Faculty Bibliography

We investigated whether there is an emotional processing deficit in ADHD and whether this only applies to specific emotional categories. In this PRISMA-compliant systematic review based on a pre-registered protocol ( https://osf.io/egp7d ), we searched MEDLINE, PsycINFO, ERIC, Scopus and Web of Science databases until 3rd December 2023, to identify empirical studies comparing emotional processing in individuals meeting DSM (version III to 5-TR) or ICD (version 9 or 10) criteria for Attention Deficit/Hyperactivity Disorder (ADHD) and in a non-psychiatric control group. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Eighty studies were included and meta-analysed (encompassing 6191 participants and 465 observations). Bayesian meta-analyses were conducted to compare individuals with ADHD and non-psychiatric controls on overall emotional processing measures (meta-analysis 1) and across emotional categories (meta-analysis 2). The type of stimulus employed, outcome measurement reported, age, sex, and medication status were analysed as moderators. We found poorer performance in both overall emotion processing (g =  - 0.65) and across emotional categories (anger g =  - 0.37; disgust g =  - 0.24; fear g =  - 0.37; sadness g =  - 0.34; surprise g =  - 0.26; happiness/positive g =  - 0.31; negative g =  - 0.20; neutral g =  - 0.25) for individuals with ADHD compared to non-psychiatric controls. Scales items and accuracy outcome being the most effective moderators in detecting such differences. No effects of age, sex, or medication status were found. Overall, these results show that impaired emotional processing is a relevant feature of ADHD and suggest that it should be systematically assessed in clinical practice.

BACKGROUND AND OBJECTIVE/OBJECTIVE:Recent studies highlight an increase in pediatric mental health disorders, amplified by COVID-19. This study examines changes in mental health-related emergency department visits among New York City public school students across the pandemic timeline. METHODS:We employed logistic regression to examine changes in the probability of a student's emergency department visit being mental health-related, and as a secondary outcome, we analyzed the difference in same-day discharge rates between mental health-related visits and other visits. For this analysis, we used the New York City Student Population Health Registry to link public school students' records to emergency department visit data. RESULTS:No significant linear trends were observed in the average monthly probability of a mental health-related visit before March 2020. From March 2020 through June 2021 there was an increase for all groups except male elementary school students. Female middle and high school students experienced the largest increase (0.031 (CI = [0.027, 0.034])) compared to pre-pandemic (0.103 (CI = [0.103, 0.104])). Post-June 2021, all groups experienced a lower probability except for female middle and high school students, who had a 0.009 (CI = [0.007, 0.011]) higher probability than during the pandemic. Compared to the pre-pandemic period and non-mental health-related visits, a 0.043 (CI = [0.029, 0.057]) lower probability of same-day discharge was observed for mental health-related visits during the pandemic period. CONCLUSIONS:The COVID-19 pandemic correlated with a significant increase in mental health-related emergency department visits and longer stays, particularly among female middle and high school students.

Every wave of preferred substance use in adolescence serves similar developmental functions. The recent explosion among adolescents of electronic nicotine delivery systems (ENDS), popularly known as vaping, offers an opportunity to revisit models of the role of substance use in adolescent development. Social media's rise alongside that of ENDS distinguishes this recent phenomenon from previous historical waves of substance abuse: Vaping was and remains highly integrated into the digital culture, situating social media as a unique window into the adolescent users' subjective experience. To that end, we employ analyses of vaping manifestations within adolescent social media to complement clinical case material. We position adolescent vaping as an action-oriented facilitation of externalization, individuation, and challenge to authority that can precipitate adolescent-adult enactments. We propose that this use-reinforcing developmental function complements other biological and social properties of ENDS to cement its position within contemporary adolescent culture. We suggest that the evolution of adolescents' preferred devices from pens to USB-like devices to round pastel Elf Bar types and new wave cannabis products is driven by this trend's successive approximation to satisfaction of an adolescent developmental demand. While legal and limit-setting efforts to reduce adolescent vaping have been partially successful, we offer this updated developmental model to complement existing public health efforts in reducing adolescent ENDS use through an understanding and integration of its developmental meanings.

BACKGROUND:Anxiety disorders may partly stem from altered neurodevelopment of attention-related networks. Neonatal alterations in resting-state functional connectivity (rsFC) among the dorsal attention (DAN); frontal parietal (FPN); salience (SN); and default mode networks (DMN)) relate to fearful temperament, a risk marker for anxiety. Nevertheless, little research examines development of these networks beyond the first months of life, particularly in fearful infants. This study examines how changes in these networks in the first two years of life relate to fearful temperament. METHODS:Using data from the Baby Connectome Project (from 180 infants across 396 sessions), we conducted independent components analysis to extract rsFC among the DMN, SN, DAN, and FPN. Longitudinal modeling characterized 1) age-related changes (slope) in rsFC through age two; 2) relations between rsFC change (slope) and fearfulness at age 2; 3) relations between rsFC and fearfulness trajectories (slope and intercept) over the first two years of life. RESULTS:Age-related decreases occurred in rsFC in DAN - FPN and DMN - SN. Smaller decreases in DAN - FPN rsFC over time related to greater fear at age 2, and to increases in fearfulness over time. High initial DAN-FPN rsFC and low initial DAN - SN rsFC also related to increasing fearfulness over time. CONCLUSION/CONCLUSIONS:This study provides the first evidence that changes in attention-related brain networks are related to early-life fearfulness, a robust early-life risk marker of anxiety.

BACKGROUND:fcMRI correlates of autism spectrum disorder (ASD) diagnosis and familial liability were studied in 24-month-olds at high (older affected sibling) and low familial likelihood for ASD. METHODS:fcMRI comparisons of high-familial-likelihood (HL) ASD-positive (HLP, N = 23) and ASD-negative (HLN, N = 91), and low-likelihood ASD-negative (LLN, N = 27) 24-month-olds from the Infant Brain Imaging Study (IBIS) Network were conducted, employing object oriented data analysis (OODA), support vector machine (SVM) classification, and network-level fcMRI enrichment analyses. RESULTS:OODA (alpha = 0.0167, 3 comparisons) revealed differences in HLP and LLN fcMRI matrices (p = 0.012), but none for HLP versus HLN (p = 0.047) nor HLN versus LLN (p = 0.225). SVM distinguished HLP from HLN (accuracy = 99%, PPV = 96%, NPV = 100%), based on connectivity involving many networks. SVM accurately classified (non-training) LLN subjects with 100% accuracy. Enrichment analyses identified a cross-group fcMRI difference in the posterior cingulate default mode network 1 (pcDMN1)- temporal default mode network (tDMN) pair (p = 0.0070). Functional connectivity for implicated connections in these networks was consistently lower in HLP and HLN than in LLN (p = 0.0461 and 0.0004). HLP did not differ from HLN (p = 0.2254). Secondary testing showed HL children with low ASD behaviors still differed from LLN (p = 0.0036). CONCLUSIONS:24-month-old high-familial-likelihood infants show reduced intra-DMN connectivity, a potential neural finding related to familial liability, while widely distributed functional connections correlate with ASD diagnosis.

BACKGROUND:Individuals with attention deficit hyperactivity disorder (ADHD) are at a higher risk of depression and lower quality of life (QoL); however, it is unclear whether disrupted sleep and circadian rhythms mediate this increased risk. OBJECTIVES/OBJECTIVE:We investigated whether disruption of self-reported sleep and circadian factors mediate the associations of ADHD traits with depression symptom severity and QoL. METHODS:1364 participants (mean: 51.86 (SD=0.37) years, 75% women) from a large-scale cross-sectional online survey (Netherlands Sleep Registry) completed a sociodemographic questionnaire, the Adult ADHD Rating Scale, Hospital Anxiety and Depression Scale, Satisfaction With Life Scale (SLS) and Cantril Ladder (CL) (QoL measures), Insomnia Severity Index, Pittsburgh Sleep Quality Index and Munich Chronotype Questionnaire. FINDINGS/RESULTS:Higher ADHD traits were significantly associated with depression symptom severity (p=0.03), lower QoL (p<0.001), insomnia severity (p<0.001), lower sleep quality (p<0.001) and later chronotype (p=0.01). No sleep or circadian factor significantly mediated the association of the severity of symptoms of ADHD and depression (all p>0.1). Conversely, only insomnia severity significantly mediated the association of ADHD traits and QoL (SLS: standardised β=-0.10, 95% CI (-0.12 to -0.04); CL: standardised β=0.103, 95% CI (0.04 to 0.16)). CONCLUSION/CONCLUSIONS:ADHD traits were associated with lower QoL and it was partially mediated by insomnia severity. Future studies targeting insomnia complaints in this population may help mitigate their depression complaints and improve their QoL. CLINICAL IMPLICATIONS/CONCLUSIONS:Our results may help current clinical guidelines that do not typically link sleep/circadian complaints to QoL in ADHD assessment.

BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) symptomatology in childhood is associated with a high risk of suicide attempt later in life. However, symptom presentation in ADHD is heterogeneous, and little is known about how suicide risk varies according to different profiles of ADHD symptoms and sex. OBJECTIVE:The aim was to investigate the longitudinal associations between childhood profiles of ADHD symptoms (ie, hyperactivity-impulsivity and inattention) and youth suicide attempt in males and females, separately. METHODS:This population-based cohort study used data from three longitudinal cohorts: the Quebec Longitudinal Study of Child Development (QLSCD), the Quebec Longitudinal Study of Kindergarten Children (QLSKC) and the Quebec Newborn Twin Study (QNTS) for a total of 4399 participants (1490 from the QLSCD, 2134 from the QLSKC and 775 from the QNTS; 50% females) followed up from ages 6-23 years. Symptoms of hyperactivity-impulsivity and inattention were assessed by teachers five times from ages 6-12 years. Suicide attempt in adolescence and young adulthood (by age 23) was self-reported. Multitrajectory modelling was used to identify profiles of ADHD symptoms, and regression analysis was used to test their association with suicide attempt, adjusting for childhood socioeconomic and clinical characteristics. FINDINGS/RESULTS:We identified four ADHD symptom profiles with distinct associations with suicide attempt for males and females. Compared with those with persistently low symptoms, females with persistently high inattention and hyperactivity-impulsivity (OR: 2.54, CI 1.39 to 4.63) or high inattention and low hyperactivity-impulsivity (OR: 1.81, CI 1.21 to 2.70) were at higher risk of suicide attempt, while, among males, only those with decreasing hyperactivity-impulsivity and inattention over time (OR: 2.23, CI 1.20 to 4.13) were at higher risk of suicide attempt. CONCLUSIONS:Risk of suicide attempt in children with ADHD symptoms varies according to both symptom profile and sex, the highest risk being for females with high inattention symptoms (with or without hyperactivity), and males with decreasing symptoms. CLINICAL IMPLICATIONS/CONCLUSIONS:Taking into account differences in both sex and ADHD symptoms profile may be relevant to more accurately identify and manage suicide risk in individuals with high ADHD symptoms, though caution is needed when generalising our population-based findings to clinical populations.