for Screening [Editorial]

Tedeschi, Frank; Junewicz, Alexandra
Recent efforts to reform and improve the juvenile justice system have overlooked one critically important issue-the widespread failure to routinely screen for intellectual and developmental disabilities (I/DD) in young offenders. Pursuant to the Americans with Disabilities Act and Individuals with Disabilities Education Act, offenders with I/DD must receive appropriate accommodations. Yet across the country, adolescents and adults with I/DD must engage with the juvenile justice system without appropriate supports and often with their disabilities unknown to corrections staff, lawyers, judges, and other personnel.
PMID: 30522734
ISSN: 1527-5418
CID: 3678602

Affective Network Neuroscience

Markett, Sebastian; Wudarczyk, Olga A; Biswal, Bharat B; Jawinski, Philippe; Montag, Christian
PMCID:6298244
PMID: 30618543
ISSN: 1662-4548
CID: 3681492

Study Registration: Encouraging the Practice of Hypothetical-Deductive Research in the Journal [Editorial]

Novins, Douglas K; Althoff, Robert R; Billingsley, Mary K; Cortese, Samuele; Drury, Stacy S; Frazier, Jean A; Henderson, Schuyler W; McCauley, Elizabeth A; White, Tonya J H
Earlier this year, we shared with you our commitment to supporting the dissemination of research that is well designed, carefully conducted, and properly interpreted, and our belief that authors, reviewers, editors, publishers, and readers should jointly strive to ensure the integrity of the science that we publish.1 Toward this end, we are pleased to announce a new submission type beginning in 2019: Registered Reports.
PMID: 30522731
ISSN: 1527-5418
CID: 3678592

Diagnostic Efficiency of Caregiver Report on the SCARED for Identifying Youth Anxiety Disorders in Outpatient Settings

Van Meter, Anna R; You, Dokyoung S; Halverson, Tate; Youngstrom, Eric A; Birmaher, Boris; Fristad, Mary A; Kowatch, Robert A; Storfer-Isser, Amy; Horwitz, Sarah M; Frazier, Thomas W; Arnold, L Eugene; Findling, Robert L; Lams Group, The
This study investigated the diagnostic and clinical utility of the parent-rated Screen for Child Anxiety Related Emotional Disorders (SCARED-P) for detecting youth anxiety disorders. Youth ages 6 to 12 years, 11 months were recruited from 9 outpatient mental health clinics (N = 707). Consensus diagnoses were based on semistructured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children) with youth and caregivers; 31% were diagnosed with at least one anxiety disorder. Caregivers completed the SCARED-P to describe youth anxiety levels. SCARED-P scores were not considered during the consensus diagnoses. Areas under the curve (AUCs) from receiver operating characteristic analyses and diagnostic likelihood ratios (DLRs) quantified performance of the SCARED-P total score and subscale scores (generalized anxiety disorder and separation anxiety disorder). SCARED-P total scores had variable efficiency (AUCs = .69-.88), and Generalized Anxiety Disorder and Separation Anxiety subscale scores were excellent (AUCs = .86-.89) for identifying specific anxiety disorders. Optimal subscale cutoff scores were computed to help rule in (DLRs = 2.7-5.4) or rule out (DLRs < 1.0) anxiety disorders among youth. Results suggest that the Generalized Anxiety Disorder and Separation Anxiety SCARED-P subscales accurately identify their respective matched diagnoses. DLRs may aid clinicians in screening for youth anxiety disorders and improve accuracy of diagnosis.
PMCID:5729056
PMID: 27485325
ISSN: 1537-4424
CID: 3658842

A Pilot Study of Behavioral, Physiological, and Subjective Responses to Varying Mental Effort Requirements in Attention-Deficit/Hyperactivity Disorder

Mies, Gabry W; Moors, Pieter; Sonuga-Barke, Edmund J; van der Oord, Saskia; Wiersema, Jan R; Scheres, Anouk; Lemiere, Jurgen; Danckaerts, Marina
Background: Attention-deficit/hyperactivity disorder (ADHD) is presumed to involve mental effort application difficulties. To test this assumption, we manipulated task difficulty and measured behavioral, as well as subjective and psychophysiological indices of effort. Methods: Fifteen adolescent ADHD boys and 16 controls performed two tasks. First, subjective estimates and behavioral and pupillary measures of effort were recorded across five levels of N-back task difficulties. Second, effort discounting was assessed. In the latter, participants made repeated choices between performing a difficult N-back task for a high reward versus an easier N-back task for a smaller reward. Results: Increasing task difficulty led to similar deteriorations in performance for both groups - although ADHD participants performed more poorly at all difficulty levels than controls. While ADHD and control participants rated the tasks equally difficult and discounted effort similarly, those with ADHD displayed slightly different pupil dilation patterns with increasing task difficulty. Conclusion: The behavioral results did not provide evidence for mental effort problems in adolescent boys with ADHD. The subtle physiological effects, however, suggest that adolescents with ADHD may allocate effort in a different way than controls.
PMCID:6336710
PMID: 30687201
ISSN: 1664-1078
CID: 3658692

PSYCHOANALYSIS AND THE ACADEMY: WORKING ACROSS BOUNDARIES WITH LINGUISTICS, COGNITIVE/DEVELOPMENTAL PSYCHOLOGY, AND PHILOSOPHY OF MIND

Erreich, Anne
ISI:000457202300003
ISSN: 0003-0651
CID: 3646582