J Atten Disord [JOURNAL]
Sun
200 papers
Susceptibility of the CAARS-2 Self-Report to Sophisticated Malingering.
Weis R, Sund AM
J Atten Disord · 2026 Aug · PMID 41821297 · Publisher ↗
OBJECTIVE: The Conners Adult ADHD Rating Scales Second Edition (CAARS-2) is a norm-referenced screening measure of ADHD symptoms and associated clinical concerns in adults. Unlike its predecessor, the CAARS-2 features a...
OBJECTIVE: The Conners Adult ADHD Rating Scales Second Edition (CAARS-2) is a norm-referenced screening measure of ADHD symptoms and associated clinical concerns in adults. Unlike its predecessor, the CAARS-2 features a Negative Impression Index (NII) to detect unrealistically negative ratings or an exaggerated description of problems. Data presented in the CAARS-2 manual indicate that the NII differentiates simulators and adults with genuine ADHD with high accuracy, sensitivity, and specificity. METHODS: We attempted to replicate these findings by conducting a simulation study with 222 adults with and without ADHD. Unlike the original studies, however, simulators were provided a plausible reason for feigning ADHD, coached to simulate and warned to avoid detection, and incentivized for credibly feigning. RESULTS: On average, simulators earned significant elevations on CAARS-2 scales assessing the number and severity of DSM inattentive and hyperactive-impulsive symptoms. Simulators' DSM scores did not differ significantly from those shown by participants with ADHD. The NII demonstrated high specificity (92%) to honest examinees with ADHD, but low sensitivity to simulators (8%). Most simulators were able to earn elevated CAARS-2 scores while avoiding detection. Most simulators were also able to provide credible responses while still earning high ADHD Index Scores (81%) and endorsing significant impairment in at least one functional domain (90%). CONCLUSION: Clinicians should continue to corroborate elevated CAARS-2 symptom scores with objective evidence of real-world functional limitations.
Identifying Candidate Mediators Linking ADHD Symptoms and Internalising Problems in Adolescence: An Exploratory Longitudinal Mediation Analysis.
Murray AL, Dryburgh K, Sonuga-Barke EJS
J Atten Disord · 2026 Aug · PMID 41789525 · Full text
OBJECTIVE: ADHD and internalising symptoms such as anxiety and depression are known to be associated in adolescence and understanding the mechanisms linking them is important for improving mental health outcomes for adol...
OBJECTIVE: ADHD and internalising symptoms such as anxiety and depression are known to be associated in adolescence and understanding the mechanisms linking them is important for improving mental health outcomes for adolescents with ADHD symptoms. Our objective was to examine these mechanisms. METHOD: In this study, we leverage a high-quality longitudinal dataset, the Millennium Cohort Study ( = 2,607 male, = 2,791 female) to simultaneously evaluate a range of hypothesised mediating mechanisms. These include indirect effects via peer problems, conduct problems, self-esteem, injuries and accidents, relationships with parents, academic performance, risky decision-making, parental mental health, educational motivation, and general health. We used exploratory longitudinal mediation analysis with regularised structural equation modelling (regSEM) to examine 14 candidate mediators of the ADHD-internalising association across ages 11, 14 and 17. RESULTS: Regularisation with lasso did not result in the de-selection of any of these mediators; however, only two were statistically significant. CONCLUSION: Results suggest there may be many mediators of small effect involved in the relation between ADHD symptoms and later internalising problems but point to self-esteem and parental mental health as priority mechanisms for further study in future causal and interventional research.
Accessibility of ADHD Assessments in Australia: A Secret Shopper Study.
O'Toole C, Finlayson J, Johnstone S … +1 more , Croaker K
J Atten Disord · 2026 Feb · PMID 41742378 · Publisher ↗
AIM: This study aimed to provide a representative indication of the accessibility of both adult and child ADHD assessments in Australia for psychologists, psychiatrists, and paediatricians. Accessibility was considered i...
AIM: This study aimed to provide a representative indication of the accessibility of both adult and child ADHD assessments in Australia for psychologists, psychiatrists, and paediatricians. Accessibility was considered in terms of clinician availability, wait times for an initial session, initial session costs, and total assessment costs across Australian states and territories, remoteness areas, and socioeconomic ranges. METHODS: Using a secret shopper design, researchers posed as potential consumers seeking an ADHD assessment for themselves and/or their child. A total of 736 clinicians were contacted via telephone between May and August 2024. RESULTS: Fifty-nine percent of clinicians responded, and 49.8% of respondents were available to book an ADHD assessment. The average wait times for psychologists, psychiatrists, and paediatricians were 7, 16, and 31 weeks, respectively (Mdn = 3, 15, and 26; IQR = 7, 16, and 31). The average initial session costs and estimated total assessment costs were $266 and $1,622 for psychologists (Mdn = 250 and 1,625; IQR = 57 and 929), $748 and $1,163 for psychiatrists (Mdn = 750 and 1,086; IQR = 340 and 555), and $500 and $598 for paediatricians (Mdn = 495 and 585; IQR = 123 and 739). CONCLUSION: This study identified substantial barriers to ADHD assessment accessibility in Australia. Low clinician availability, long wait times, and high costs for assessments are all factors contributing to healthcare access inequality. Policy changes and investment, as well as further research into contributing factors, are needed to improve availability and accessibility.
Episodic Future Thinking Improves Everyday Prospective Memory Performance in Adults With a Previous Diagnosis of Attention Deficit Hyperactivity Disorder by Community Providers.
Altgassen M, Heinrich H, Edel MA
J Atten Disord · 2026 May · PMID 41684048 · Publisher ↗
This study investigated the effects of the encoding strategy episodic future thinking on prospective memory performance (i.e., remembering to execute intended actions in the future) in individuals with a diagnosis of Att...
This study investigated the effects of the encoding strategy episodic future thinking on prospective memory performance (i.e., remembering to execute intended actions in the future) in individuals with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) by community providers. Individuals with ADHD often have difficulties to plan and execute delayed intentions in everyday life; thus, they show reduced prospective memory performance. Several studies indicate that engaging in episodic future thinking (i.e., mentally imagining executing the planned activity) during intention formation can improve prospective memory performance in typically developing populations in lab-based settings. To assess the execution of everyday intentions, we requested participants to perform the diary task. Thirty-two adults with ADHD and 31 controls were allocated to an episodic future thinking encoding condition and 31 adults with ADHD and 33 controls to a standard encoding condition. Analyses of variance revealed significant main effects of group and of encoding condition. Overall, controls remembered to execute more intentions than individuals with ADHD. Across groups, episodic future thinking increased the realization of intentions as compared to the standard encoding condition; however, this effect was no longer significant when verbal ability was statistically controlled. There was no significant interaction effect. This study replicates earlier findings of reduced intention execution in ADHD and provides preliminary support for episodic future thinking as a strategy to enhance PM in daily life, though its effects may depend on verbal ability, warranting further research.
The Association Between Attention Performance and Empathy in Children Diagnosed with ADHD.
Soyal S, Metin B
J Atten Disord · 2026 Aug · PMID 41679739 · Publisher ↗
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is associated not only with cognitive impairments but also with deficits in social cognitive abilities, including empathy. Although attention and empathy have be...
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is associated not only with cognitive impairments but also with deficits in social cognitive abilities, including empathy. Although attention and empathy have been individually studied in children with ADHD, the link between performance-based attention measures and empathy remains underexplored. Thus, this study examined the relationship between attention performance and empathy in children diagnosed with ADHD. METHOD: The sample included 53 children aged 7 to 12, consisting of 27 children diagnosed with ADHD and 26 typically developing control group. All participants were recruited from educational and clinical settings. Attention was measured using a computer-based Go/No-Go task, and empathy was assessed using the Reading the Mind in the Eyes Test (RMET). ADHD symptom severity was assessed using the Turgay DSM-IV-Based Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S). RESULTS: Children with ADHD made significantly more omission errors and scored lower on RMET than typically developing group. Significant negative correlations were found between RMET total score and omission errors and inattention scores. Regression analyses further supported these associations by indicating that attention-related variables significantly predicted empathy performance. CONCLUSION: Attention performance is closely associated with empathy in children with ADHD. These findings underscore the need for early and integrative interventions targeting both attentional and socio-cognitive dimensions in children with ADHD.
Treatment Patterns and Clinical Outcomes in Youth with Comorbid ADHD and PTSD: Insights from Real-World Data.
Baweja R, Lopes F, Padilla FM … +4 more , Baweja R, Amaya-Jackson L, Waschbusch DA, Waxmonsky JG
J Atten Disord · 2026 Jul · PMID 41679734 · Full text
OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) often co-occur in youth, complicating the clinical presentation. However, little is known about how PTSD influences tr...
OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) often co-occur in youth, complicating the clinical presentation. However, little is known about how PTSD influences treatment selection or outcomes in youth with ADHD. This study examined prescribing patterns and clinical outcomes among youth with ADHD, with and without comorbid PTSD. METHODS: This retrospective cohort study used electronic health record data from the TriNetX Research Network, including over 714,000 youth (ages 6-18) diagnosed with ADHD (F90), of whom 30,341 (4.25%) also had comorbid PTSD (F43.1). Outcomes included treatment trends, emergency visits, hospitalizations, and subsequent antipsychotic or mood stabilizer prescriptions. Relative risks (RR), hazard ratios (HR), and 95% confidence intervals were calculated using propensity score matching and Cox proportional hazards models adjusted for sociodemographic and psychiatric variables. RESULTS: Among youth with ADHD, those with comorbid PTSD were older, had more psychiatric comorbidities, and were more likely to receive non-stimulants ( 1.54, 95% CI [1.51, 1.57]), antidepressants, antipsychotics, mood stabilizers (RRs 1.29-1.70), and psychotherapy ( 1.55, 95% CI [1.51, 1.60]). Methylphenidate prescriptions were slightly lower ( 0.97, 95% CI [0.95, 0.99]), while amphetamine use remained stable. Among youth with ADHD and PTSD, CNS stimulants were associated with the most favorable outcomes across all clinical measures, including hospitalizations, emergency visits, and subsequent antipsychotic and mood stabilizer use (aHRs 0.52-0.74), compared with non-stimulants and antidepressants. CONCLUSIONS: Youth with ADHD and PTSD are clinically complex and receive broader treatment interventions. Clinicians appear to de-prioritize stimulants after PTSD diagnosis, despite evidence of superior clinical outcomes. Findings underscore the need for prospective studies and evidence-based treatment guidelines for this high-risk population.
Younger-for-Grade Children are Not at Greater Likelihood for ADHD Diagnosis During Elementary School: Repeated Evidence of a Null Relative Age Effect.
Hu EH, Faraone SV, Morgan PL
J Atten Disord · 2026 Feb · PMID 41668340 · Publisher ↗
BACKGROUND: Prior work reports a relative age effect (RAE), in which children are more likely to be diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) if they are relatively younger than their classmates. Yet...
BACKGROUND: Prior work reports a relative age effect (RAE), in which children are more likely to be diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) if they are relatively younger than their classmates. Yet work reporting a RAE in ADHD diagnosis has analyzed relatively dated samples, has not examined moderation across sociodemographic characteristics, and has largely not examined the RAE in longitudinal analyses. We examined whether entering kindergarten as a relatively younger student increased the likelihood being diagnosed with ADHD across elementary school. We also examined moderation by race and ethnicity, biological sex, socioeconomic status, and home language. METHODS: We analyzed data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K: 2011; = 11,410), a nationally representative cohort. Logistic regression models estimated relations between children's relative age and both grade-specific and cumulative ADHD diagnoses during elementary school. Discrete-time event history logit regression models examined the timing of ADHD diagnosis from kindergarten through fifth grade. Interaction terms assessed moderation by sociodemographic characteristics. RESULTS: We generally failed to observe evidence of a RAE, either cumulatively or within specific grades. Discrete-time event models indicated no significant relations between relative age and timing of ADHD diagnosis. Moderation analyses identified isolated interactions, indicating the possibility of a specific RAE for Black children and those from non-English-speaking homes in select grades. However, these predicted effects were not consistently observed and did not survive correction for multiple comparisons. CONCLUSIONS: In contrast to prior work analyzing older datasets, we failed to observe a RAE in U.S. elementary schools. Our finding suggest that relatively younger children attending U.S. elementary schools are not at increased likelihood for ADHD diagnosis.
ROAR-Early Childhood: Pilot Testing a Brief Telemedicine Parent Training Program for Rural Children Diagnosed with ADHD.
Craig JT, Sanders MT, Moore CC … +6 more , Barnett E, Sternberg KF, Breslend NL, Vazquez LC, Sand-Loud N, Jankowski MK
J Atten Disord · 2026 Jul · PMID 41652302 · Publisher ↗
OBJECTIVE: Attention Deficit/Hyperactivity Disorder (ADHD) is a chronic and impairing neurodevelopmental disorder diagnosed in approximately 2% to 4% of preschool-age children and 9% of all children. Behavioral parent tr...
OBJECTIVE: Attention Deficit/Hyperactivity Disorder (ADHD) is a chronic and impairing neurodevelopmental disorder diagnosed in approximately 2% to 4% of preschool-age children and 9% of all children. Behavioral parent training (BPT) and high-quality education are effective treatments for young children with ADHD; however, poor rates of treatment access and participation limit the reach of BPTs to rural and underserved communities. In this study, we tested the newly developed Rural Outreach and ADHD Research-Early Childhood (ROAR-EC) program, a clinician-led, 7-session education and parent training program designed for delivery over telemedicine. METHOD: We conducted a pilot RCT to assess the feasibility, acceptability, engagement of mechanism, and exploratory group × time effects of the ROAR-EC program compared to a control group in a sample of 44 children diagnosed with ADHD from a predominantly rural area (ages 3-7; = 4.8; 62% male; 96% White; 89% non-Hispanic/Latinx). Families were randomized into either ROAR-EC or treatment as usual through developmental pediatrics and followed for 24 weeks. Assessed were metrics of feasibility, acceptability, parenting practices, caregiver empowerment, disruptive behaviors, and ADHD symptoms. RESULTS: Results indicated that ROAR-EC was feasible to implement and acceptable to caregivers. Repeated measures ANOVAs found significant group × time interaction effects in favor of the treatment group compared to control for family empowerment, parenting practices, total behavior problems, impairment, and inattentive symptoms. CONCLUSIONS: This study demonstrated the promise of brief telemedicine programs as feasible, acceptable, and likely beneficial alternatives to traditional BPTs for young children with ADHD in rural and low-resource areas.
Fielded Attention: Reframing ADHD Through a Relational Ontology of Context.
Carr BR
J Atten Disord · 2026 Jan · PMID 41609226 · Publisher ↗
BACKGROUND: Since DSM-5, ADHD has been classified as a neurodevelopmental disorder, and this placement has often reinforced dominant models that emphasize neurobiological mechanisms-treating attention as an internal trai...
BACKGROUND: Since DSM-5, ADHD has been classified as a neurodevelopmental disorder, and this placement has often reinforced dominant models that emphasize neurobiological mechanisms-treating attention as an internal trait shaped by executive dysfunction or dopaminergic imbalance. While these frameworks offer valuable insights, they often marginalize the ecological, relational, and sociomaterial contexts in which attention arises or collapses. Context is too often treated as background rather than condition. OBJECTIVE: This paper proposes a field-based reconceptualization of attention: a relational ontology in which patterns of behavior and experience gathered under the ADHD diagnosis are not solely located within the individual but emerge from dynamic tension between organism and environment. METHODS: Drawing from ecological psychology, dynamic systems theory, and phenomenological psychiatry, we develop the notion of -a model in which attention is not a fixed trait but a modulation shaped by rhythm, affordance, and environmental curvature. We conduct a conceptual analysis in three stages: (1) critique of trait-based diagnostic frameworks that statistically neutralize context; (2) elaboration of a field ontology of attention that reframes breakdowns as ruptures in relational coherence; and (3) derivation of translational implications for research and care design. RESULTS: The analysis identifies an epistemic shift in which environmental and social structures are often flattened into reductionist risk factors, and heterogeneity in ADHD symptom expression is reframed as field sensitivity-a signal of developmental plasticity rather than diagnostic noise. Translational implications include the design of learning and care environments (including architectural and temporal structure) and adoption of field-sensitive research methods such as ecological momentary assessment and spatial diaries. CONCLUSIONS: Rather than reject biological models, this framework resituates them within broader ecologies of modulation. By repositioning context as ontologically central, advances a more ethically responsive and developmentally situated account of ADHD.
Gender Differences in Cognitive Behavioral Therapy Outcomes for Adolescents With ADHD: Examining the Impact of Internalizing Symptoms.
Hanes TK, Andersen AC, Boyer BE … +1 more , Wagner K
J Atten Disord · 2026 Jul · PMID 41588643 · Publisher ↗
OBJECTIVE: This study investigates the effectiveness of Cognitive Behavioral Therapy (CBT) for adolescents with ADHD, while focusing on gender differences and comorbid internalizing symptoms. METHOD: A quantitative secon...
OBJECTIVE: This study investigates the effectiveness of Cognitive Behavioral Therapy (CBT) for adolescents with ADHD, while focusing on gender differences and comorbid internalizing symptoms. METHOD: A quantitative secondary data analysis was performed on 200 adolescents aged 12 to 18 years who participated in randomized control trials in either the Netherlands or Norway. RESULTS: Overall, CBT significantly reduced ADHD symptoms from pretest to posttest on parent measures; however, treatment response varied based on gender, internalizing symptoms, and treatment formats. Girls with elevated depression showed significantly smaller reductions in ADHD symptoms compared to boys with similar depressive profiles ( = .02), even after controlling for baseline ADHD severity. Effect size analyses revealed that girls benefited from both CBT delivery formats, but symptom improvement was nearly twice as large in individual CBT ( = 0.90, large effect) compared to group CBT ( = 0.49, moderate effect). CONCLUSION: These findings suggest that depression may impact treatment response among girls, and that individual CBT may offer enhanced benefits for adolescent girls with ADHD.
Multinutrient Supplementation in Children With ADHD Reduced Pro- and Anti-Inflammatory Immune Factors in the MADDY Randomized Controlled Trial.
Loftis JM, Ast HK, Bruton AM … +9 more , Srikanth P, Ramesh R, Erikson DW, Robinette LM, Hatsu IE, Leung BMY, Machingo TA, Arnold LE, Johnstone JM
J Atten Disord · 2026 Jun · PMID 41571599 · Full text
OBJECTIVE: While individual nutrients have shown effects on inflammatory mechanisms, the effects of multinutrients (vitamins + minerals, antioxidants, and amino acids) on inflammation are unknown. We investigated whether...
OBJECTIVE: While individual nutrients have shown effects on inflammatory mechanisms, the effects of multinutrients (vitamins + minerals, antioxidants, and amino acids) on inflammation are unknown. We investigated whether 8 weeks of multinutrient supplementation, in a randomized controlled trial of 83 children with ADHD, would alter immune factors compared to placebo. METHODS: Multiplex technology was used to measure 25 immune factors in blood samples collected at baseline and week 8. Immune factors were compared between multinutrient and placebo groups using the Mann-Whitney test. Linear mixed effects models evaluated immune factor change over time. To understand the functional relevance of the immune factors affected by multinutrient supplementation, pathway analysis was performed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) v6.7 Bioinformatics Resources. RESULTS: Interleukin (IL)-5 and IL-13 levels differed following multinutrient supplementation versus placebo ( = .005 and .03, respectively). IL-5 decreased by 1.3% in the multinutrient group (95% CI [-8.6%, 6.7%]) and increased by 17.5% in the placebo group (95% CI [6.9%, 29.2%]). IL-13 decreased by 11.4% in the multinutrient group (95% CI [-18.2%, -4.0%]), compared to a 2.4% increase in the placebo group (95% CI [-7.2%, 13.1%]). When comparing immune factors between treatment responders versus non-responders in the multinutrient group, there was a 4.3% increase in IL-15 in multinutrient responders (95% CI [-6.8%, 16.8%]) and a 14.3% decrease in non-responders ( = .03, 95% CI [-24.9%, -2.4%]). Pathway analysis identified T helper type 2 (Th2) signaling pathways affected by multinutrient supplementation, including IL-17 and cytokine-cytokine receptor interaction pathways. CONCLUSION: Th2 immune factors may be influenced by multinutrient supplementation and associated with behavioral improvements in ADHD.
Disparities in Adult ADHD Care Delivery Among U.S. Telepsychology Providers.
Rout MR, Gaddis A, Yeguez CE … +2 more , Sibley MH, Groves NB
J Atten Disord · 2026 May · PMID 41571598 · Publisher ↗
OBJECTIVE: At least a third of U.S. adults with ADHD do not access recommended treatments (medication or cognitive behavioral therapy [CBT]), and those receiving treatment face barriers (e.g., inconsistent availability o...
OBJECTIVE: At least a third of U.S. adults with ADHD do not access recommended treatments (medication or cognitive behavioral therapy [CBT]), and those receiving treatment face barriers (e.g., inconsistent availability of medication). We investigated systemic inequities in CBT access for adults with ADHD versus psychiatric diagnoses with similar prevalence. METHOD: We accessed and extracted publicly available listings from the Psychology Interjurisdictional Compact (PSYPACT) provider directory ( 12,898) in April 2025. RESULTS: Only 26.4% of PSYPACT providers explicitly offer any services for adult ADHD. They were nearly three times more likely to treat adult depression (69.2%) and anxiety (74.0%). CBT for adult ADHD was offered by just 21.3% of providers. CONCLUSION: U.S. psychologists are chief CBT providers for adult mental disorders; however, they systemically underserve adults with ADHD. Contributors to this inequity must be identified to advance adult ADHD care, as untreated ADHD is a costly public health burden.
Parent Perspectives on Barriers to Behavioral Health Services for Children With ADHD.
Taylor BJ, DiGirolamo A, Snyder A … +4 more , Smith C, Claussen AH, Hutchins HJ, Phillips Martinez A
J Atten Disord · 2026 Jan · PMID 41568706 · Full text
OBJECTIVE: The American Academy of Pediatrics (AAP) recommends behavioral therapy as first-line evidence-based treatment for young children with ADHD, and in combination with medications for children ages 6 years and old...
OBJECTIVE: The American Academy of Pediatrics (AAP) recommends behavioral therapy as first-line evidence-based treatment for young children with ADHD, and in combination with medications for children ages 6 years and older. However, a significant percentage of young children are receiving medication treatment for ADHD rather than behavioral treatment. There is limited research capturing parent experiences of barriers to implementing behavioral health services for young children with ADHD diagnoses. This paper seeks to fill this gap by exploring these perceived barriers among parents of children diagnosed with ADHD. METHOD: Parents of children with ADHD diagnoses ( = 29) were invited to participate in four focus groups to discuss their experiences with accessing treatment for their child. Focus group participants were recruited from one Southeast city through an ADHD parental support group and nationally from parents attending a conference on ADHD. RESULTS: Three themes emerged as perceived barriers that impact ADHD treatment. Parents reported barriers that can be conceptualized as (1) misconceptions and stigma; (2) availability of financial and time-related resources; and (3) treatment messaging and provider coordination. These barriers may be more pronounced for parents of young children with ADHD living in the Southeast. CONCLUSION: Parent responses about perceived barriers in this study suggest a need for better coordinated care of ADHD across places of service, providers, and families. These findings may inform future efforts to improve access to and utilization of evidence-based treatments for ADHD in the Southeast and nationwide.
Medication Adherence in Children and Adults Receiving Treatment for Attention Deficit Hyperactivity Disorder (ADHD) in Sweden: A Nationwide Study.
Giacobini M, Zhao J, Freilich J … +3 more , Brünner C, Wallin Bernhardsson N, Ahnemark E
J Atten Disord · 2026 May · PMID 41562322 · Full text
OBJECTIVE: To estimate the adherence of children and adults to oral stimulant ADHD treatments in Sweden during the period 2015 to 2020. METHODS: This retrospective, nationwide, register-based study evaluated all patients...
OBJECTIVE: To estimate the adherence of children and adults to oral stimulant ADHD treatments in Sweden during the period 2015 to 2020. METHODS: This retrospective, nationwide, register-based study evaluated all patients who were dispensed oral formulation stimulants (Anatomical Therapeutic Chemical [ATC] codes: N06BA01, N06BA02, N06BA04, N06BA12) identified in the Swedish Prescribed Drug Register. Treatment episodes were constructed based on drug dispensation data, and treatment adherence was calculated for each treatment episode using a Proportion of Days Covered approach with a modified one-pill-a-day method. RESULTS: Between 2015 and 2020, 158,413 treatment episodes were recorded in 128,366 patients, corresponding to a median 1.23 treatment episodes per patient. The majority of treatment episodes involved methylphenidate (64.0%), followed by lisdexamfetamine (32.2%), dexamfetamine (3.0%), and amphetamine (0.8%). Overall treatment adherence was high (78.2%), and was similar for patients receiving methylphenidate, lisdexamfetamine, and dexamfetamine. The proportion of patients with ≥80% medication adherence was high (69.3%-71.8%) for adults aged ≥25 years, but was low for adolescents aged 12 to 17 years (49.7%-52.4%). CONCLUSIONS: The overall rates of treatment adherence are high for children and adults receiving ADHD medication in Sweden. We observed lower adherence among adolescents, which warrants further study.
What Are You Waiting For?! Roles of Motivation, Goal Orientation, and Emotion Regulation in Explaining the Link Between ADHD and Procrastination.
Netzer Turgeman R, Pollak Y
J Atten Disord · 2026 May · PMID 41549051 · Full text
OBJECTIVE: This study aims to investigate the complex relation between adult ADHD symptoms, procrastination, and mediating factors, in light of leading procrastination theories: the Temporal Motivation Theory (TMT), emot...
OBJECTIVE: This study aims to investigate the complex relation between adult ADHD symptoms, procrastination, and mediating factors, in light of leading procrastination theories: the Temporal Motivation Theory (TMT), emotion regulation, and a General Architecture for Modeling the Dynamics of Goal-Directed Motivation and Decision-Making - the GOAL architecture. METHOD: The study was preregistered. A survey was conducted with 640 adults recruited online to examine the associations between ADHD symptoms, procrastination, and seven mediating factors. Participants completed measures assessing ADHD symptoms, procrastination tendencies, emotion regulation, motivation, and goal-related behaviors. Structural equation modeling (SEM) was used to test the direct and indirect pathways among the variables. RESULTS: A positive association was revealed between ADHD inattention symptoms and procrastination tendencies. The mediating factors that significantly contributed to this relations were sensitivity to delay, perceived low value of the task, and flexible goal adjustment. While ADHD inattention symptoms was associated with all seven variables, three variables directly contributed to increased procrastination behavior, thus explaining the link between inattention symptoms and procrastination. CONCLUSIONS: The study highlights the relations between procrastination and adult ADHD symptoms and underscores the need to address mediating factors in intervention strategies. Understanding these mechanisms is essential for developing targeted interventions to improve functional outcomes for individuals with ADHD.
Social Skills and Emotion Recognition in Children With Elevated Cognitive Disengagement Syndrome Symptoms: A Comparative Study With Children Diagnosed With ADHD and Typically Developing Peers.
Kaçmaz U, Cevher Binici N, Ercan ES … +2 more , Durak FS, Tufan AE
J Atten Disord · 2026 Aug · PMID 41504022 · Publisher ↗
OBJECTIVE: Cognitive Disengagement Syndrome (CDS) is increasingly viewed as a distinct childhood condition. Although it overlaps with ADHD in some features, emerging evidence suggests a unique behavioral and cognitive pr...
OBJECTIVE: Cognitive Disengagement Syndrome (CDS) is increasingly viewed as a distinct childhood condition. Although it overlaps with ADHD in some features, emerging evidence suggests a unique behavioral and cognitive profile. However, research examining social functioning and emotion recognition in children with pure CDS remains limited. METHODS: This study compared social competence and facial emotion recognition abilities among children aged 8 to 12 years across three groups: those with elevated CDS symptoms (n = 43), those with ADHD (n = 40), and healthy controls (n = 43). Social functioning and peer relationships were evaluated using parent- and child-report social skills scales and peer interaction questionnaires. Emotion recognition was measured with the Reading the Mind in the Eyes Test (RMET). RESULTS: Children with CDS showed significantly lower social skills and RMET scores than both ADHD and control groups (p < .001). Teachers reported fewer school friendships for the CDS group compared to ADHD and controls (p < .001), and CDS children also reported fewer out-of-school friendships than peers in the other groups (p = .035). Both child and teacher reports noted greater peer relationship difficulties in the CDS group compared to the other groups (p < .001). Teachers also observed more solitary behavior and lower group participation among CDS children (p < .001). Within the CDS group, social skills were negatively associated with oppositionality (r = -.347) and positively associated with inattention severity (r = .346). Regression analysis identified social skills scores as independent predictors of peer relationships across the full sample (p < .001). CONCLUSION: These findings suggest that children with elevated CDS symptoms experience greater social difficulties and more pronounced emotion recognition impairments than both ADHD and typically developing peers, reflecting a distinct social-cognitive profile that extends beyond overlapping ADHD symptoms. The results underscore the importance of early recognition and targeted interventions.
Parental Stress and Child Irritability in ADHD: A Two-Wave Longitudinal Serial Mediation Model via Experiential Avoidance and Negative Parent-Child Relationship.
Aral A, Gerdan G, Gürlük YO
J Atten Disord · 2026 Mar · PMID 41496615 · Publisher ↗
ADHD is complex neurodevelopmental disorder that causes considerable individual and social difficulties, creating significant parental stress. This study aimed to examine the indirect associations between parental stress...
ADHD is complex neurodevelopmental disorder that causes considerable individual and social difficulties, creating significant parental stress. This study aimed to examine the indirect associations between parental stress and child irritability through two sequential parenting mechanisms: experiential avoidance and negative parent-child relationship, within a sample of school-aged children with ADHD (ages 6-12). Using a two-wave longitudinal serial path analysis based on parent-reported data collected at two time points 1-month apart (Time 1 and Time 2), the study investigated whether early parental stress predicted subsequent child irritability via its influence on experiential avoidance and the quality of the parent-child relationship. Findings supported the hypothesized model. More precisely, higher parental stress was associated with greater experiential avoidance, which in turn predicted more negative parent-child relationship, ultimately resulting in elevated child irritability. Longitudinal serial mediation effects confirmed that all Time 1 variables significantly predicted corresponding Time 2 outcomes across the proposed sequential pathway. Notably, the model explained 41.1% of the variance in child irritability at Time 2, underscoring how stress-related disruptions in experiential avoidance and parent-child relationship can affect child irritability even over a short period of time. Taken together, these findings provide empirical support for a stress-driven sequence of parental mechanisms through which parental stress may contribute to child irritability in ADHD. In this context, interventions targeting parental experiential avoidance and improving the quality of parent-child relationship may help mitigate the early development of irritability in children with ADHD. Clinical implications are discussed.
Increased Serum Netrin-1 Levels Among Children Diagnosed With ADHD.
Öztürk HH, Sezen S, Çağlar E … +2 more , Elgün Ülkar S, Açıkel SB
J Atten Disord · 2026 Jun · PMID 41482947 · Publisher ↗
OBJECTIVE: ADHD is a common neurodevelopmental disorder of childhood characterized by altered projections of dopaminergic neurons and connectivity issues in various brain regions. In our study, we aim to investigate the...
OBJECTIVE: ADHD is a common neurodevelopmental disorder of childhood characterized by altered projections of dopaminergic neurons and connectivity issues in various brain regions. In our study, we aim to investigate the potential effects of axon guidance molecules, Netrin-1 and Semaphorins 3A, 4D, and 7A, on these connectivity problems by examining the levels of these molecules in the peripheral blood of children with ADHD compared to healthy controls. METHODS: A total of 43 children with ADHD and 40 healthy controls 6 to 12 years of age were included in the study. The K-SADS-PL was administered to exclude any additional psychopathologies (excluding ODD in the ADHD group). The Revised Child Anxiety and Depression Scale was provided to the children, while parents completed the revised Conners' Parent Rating Scale (CPRS-R), the Social Responsiveness Scale (SRS), and the Behavior Rating Inventory for Executive Functioning (BRIEF). Additionally, teachers of the ADHD group were given the Conners' Teacher Rating Scale. Furthermore, the WISC-4 was administered to assess the IQ profile of 35 children in the ADHD group. RESULTS: Netrin-1 was found to be statistically higher in the ADHD group. When the R-CADS scores were recalculated taking the covariate into account, the significant increase in the ADHD group remained. There was no statistically significant difference between the two groups for semaphorin 3A, 4D, and 7A. The positive correlation of Netrin-1 with the hyperactivity subscores on the CPRS-R and the Global Executive Score on the BRIEF scale is noteworthy. CONCLUSION: Netrin-1 may play a role in the etiopathogenesis of ADHD. Further studies are needed to clarify the relationship between Netrin-1 and ADHD.
Preventing Prescription Stimulant Diversion and Misuse via a Web-Based Intervention: A Randomized Controlled Trial.
Holt LJ, Looby A, Feinn R … +1 more , Schepis TS
J Atten Disord · 2026 Feb · PMID 41467299 · Full text
Prescription stimulant diversion (i.e., giving, selling, or trading one's medication) and non-medical prescription stimulant use (i.e., using in ways not prescribed) are common among undergraduates; however, few evidence...
Prescription stimulant diversion (i.e., giving, selling, or trading one's medication) and non-medical prescription stimulant use (i.e., using in ways not prescribed) are common among undergraduates; however, few evidence-based interventions target these behaviors. This study evaluated the efficacy and feasibility of a 30-min, interactive web-based intervention providing psychoeducation around diversion and non-medical use, practice refusing medication requests, and medication adherence strategies. Students ( = 20.42 years; 74% female; 86% White) with current stimulant prescriptions from three US universities were randomized to the intervention ( = 128) or attention-matched placebo ( = 121) in a single-blind design, with 1- and 2-month boosters and 3- and 6-month follow-ups. Primary outcomes were diversion, non-medical use, and diversion intentions; secondary outcomes were perceived norms, perceived risk, self-efficacy to resist diversion and non-medical use, and prescriber communication. Contrary to pre-registered hypotheses, intervention participants did not report decreases in primary outcomes. There were small-to-medium effects on secondary outcomes of risk perceptions ( = 0.39 [0.12, 0.68]), perceived non-medical use norms ( = 0.51 [0.24, 0.76]), and self-efficacy to avoid non-medical use ( = 0.47 [0.10, 0.85]), but not on perceived diversion norms, self-efficacy to avoid diversion, and prescriber communication. Post-hoc analyses showed a 76% reduction in odds of diversion ( = 0.24 [0.08, 0.68]) and a 60% reduction of non-medical use ( = 0.40 [0.21, 0.77]) for intervention participants during the 6-month follow-up period. This intervention was acceptable and feasible to implement and evidenced some efficacy in modifying risk perceptions, self-efficacy, and perceived norms. Since diversion and misuse episodes were not reduced, future intervention refinements may tailor content to different levels of diversion and misuse risk. Registered in ClinicalTrials.gov on May 12, 2021: NCT04885166.
Changes in ADHD Symptoms and Mood Across the Menstrual Cycle in Females Treated With Stimulants: A Pilot Study.
Zaritsky R, Reed SC, Evans SM
J Atten Disord · 2026 Mar · PMID 41451846 · Publisher ↗
OBJECTIVE: Females represent a growing proportion of adults with ADHD yet remain understudied in the literature compared to males. An important aspect of the experience of females with ADHD is the impact of the menstrual...
OBJECTIVE: Females represent a growing proportion of adults with ADHD yet remain understudied in the literature compared to males. An important aspect of the experience of females with ADHD is the impact of the menstrual cycle and ovarian hormones on both the symptoms of ADHD and effects of stimulant medications on treating these symptoms. METHOD: In the present pilot study, female participants being treated with amphetamine salts for ADHD ( = 30) were recruited to complete 35 daily online surveys to track ADHD symptoms, mood, and medication use through the menstrual cycle. RESULTS: Results indicated that the degree of ADHD symptoms was significantly associated with menstrual cycle phase with ADHD symptoms being most severe in the menstruation phase and comparatively milder ADHD symptoms in the mid-follicular phase. This difference was positively correlated with subjective changes in negative mood. CONCLUSION: These results indicate that ADHD symptoms vary across the menstrual cycle among females being treated with amphetamine salts for their ADHD, a finding that could inform clinical and prescribing practices for physicians caring for females with ADHD.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe