Search Results (100)

Background/Objectives: Executive function (EF) difficulties are increasingly recognized as closely linked to ADHD, particularly when assessed via rating scales. Methods: The present study investigated the nature of these associations, using the Conners 3 Rating Scales to assess ADHD symptoms and the Executive Function Questionnaire (EFQU) to assess EF impairments, in a sample of 1068 children (40.8% males, 38.8% females) aged 7–14 years (M = 10.7, SD = 1.74). Results: Both parent and teacher ratings revealed strong correlations, particularly between inattentive symptoms and EF difficulties, across multiple executive domains. To examine whether these associations stemmed from construct or phrasing overlap, exploratory and confirmatory factor analyses were conducted. The results demonstrate that the Conners 3 and the EFQU capture distinct latent dimensions of functioning, with virtually no overlap in item content. Conclusions: The strength and consistency of the associations between these latent factors support the interpretation that, although conceptually distinct, ADHD symptoms and EF impairments are empirically intertwined in everyday functioning, as consistently reported by both parents and teachers. Interestingly, teachers provided more integrated views of behavior, while parents tended to distinguish ADHD and EF traits more clearly. These findings underscore the importance of multi-informant assessment and contextual variability in understanding children’s functioning. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with chronic inattention, hyperactivity, and impulsivity and is linked with significant functional impairment. Despite being highly prevalent, diagnosis of ADHD continues to rely on subjective assessment reports of behavior and is often delayed or inaccurate. This review summarizes current advances in biomarkers and neuropsychological tests for the improvement of ADHD diagnosis and treatment. Key biomarkers are neuroimaging methods (e.g., structural and functional MRI), electrophysiological measures (e.g., EEG, ERP), and biochemical measures (e.g., cortisol, vitamin D). Additionally, novel experimental measures, e.g., eye-tracking, pupillometry, and microbiome analysis, hold the promise to be objective and dynamic measures of ADHD symptoms. The review also comments on the impact of the burden of ADHD on quality of life, e.g., emotional well-being, academic achievement, and social functioning. Additionally, differences between individuals, such as age, sex, comorbidities, and the impact of social and family support, are also addressed in relation to ADHD outcomes. In summary, we highlight the potential of these emerging biomarkers and tools to revolutionize ADHD diagnosis and guide personalized treatment strategies. These insights have significant implications for improving patient outcomes. Full article

Background/Objectives: Attention-Deficit Hyperactivity Disorder (ADHD) is an immensely heterogeneous developmental disorder, uniquely impacting each individual. Physical movement is a promising adjunct behavioral treatment that can promote executive functioning in children with ADHD. The current study used neuroimaging and behavioral techniques to investigate the impact of movement during executive functioning on dorsolateral prefrontal cortical (DLPFC) activity and inhibitory control in children with ADHD, with particular focus on key individual difference factors in ADHD, such as subtype, severity, and gender. Methods: Twenty-eight children with ADHD completed a Stroop task while remaining stationary (stationary condition) and while desk cycling (movement condition). Simultaneous functional near-infrared spectroscopy (fNIRS) recorded oxygenated and deoxygenated changes in hemoglobin within the left DLPFC. Participants were categorized into ADHD subtype (hyperactive/impulsive, inattention, combined), ADHD severity (low, moderate, high), and gender (male, female). Results: Those with the hyperactive and combined ADHD subtypes, those with high ADHD severity, and males with ADHD showed greater DLPFC activation when engaging in movement during executive functioning compared to remaining stationary. In contrast, those with the inattentive ADHD subtype, those with low-to-moderate ADHD severity, and females with ADHD showed greater DLPFC activation when remaining stationary during executive functioning compared to engaging in movement. Inhibitory control improved in the stationary condition for females who were predominantly inattentive. Conclusions: This work underscores the importance of considering individual difference factors in ADHD when designing physical activity interventions, as treatment efficacy may vary. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, impulsivity and/or hyperactivity. In recent years, metabolic alterations, primarily obesity, insulin resistance, and diabetes, have emerged as frequent comorbidities in individuals with ADHD, suggesting a bidirectional relationship between neurodevelopmental and metabolic dysfunctions. Emerging evidence indicates that dysregulation of dopaminergic signaling, disturbances in the hypothalamic-pituitary-adrenal (HPA) axis, and chronic low-grade inflammation are central to both ADHD symptomatology and metabolic impairments. For instance, alterations in dopamine-related genes (e.g., DRD4, DAT1) not only affect cognitive and behavioral functions but also play a role in appetite regulation and glucose homeostasis. Epidemiological studies further demonstrate that individuals with ADHD exhibit poorer glycemic control and a higher prevalence of both type 1 and type 2 diabetes, while early-life metabolic challenges such as maternal diabetes may predispose offspring to ADHD. This review aims to comprehensively synthesize the epidemiological, genetic, and pathogenetic evidence linking ADHD to metabolic alterations. We discuss key pathophysiological pathways—including dopaminergic dysregulation, HPA axis disturbances, inflammation, and oxidative stress—and evaluate their contributions to the co-occurrence of ADHD and metabolic disorders. In addition, we explore the clinical implications and integrated treatment approaches that encompass lifestyle modifications, pharmacological therapies, and multidisciplinary care. Finally, we outline future research directions to develop personalized and holistic interventions. Full article

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsive behavior. In recent years, studies have shown that patients with ADHD often experience sleep problems, raising clinical interest in the potential role of polysomnography (PSG) in the diagnosis and management of ADHD. This study examines polysomnographic findings in children with ADHD who present with diverse sleep complaints. Methods: A cohort of children aged younger than 18 years, diagnosed with ADHD based on DSM-5 criteria, underwent overnight polysomnography. The study assessed various sleep parameters, including sleep latency, sleep efficiency, total sleep time, and the presence of sleep-disordered breathing. Results: A retrospective analysis was conducted on 36 children (29 boys and 7 girls) aged 6 to 14 years, diagnosed with ADHD, who underwent polysomnography between 2021 and 2024. Polysomnographic findings revealed that 77.78% of the children demonstrated significant snoring. Furthermore, 50.0% were diagnosed with obstructive sleep apnea syndrome (OSAS). In addition, eight children exhibited parasomnias. Among them, six had bruxism, three were diagnosed with periodic limb movement disorder (PLMD), and two experienced sleep talking. Other notable sleep-related conditions included two cases of narcolepsy, one case of prolonged sleep onset latency, and one case of central apnea syndrome. Total sleep time (TST) was significantly longer in females compared to males (400.71 ± 32.68 min vs. 361.24 ± 41.20 min, p = 0.0215), whereas rapid eye movement (REM) latency was longer in males compared to females (118.62 ± 55.60 min vs. 78.57 ± 27.82 min, p = 0.0194). These findings highlight the high prevalence of sleep-disordered breathing (SDB) in children with ADHD who present with sleep disturbances. Furthermore, sleep quality, as indicated by longer TST and shorter REM latency, appears to be better in females with ADHD. Conclusions: The findings of this study underscore the critical role of polysomnography (PSG) in the assessment of children with ADHD. PSG provides an objective evaluation of sleep abnormalities commonly associated with ADHD, which may influence symptom manifestation and treatment outcomes. Notably, the results suggest that females with ADHD exhibit better sleep quality, as indicated by longer total sleep time (TST) and shorter rapid eye movement (REM) latency compared to males. We recommend incorporating polysomnography (PSG) into the comprehensive assessment of children with ADHD who present with significant sleep disturbances. Further research is warranted to investigate the impact of targeted interventions for sleep abnormalities on ADHD symptoms, prognosis, and potential sex-specific differences. Full article

Background/Objectives: Few studies have examined the association between developmental coordination disorder (DCD) traits and emotional/behavioral problems in preschool children, considering the influence of autistic traits. Furthermore, no consistent results have been obtained. The aim of this study was to investigate how DCD traits in preschool children are related to emotional/behavioral problems, controlling for the effects of autistic traits. Methods: A questionnaire survey was administered to 277 parents of children (154 boys, 73.0 ± 3.8 months) who underwent the school physical examination in Y city near Tokyo, Japan, from October to December 2021. The Developmental Coordination Disorder Questionnaire–Japanese version (DCDQ-J) was used to measure DCD traits, the Autism Spectrum Screening Questionnaire (ASSQ) was used to measure autistic traits, and the Strengths and Difficulties Questionnaire (SDQ) was used to measure emotional/behavioral problems. In the hierarchical multiple regression analysis, the SDQ was the dependent variable, with gender entered in Step 1, ASSQ in Step 2, and DCDQ in Step 3. Results: The results showed that autistic traits are associated with preschool children’s emotional/behavioral problems, but even after controlling for autistic traits, higher DCD traits had a relationship with higher conduct problems, hyperactivity/inattention, and peer problems and lower prosocial behavior of preschool children. Conclusions: This result indicates the need for the support of children with motor skill difficulties. Additionally, a focus on mitigating DCD traits not only improves motor skills but also prevents emotional/behavioral problems in preschool children. Full article

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Adolescents with ADHD have an elevated risk of developing Internet Gaming Disorder (IGD), a condition involving excessive gaming that disrupts daily life. IGD is linked to traits such as low frustration tolerance and sensation-seeking, with comorbid conditions like anxiety and depression further increasing vulnerability. Gaming frequently serves as a coping strategy due to emotional regulation difficulties. The dynamics within family units and peer relationships play a pivotal role, with dysfunctional environments heightening the risks and positive interactions serving as protective factors. Methods: This scoping review analyzed empirical studies published in the last decade exploring the association between ADHD, Problematic Internet Use (PIU), or IGD, focusing on neurobiological, psychological, and environmental factors. Results: The findings highlight that impulsivity and emotional dysregulation in ADHD contribute to IGD. Gaming is frequently used as a maladaptive coping strategy, with social and family influences modulating risk. Diagnostic complexities arise in distinguishing ADHD-related behaviors from IGD symptoms. Conclusions: Addressing these comorbid conditions requires interdisciplinary collaboration and evidence-based interventions. Future research should focus on understanding ADHD, PIU, or IGD interactions and developing targeted interventions. Longitudinal studies are necessary to establish causal links and assess effective treatment strategies. Full article

Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent, heterogeneous neurodevelopmental disorder. Methods: This study presents, for the first time, a comprehensive investigation of white matter microstructural differences between familial ADHD (ADHD-F) and non-familial ADHD (ADHD-NF) using advanced diffusion tensor imaging analyses in a large community-based sample. Results: Children with ADHD-F exhibited significantly greater volume in the right anterior thalamic radiations and the left inferior fronto-occipital fasciculus compared to controls, and greater volume in the left inferior longitudinal fasciculus relative to ADHD-NF. The ADHD-NF group showed reduced fractional anisotropy in the left inferior longitudinal fasciculus compared to the controls. In both the ADHD-F and ADHD-NF groups, a greater volume of anterior thalamic radiation significantly contributed to reduced ADHD symptoms. Conclusions: Our findings suggest that white matter microstructural alterations along the frontal-thalamic pathways may play a critical role in hereditary factors among children with ADHD-F and significantly contribute to elevated inattentive and hyperactive/impulsive behaviors in the affected children. Full article

Background: Attention Deficit Hyperactivity Disorder (ADHD) has been described as a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity affecting cognitive, emotional, and social functioning. While pharmacological and behavioral treatments remain primary, physical activity (PA) (digital and non-digital versions) has emerged as a great complementary intervention due to its potential impact on executive functions, emotional regulation, and neurobiological markers. Objectives: This study aimed to assess the effects of PA on ADHD symptoms, executive function, and emotional regulation, exploring its potential impact and new practical applications in digital and non-digital treatment. Methods: This narrative review assessed 132 studies published between 1 January 2010 and January 2025, ensuring the inclusion of the most recent and relevant findings. The review was conducted in Scopus, PubMed, and Web of Science, using a predefined combination of terms related to ADHD, physical activity, executive function, neuroplasticity, and emotional regulation. Results: Regular PA improves executive functions, attention, inhibitory control, and cognitive flexibility in ADHD. Aerobic exercise enhances sustained attention, high-intensity training improves impulse control, and coordinative activities boost cognitive flexibility. Non-digital and digital innovations, such as exergaming and wearable fitness trackers, offer promising solutions to improve adherence to PA regimens, reinforcing their role as a key intervention in ADHD management. Conclusions: PA could be a valuable complementary intervention for ADHD through a hybrid approach that may improve cognitive and emotional functioning while addressing comorbidities. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. These symptoms can significantly impact academic performance, social interactions, and daily activities, often creating cycles that worsen long-term challenges. This review introduces the Multidimensional Dynamic Feedback Model (MDFM), which aids in understanding ADHD’s development and guiding intervention strategies. The model emphasizes the dynamic interactions among genetic, environmental, cognitive, and behavioral factors. The MDFM consists of three key aspects: (1) the interplay between genetic and environmental factors in shaping ADHD’s biological basis, (2) the role of cognitive and neural processes in driving core symptoms, and (3) the influence of behavioral feedback loops that reinforce negative behaviors and hinder adaptation. The model highlights the importance of personalized interventions and effective feedback systems, including early prevention, supportive family and school environments, and the impact of social and cultural backgrounds on treatment outcomes. As a comprehensive framework, the MDFM offers a holistic perspective for clinicians, aiming to enhance long-term outcomes and promote the health and well-being of individuals with ADHD across the lifespan. By addressing implementation challenges, the model seeks to improve ADHD prevention and management, ultimately supporting individuals and their communities. Full article

Previous research has investigated non-pharmacological digital therapeutic interventions to improve compliance and reduce side effects in attention-deficit/hyperactivity disorder (ADHD) medication treatments for children. This study focuses on validating the effects of game-based intervention content for enhancing working memory and concentration. It tracks quantitative changes to evaluate improvements in concentration and working memory when digital game-based content is used as adjunct therapy alongside medication for children with ADHD. Thirty children participated; one group received digital therapeutic intervention based on game content alongside medication (experimental) and the other group received conventional treatments (control). The study results show that children with ADHD in the experimental group, who use digital game-based content, exhibit a reduction of 8.13 ± 6.71 points in the K-ARS total score at the fourth week compared to baseline, while the control group shows a reduction of 7.14 ± 8.73 points. Inattention decreases by 36.84% in the experimental group and 28.56% in the control group, while hyperactivity–impulsivity decreases by 50.71% in the experimental group and 34.00% in the control group. All the results are analyzed using a paired t-test between baseline and the fourth week. Significant decreases in the K-CBCL total problem behavior score and internalizing and externalizing behaviors are consistently observed at 28 days compared with baseline. The FAIR attention–concentration test results show significant differences between the experimental and control groups in the Q-percentile and Q-standard scores, with repeated measures ANOVA results showing p = 0.006 and p = 0.007, respectively. Digital content was shown to influence digital therapeutic intervention—a non-pharmacological treatment for ADHD. Full article

Background: The COVID-19 pandemic triggered a global transition to distance learning, which significantly impacted children’s mental health. In Saudi Arabia, remote education began on 8 March 2020, lasting between 1.5 to 2.5 years. This study aims to explore the psychological effects of distance learning on children and adolescents, with a focus on mental health challenges and coping mechanisms. Methods: A cross-sectional study was conducted using an online survey distributed to parents of children aged 6 to 18 in the major metropolitan areas of Jeddah and Riyadh. The survey included demographic questions and the Arabic version of the Vanderbilt ADHD Diagnostic Rating Scale, a tool for assessing behavioral challenges, anxiety, and symptoms of attention deficit hyperactivity disorder (ADHD). Results: A total of 71.6% of families reported a positive experience with distance learning. A significant correlation was found between parents’ marital status and children’s ability to cope with remote education. Interestingly, children without ADHD symptoms experienced three times more negative outcomes than those with ADHD symptoms. However, despite reporting fewer negative experiences, children with ADHD exhibited increased symptom severity and academic difficulties. Of the students, 5.4% were diagnosed with predominantly inattentive ADHD, 1.8% with predominantly hyperactive/impulsive ADHD, and 3.9% with combined ADHD. Additionally, 7.2% of students screened positive for oppositional defiant disorder, 1.5% for conduct disorder, and 6.6% for anxiety or depression. Children from separated or divorced families were more likely to exhibit ADHD symptoms (p = 0.002). Children with ADHD symptoms reported a more positive experience with distance learning (p < 0.05). Conclusion: This study represents the first comprehensive, multi-city investigation in Saudi Arabia examining the relationship between distance learning, sociodemographic factors, and mental health symptoms in children. The findings highlight the psychological challenges faced by children during the pandemic and emphasize the need for targeted interventions to support both mental health and academic outcomes. These results offer valuable insights for future research and inform strategies to address children’s well-being in scenarios involving distance learning. Full article

The global prevalence of suicidal behaviors in children is rising, with attention-deficit hyperactivity disorder (ADHD) proposed as a contributing factor. This study examines the association between ADHD facets (hyperactivity and inattention) and suicidal behavior and attempts in children. Additionally, it seeks to compare self-reported ADHD symptoms and suicide-related incidents with parental reports. A cohort of 71 children referred from emergency departments due to suicidal thoughts and behaviors completed self- and parental report questionnaires. The results revealed that elevated hyperactivity scores, surpassing the ADHD diagnosis threshold, were significantly associated with increased rates of suicidal behavior. Hyperactivity demonstrated a stronger association with lifetime suicide attempts compared to inattention. Moreover, children’s self-reported ADHD symptoms exhibited a stronger correlation with suicide attempts than parental reports. This study highlights the critical role of hyperactivity in understanding suicidal behaviors among children with ADHD. It underscores the importance of considering hyperactivity-related symptoms in assessment and treatment approaches for suicidal behavior in this population. Full article

Advanced Driver Assistance Systems, such as Forward Collision Warning and Lane Departure Warning, play a crucial role in accident prevention by alerting drivers to potential hazards. With the advent of fully autonomous driving technology that requires no driver input, there is now a greater emphasis on monitoring the state of vehicle occupants. This is particularly important because, in emergency situations where control must suddenly be transferred to an unprepared occupant, the risk of accidents increases significantly. To mitigate this risk, new monitoring technologies are being developed to analyze driver behavior and detect states of inattention or drowsiness. In response to the emerging demands of driver monitoring technology, we have developed the Customized Driver Inattention Detection Model (CDIDM). This model employs video analysis and statistical techniques to accurately and rapidly classify information on drivers’ gazes. The CDIDM framework defines the components of inattentive or drowsy driving based on the Driver Monitoring System (DMS) safety standards set by the European New Car Assessment Programme (EuroNCAP). By defining six driving behavior-related scenarios, we have improved the accuracy of driver inattention assessment. The CDIDM estimates the driver’s gaze while simultaneously analyzing data in real-time. To minimize computational resource usage, this model incorporates a series of preprocessing steps that facilitate efficient time series data analysis, utilizing techniques such as DTW Barycenter Averaging (DBA) and K-means clustering. This results in a robust driver attention monitoring model based on time series classification. Full article

Objectives: Paternalistic care behavior in health contexts reduces involvement in the decision-making process and dissatisfaction in healthcare, which may negatively influence older adults’ mental health. This study comprised two main objectives: (1) to explore older adults’ experiences of paternalistic behavior in the context of health services and (2) analyze the influence of paternalistic behavior on older adults’ mental health. Methods: The sample involved 416 participants aged 65 to 81 (M = 70.1 ± 5.73) with three different nationalities (English, Brazilian ad Portuguese). All interviews went through content analysis. Results: For the first objective, content analysis identified seven themes: (1) perceived inattention to the uniqueness of each person (81%); (2) feeling a duality of supporting and suppressing independence (79%); (3) selective disclosure of information to keep the person’s spirit up (74%); (4) feeling neglected (66%); (5) feeling unable to make decisions (64%); (6) receiving opposition to the person’s requests (60%); and (7) routine actions being considered as the best action (57%). For the second objective, three main themes emerged: (1) feeling anxious and stressed (88%); (2) feeling frustration and despair (87%); and (3) feeling injustice and anger (72%). Conclusions: Healthcare paternalism negatively affects older adults’ mental health, emphasizing the need for their agency, involvement in decisions, and personalized care. These findings highlight the negative influence of paternalistic behavior on the mental health of older adults and may contribute to future targeted interventions and policy programs among the older population. Full article