J Atten Disord [JOURNAL]
Sun
200 papers
Neural Oscillation Features of ADHD Symptoms in Children: EEG Evidence From Resting State and Oddball Task.
Zhang S, Yu S, Cui X … +2 more , Liang L, Li X
J Atten Disord · 2026 Apr · PMID 41414780 · Publisher ↗
OBJECTIVE: The aim of this study was to explore neural oscillation features (resting-state + oddball-EROs) of ADHD symptoms in children in a dimensional approach and to construct a multi-metric model combining objective...
OBJECTIVE: The aim of this study was to explore neural oscillation features (resting-state + oddball-EROs) of ADHD symptoms in children in a dimensional approach and to construct a multi-metric model combining objective EEG measures and subjective parental ratings to predict children's behavioral performance. METHOD: Seventy-seven children (age range: 6-12 years) participated in laboratory assessment. ADHD symptoms were first evaluated using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), followed by EEG recordings during both resting-state and oddball task conditions. Three parent rating scales were also used to evaluate children's behavioral performance: the ADHD Rating Scale-IV (ADHD RS-IV): Home Version, the Child Behavior Checklist (CBCL), and the Conners' Parent Rating Scales (CPRS). RESULTS: Seventy-one children with valid IVA-CPT results were included in data analysis. The main results revealed a relationship between poorer attention performance and decreased eye-open alpha1 power in the resting state, reduced N2 delta power in the oddball condition, and elevated non-delta band power in the standard condition of the oddball task. Poorer response control performance was associated with increased eye-closed alpha1 power, as well as increased eye-open alpha2 and beta2 power. Stepwise regression analysis showed that the inattention subscale from parental assessments on the RS-IV, combined with P3 alpha power in the standard condition of the oddball task, was the strongest predictor of children's attention performance. CONCLUSION: The current study identified important neural oscillation features of ADHD symptoms in both the resting state and during an oddball task and offers new insights into multi-metric prediction for ADHD assessment and diagnosis.
Co-occurrence Patterns of ADHD Symptoms and Reactive and Proactive Aggression in Chinese Adolescents: Associations With Parenting Practices.
Yang Z, Luo Y, Chen F … +3 more , Luo R, Pu Q, Wang Y
J Atten Disord · 2026 Apr · PMID 41403111 · Publisher ↗
OBJECTIVE: Previous studies have found that ADHD symptoms often co-occur with aggressive behavior in adolescents, and that reactive aggression is more closely related to ADHD symptoms than proactive aggression. However,...
OBJECTIVE: Previous studies have found that ADHD symptoms often co-occur with aggressive behavior in adolescents, and that reactive aggression is more closely related to ADHD symptoms than proactive aggression. However, the specific co-occurrence patterns of ADHD symptoms and different functions of aggression remain unclear, as does their relationship with parenting practices. This study used a person-centered approach to examine the co-occurrence patterns of ADHD symptoms, reactive aggression, and proactive aggression and their associations with parenting practices. METHOD: A total of 1,152 mother-adolescent dyads participated in this study (adolescents: = 14.29; 48.0% girls). Latent profile analysis was conducted to identify adolescent profiles of ADHD, reactive, and proactive aggression, followed by multinomial logistic regression to examine relationships between these profiles and auxiliary variables. RESULTS: Latent profile analysis identified three patterns of adolescent- and mother-reported ADHD symptoms, reactive aggression, and proactive aggression: (84.4%), (10.0%), and (5.6%). Multinomial logistic regression revealed that adolescents in the complete co-occurrence group had higher rates of corporal punishment, while adolescents in the reactive co-occurrence group exhibited higher rates of verbal hostility. CONCLUSION: These findings highlight the importance of distinguishing between reactive and proactive aggression in the context of ADHD and suggest that different co-occurrence patterns may be shaped by distinct parenting practices. Addressing specific parenting behaviors could help mitigate aggression in adolescents with ADHD symptoms.
Mind-Wandering in Adolescents With ADHD: A Comparative Study.
Ogata H, Nakane E, Kondo C … +2 more , Saima S, Ihara H
J Atten Disord · 2026 Apr · PMID 41403110 · Publisher ↗
OBJECTIVE: Mind-wandering is a common cognitive experience that may be particularly salient in adolescents with attention-deficit/hyperactivity disorder (ADHD). This study aimed to investigate the characteristics and cli...
OBJECTIVE: Mind-wandering is a common cognitive experience that may be particularly salient in adolescents with attention-deficit/hyperactivity disorder (ADHD). This study aimed to investigate the characteristics and clinical relevance of mind-wandering in this population. METHOD: We retrospectively analyzed data from 440 psychiatric outpatients aged 10-19 years (ADHD: n = 137; non-ADHD: n = 303) who visited a university hospital between 2023 and 2025. Mind-wandering was assessed using the Mind-Wandering Questionnaire (MWQ). Group differences in MWQ scores were examined using analysis of covariance, controlling for age, sex, Autism-Spectrum Quotient, and Quick Inventory of Depressive Symptomatology. Additional analyses compared ADHD-only with ADHD plus autism spectrum disorder (ASD) comorbidity, and hierarchical regression was conducted to determine the independent contribution of ADHD to mind-wandering. RESULTS: Adolescents with ADHD reported significantly higher MWQ scores than those without ADHD ( < .001, Cohen's = 0.92), and this difference remained significant after covariate adjustment (η² = 0.098). No significant difference was observed between the ADHD-only and ADHD + ASD groups ( = .737). Hierarchical regression confirmed that ADHD independently predicted mind-wandering scores (β = 0.320, < .001). CONCLUSION: Adolescents with ADHD exhibit elevated mind-wandering, which may represent a core attentional characteristic independent of comorbidities or demographic factors. Further research is needed to clarify the mechanisms underlying mind-wandering in ADHD and to evaluate potential interventions aimed at reducing its impact.
Impaired Exogenous Attentional Orienting to Gaze Cues in Children With ADHD: Evidence From Inhibition of Return.
Wang J, Wang A, Gu J … +2 more , Cai S, Zhang M
J Atten Disord · 2026 Apr · PMID 41403109 · Publisher ↗
OBJECTIVE: To examine whether children with attention-deficit/hyperactivity disorder (ADHD) can produce attentional orienting in response to gaze cues, and to identify which type of attentional orienting is impaired and...
OBJECTIVE: To examine whether children with attention-deficit/hyperactivity disorder (ADHD) can produce attentional orienting in response to gaze cues, and to identify which type of attentional orienting is impaired and why. METHOD: Two experiments employed a gaze cue-target paradigm using inhibition of return (IOR) as an indicator of exogenous attentional orienting. Experiment 1 used normal upright gaze faces as cues. Experiment 2 used inverted gaze faces as cues. RESULTS: When normal gaze faces were used as the gaze cue, no IOR effect was observed in children with ADHD (Experiment 1); whereas when inverted gaze faces were used as the gaze cue, the IOR effect was produced in children with ADHD (Experiment 2). CONCLUSION: These results indicated that the ability to produce exogenous attentional orienting to the gaze cue is impaired in children with ADHD and that this impairment resulted from their reduced ability to exogenously orient to the intact face. These findings provide new evidence of social cognitive deficits and attentional orienting deficits in children with ADHD, and help provide support for children in educational settings.
Effects of Exercise on Hyperactivity/Impulsivity and Inhibitory Control at Behavioral and Electrophysiological Levels in ADHD: A Systematic Review and Meta-Analysis.
Zhang Z, Bo X, Liu K … +3 more , Su J, Zhu Y, Yang S
J Atten Disord · 2026 May · PMID 41403099 · Publisher ↗
OBJECTIVE: This study aimed to assess the impact of exercise on hyperactivity/impulsivity, inhibitory control, and inhibition-related event-related potential (ERP) components in individuals with ADHD. METHOD: A systemati...
OBJECTIVE: This study aimed to assess the impact of exercise on hyperactivity/impulsivity, inhibitory control, and inhibition-related event-related potential (ERP) components in individuals with ADHD. METHOD: A systematic search identified relevant studies, and methodological quality was assessed using the Revised Cochrane Risk-of-Bias tool for randomized trials (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), with data analysis conducted using Stata software. RESULTS: A total of 36 studies (38 comparisons) were included, comprising 10 acute and 26 chronic exercise interventions. Exercise yielded a small-to-moderate improvement in inhibitory control but showed no significant effects on hyperactivity/impulsivity or inhibition-related N2 and P3 components. Subgroup analyses of inhibitory control revealed significant moderating effects of age (children/adolescents), intervention type (chronic interventions), frequency (three sessions per week), control condition (sedentary or no-intervention groups), and study quality (studies with moderate or high risk of bias). CONCLUSION: Exercise enhances inhibitory control in individuals with ADHD, with the effect being especially pronounced in children and adolescents. Chronic interventions and a frequency of three sessions per week appear to be most beneficial. However, it shows no significant effect on hyperactivity/impulsivity or inhibition-related N2 and P3 components. The impact of exercising should not be overestimated.
Inattention and Hyperactivity Symptom Dimensions of ADHD Differentially Moderate the Relationship Between Concurrent Attention States and Affective Valence.
Ain Y, Rai S, Galbraith A … +4 more , Buerkner J, Andrews-Hanna JR, Callahan BL, Kam JWY
J Atten Disord · 2026 Feb · PMID 41400041 · Full text
BACKGROUND: ADHD has been characterised by excessive mind wandering (MW), or thoughts unrelated to the task at hand, with recent findings indicating that ADHD is specifically associated with more unintentional, but not i...
BACKGROUND: ADHD has been characterised by excessive mind wandering (MW), or thoughts unrelated to the task at hand, with recent findings indicating that ADHD is specifically associated with more unintentional, but not intentional, MW. These two types of MW are also differentially associated with affective well-being. Most existing studies in ADHD, however, mainly rely on retrospective reports of MW tendencies, which are susceptible to memory-related errors and biases. Further, most studies categorise participants based on overall levels of ADHD, instead of accounting for the spectrum and dimensional heterogeneity of ADHD, including inattention and hyperactivity symptom dimensions. Our study aimed to address the knowledge gap regarding the relationship between different types of MW and affective well-being, across different symptom dimensions of ADHD. METHODS: We used ecological momentary assessment to capture participants' momentary attention state (on-task, intentional MW, or unintentional MW) and affective valence, six times daily for 7 days. Using linear mixed-effects modelling to account for inter-individual variance, we tested whether inattention and hyperactivity symptom dimensions of ADHD differentially moderate the relationship between attention states and affective valence. RESULTS: We found that higher levels of inattention symptoms predicted more negative affect during intentional MW compared to on-task attention; in contrast, higher levels of hyperactivity symptoms predicted more positive affect during intentional MW compared to on-task attention. DISCUSSION: Together, our results indicate that intentional MW moderates opposing effects of inattention and hyperactivity ADHD symptoms on affective valence. Our findings suggest that intentional MW - and not just unintentional MW - may also play a role in affective or behavioural outcomes associated with ADHD symptomatology, and highlight the importance of considering the heterogeneity of ADHD symptomatology, as well as the distinction between intentional and unintentional MW, in future ADHD research.
Prescription Stimulant Continuation in Pregnancy and Birth Outcomes.
Hasan SA, Murugappan M, Westberg S … +4 more , Contag SA, Melnik T, Rajpurohit A, Farley JF
J Atten Disord · 2026 Mar · PMID 41400021 · Publisher ↗
OBJECTIVE: Although studies examining utero exposure to prescription stimulants have suggested an association with maternal and fetal adverse events, results have been inconsistent. Therefore, clinicians may not have cle...
OBJECTIVE: Although studies examining utero exposure to prescription stimulants have suggested an association with maternal and fetal adverse events, results have been inconsistent. Therefore, clinicians may not have clear guidance about stimulant use during pregnancy. The objective of this study was to evaluate maternal and fetal risks of prescription stimulant exposure among women of reproductive age throughout the continuum of pregnancy in a large, commercially insured United States population. METHODS: We used a large administrative claims database from 2013 to 2021 to compare stimulant exposed pregnancies to a matched cohort of non-exposed pregnancies. Stimulant exposed pregnancies included early stimulant use, defined as one or more stimulant prescription fills at any point during the first trimester and continued exposure, defined as continuation into the second or third trimesters. Relative risk regression models were used to compare the risk of each outcome between exposure and duration of exposure cohorts matched on clinical conditions and medication used by 1:1 greedy neighbor propensity score matching. RESULTS: Among a sample of 10,265 matched patients, early stimulant exposure (first trimester only) was associated with a higher likelihood of live birth (RR = 1.08, 95% CI [1.06, 1.10]) and lower risks of spontaneous abortion (RR = 0.69, 95% CI [0.64, 0.76]) and preterm birth (RR = 0.75, 95% CI [0.62, 0.90]) compared with no stimulant exposure. Stillbirth and ectopic pregnancy did not differ. When exposure continued into the second or third trimesters, risks increased for placental abruption (RR = 1.63, 95% CI [1.03, 2.57]), pre-eclampsia (RR = 1.42, 95% CI [1.19, 1.69]), gestational hypertension (RR = 1.37, 95% CI [1.16, 1.61]), and preterm birth (RR = 1.34, 95% CI [1.12, 1.62]) compared with non-exposed pregnancies. Stillbirth was not significantly different in this comparison (RR = 1.42, 95% CI [0.76, 2.67]). Direct comparison of continued versus early exposure highlighted more pronounced risks with continuation: higher stillbirth (RR = 3.54, 95% CI [1.48, 8.44]), spontaneous abortion (RR = 1.53, 95% CI [1.38, 1.68]), preterm birth (RR = 1.86, 95% CI [1.51, 2.28]), placental abruption (RR = 1.78, 95% CI [1.11, 2.84]), and pre-eclampsia (RR = 1.33, 95% CI [1.12, 1.59]). Small-for-gestational-age infants were also more frequent in the continuation group (RR = 1.47, 95% CI [1.12, 1.92]). Analyses stratified by stimulant class (amphetamine vs methylphenidate containing) were directionally consistent with the overall findings. CONCLUSIONS: Although early stimulant exposure was not associated with increases in maternal or fetal risk, our study suggests that continuation of stimulants into trimesters 2 and/or 3 may increase some pregnancy complications including stillbirth, preterm birth, hypertensive disorders of pregnancy, and placental abruption. Clinicians should consider these risks when making the decision to continue stimulants during pregnancy, especially in treating ADHD.
Investigation of Tight Junction Protein Alterations in ADHD: The Role of Claudin-5, β-Catenin and Paxillin.
Uzun N, Bilgiç A, Ferahkaya H … +3 more , Taş MB, Kılınç İ, Kılıç AO
J Atten Disord · 2026 Jun · PMID 41358568 · Full text
OBJECTIVE: Blood-brain barrier permeability (BBB) has been suggested to be involved in the etiopathogenesis of ADHD. Claudin-5, β-catenin and paxillin are important molecules with different roles in this barrier. Alterat...
OBJECTIVE: Blood-brain barrier permeability (BBB) has been suggested to be involved in the etiopathogenesis of ADHD. Claudin-5, β-catenin and paxillin are important molecules with different roles in this barrier. Alterations in these molecules may disrupt the neurodevelopmental process by affecting various critical processes in the developing brain. Therefore, this study aimed to evaluate whether the peripheral levels of these molecules differ in children and adolescents with ADHD. METHOD: A total of 90 patients with ADHD aged between 8 and 18 years and 60 healthy controls were included in this study. The severity of ADHD symptoms was determined with the Atilla Turgay Scale. Child Anxiety-Depression Scale-Revised was completed to evaluate additional psychiatric problems of the patients. Serum levels of biochemical parameters were measured using enzyme-linked immunosorbent assay kits. RESULTS: Serum claudin-5 levels were significantly lower and β-catenin levels were significantly higher in the ADHD group compared to the control group. However, there was no significant difference in paxillin serum levels between the groups. CONCLUSION: This study suggests that claudin-5 and beta-catenin may play a role in the pathogenesis of ADHD. These proteins may affect the brain by causing a dysregulation in BBB permeability or through other mechanisms.
Self-Reported ADHD Symptoms and Cognitive Performance in a National Sample of US Older Adults.
Mansoor M, Breaux R, Lee TH … +1 more , Katz B
J Atten Disord · 2026 May · PMID 41334628 · Publisher ↗
OBJECTIVE: Although inattention symptoms have been previously linked to cognitive performance in younger samples, few studies have examined links between ADHD symptoms and cognitive performance for middle aged and older...
OBJECTIVE: Although inattention symptoms have been previously linked to cognitive performance in younger samples, few studies have examined links between ADHD symptoms and cognitive performance for middle aged and older adults. METHODS: In this study, we drew from a nationally representative sample from the Health and Retirement Study (HRS) of ~1,400 middle to older adults ( = 66.9, = 8.4; 41.4% male; 60.7% White) who completed a set of cognitive measures and an ADHD symptomatology questionnaire in the 2016 Wave of the HRS. A multigroup path model was run by examining the association between self-reported ADHD symptom subscale scores for inattention and hyperactivity/impulsivity as well as self-reported depressive symptoms and cognitive outcomes across three groups: middle age, young-old, and middle-old. RESULTS: Inattention symptoms were significantly associated with Serial 7s and Immediate Recall, however the constrained model was the best fitting model, suggesting no differences in the associations between self-reported inattention symptoms and cognitive outcomes by age. CONCLUSION: These results are consistent with previous work on the links between ADHD symptoms and cognitive performance in younger populations and add to the literature on ADHD in later life. This may have implications for clinicians and practitioners as well as future research on older adults with ADHD.
Working Memory Load and Inhibition Performance Among Children With ADHD.
Orhan I, Paralik I
J Atten Disord · 2026 Apr · PMID 41321064 · Publisher ↗
OBJECTIVE: Inhibition is a critical executive function for stopping routine responses and facilitating planned behaviour. Although the results are mixed, individuals with ADHD are reported to have poorer inhibition perfo...
OBJECTIVE: Inhibition is a critical executive function for stopping routine responses and facilitating planned behaviour. Although the results are mixed, individuals with ADHD are reported to have poorer inhibition performance; however, this remains a subject of ongoing debate. Findings in the literature suggest that the central executive component of working memory and resource allocation could play a role. The present study investigated whether varying maintenance demands would influence inhibition performance among children with and without ADHD. MATERIALS AND METHODS: The study sample comprised 80 children aged between 7 and 11 years (60 males and 20 females; = 9.01). For the first time in the literature, participants completed a Go/no-go Task with four levels of gradually increased working memory load. The data was analysed using mixed repeated measures ANOVA. RESULTS AND CONCLUSION: A significant main effect of group, load and interaction were obtained. There was no significant difference in inhibition performance between the two groups when there was no working memory load. However, in the presence of a load, the ADHD group consistently scored lower across all load conditions. Their inhibition performance declined as the load increased. Under the heaviest load condition, the ADHD group obtained the worst scores, whereas the control group's performance improved. In conclusion, introducing a working memory load has a large negative impact on the inhibition performance of the ADHD group but not the control group. These results suggest that children with ADHD struggle to allocate enough resources to meet the increased task demand for optimal inhibition performance.
How Does Adult Temperament Relate to ADHD Symptom Domains? Testing the Dual-Pathway Model.
Teuchert C, Kerner Auch Koerner J, Daseking M … +1 more , Heinze H
J Atten Disord · 2026 Mar · PMID 41316947 · Full text
OBJECT: Temperament provides a valuable framework for understanding ADHD across the lifespan, as extreme temperamental traits are considered etiological risk factors. The dual-pathway model links specific temperamental t...
OBJECT: Temperament provides a valuable framework for understanding ADHD across the lifespan, as extreme temperamental traits are considered etiological risk factors. The dual-pathway model links specific temperamental traits to ADHD symptom domains: elevated reactive traits, surgency and negative affect, to hyperactivity/impulsivity, and a low regulatory trait, effortful control, to inattention. METHOD: One hundred fifty-eight adults (79 with clinical diagnoses of ADHD and 79 controls) filled in the Adult Temperament Questionnaire. Consistent with a compensatory extension of the dual-pathway model, it was hypothesized that effortful control would moderate the effects of reactive traits (surgency/negative affect) on hyperactive/impulsive symptoms and influence both ADHD symptom domains. For exploratory purposes, orienting sensitivity, an adult temperament factor related to perceptual sensitivity, was included in the analyses. RESULTS: Binary logistic regression identified lower effortful control as the strongest predictor of an ADHD diagnosis. Negative affect had a significant but small effect, while surgency and orienting sensitivity were non-significant. Two hierarchical regressions were performed for self-rated symptoms of hyperactivity/impulsivity and inattention. Consistent with a compensatory model, effortful control was significantly related to symptom expression in both ADHD symptom domains. Contrary to expectations, surgency did not explain variance in hyperactivity/impulsivity, and the effect of negative affect was strongly reduced, after effortful control was added to the model. Effortful control did not moderate the effects of surgency and negative affect. CONCLUSION: These findings challenge the dual-pathway model and highlight self-regulation deficits over reactive traits in sustaining ADHD in adulthood. They underscore the value of temperament-based approaches for refining diagnosis and developing targeted interventions for adult ADHD.
ADHD Knowledge as a Barrier to Problem Recognition in Asian American and Native Hawaiian/Pacific Islander Versus White College Students.
Goh PK, Chung S, Jhawar N … +4 more , Wong AWWA, Mellor GS, Banerjee M, Hartung CM
J Atten Disord · 2026 Feb · PMID 41315907 · Publisher ↗
OBJECTIVE: The Asian American and Native Hawaiian/Pacific Islander (AA & NH/PI) population represents one of the fastest-growing racial /ethnic groups in the United States, yet members of this community are among the lea...
OBJECTIVE: The Asian American and Native Hawaiian/Pacific Islander (AA & NH/PI) population represents one of the fastest-growing racial /ethnic groups in the United States, yet members of this community are among the least likely to receive services for ADHD. Studies seeking to explain discrepancies between the need for and use of ADHD services in AA & NH/PI populations have highlighted decreased problem recognition as precluding access to services. We sought to investigate the roles of three previously proposed factors (i.e., perceived impairment, ADHD knowledge, and ADHD stigma) in explaining differences in ADHD problem recognition in AA & NH/PI versus White, Black, Hispanic/Latinx, and Multiracial/Multiethnic college students. METHOD: Participants were 1,451 college students aged 18 to 29 years ( = 19.3, = 1.64) who met self-reported symptom and impairment criteria for ADHD. They completed questionnaires assessing ADHD problem recognition, perceived impairment, ADHD knowledge, and ADHD stigma. RESULTS: Compared to the White Group, the AA & NH/PI Group had significantly lower probability of endorsing the belief that they should be diagnosed with ADHD. The AA & NH/PI Group also reported lower levels of ADHD knowledge and increased levels of ADHD stigma and perceived impairment compared to the White Group. Increased ADHD knowledge was associated with greater likelihood of ADHD problem recognition. Examination of indirect effects suggested that differences in ADHD problem recognition between AA & NH/PI and White Groups were partially explained by differences in ADHD knowledge. CONCLUSION: Results highlighted the importance of clarifying mechanisms underlying ADHD-related service-use patterns in AA & NH/PI populations to better understand and address mental health needs.
Does Delivery Mode Matter? A Randomised Controlled Trial of the Sleeping Sound Intervention: Predicting Sleep Outcomes in Children With ADHD.
Malkani MK, Sheridan AMC, Crichton AJ … +2 more , Bucks RS, Pestell CF
J Atten Disord · 2026 Jul · PMID 41292355 · Full text
OBJECTIVE: The effectiveness of behavioural interventions to improve sleep in children with ADHD has been demonstrated, although most treatments are conducted in-person, with limited evidence for paediatric telehealth ap...
OBJECTIVE: The effectiveness of behavioural interventions to improve sleep in children with ADHD has been demonstrated, although most treatments are conducted in-person, with limited evidence for paediatric telehealth approaches. Study 1 is a randomised controlled trial evaluating the ADHD Sleeping Sound intervention to compare outcomes between in-person and telehealth modalities. Study 2 examined whether baseline sleep problems and treatment response were predicted by baseline symptom presentation, attachment security, and family functioning. METHOD: Children aged 5 to 12 years (65.4% male) with ADHD received either in-person ( = 40) or telehealth ( = 38) treatment. Subjective (Children's Sleep Habits Questionnaire) and objective (actigraphy) sleep variables were assessed at baseline, post-intervention (1 week), and follow-up (3 months). RESULTS: As expected, subjectively measured sleep disturbance significantly improved post-treatment, with no significant difference in rate of change between in-person and telehealth modalities. For Study 2, baseline measures comprised the Conners CBRS, Attachment Insecurity Screening Inventory, Security Scale, and Family Assessment Device. Latent growth curve modelling analysed data via intention-to-treat (primary) and per protocol (secondary) methods. Higher attachment insecurity and lower family functioning were significantly associated with greater (subjective) baseline sleep problems. Additionally, attachment security predicted changes in sleep duration over time, highlighting the importance of considering relational family factors when designing sleep interventions. CONCLUSION: Telehealth ADHD sleep interventions represent a promising approach to enhancing health equity and access for families experiencing geographical and/or structural barriers to in-person treatment.Trial RegistrationANZCTR, ACTRN12621001681842. Registered 9 December 2021 - https://anzctr.org.au/ACTRN12621001681842.aspx.
Treatment Adherence in ADHD: A Systematic Review of Influencing Factors and Strategies for Improvement.
Karimi M, Ghasemzadeh S, Shabanali Fami F
J Atten Disord · 2026 May · PMID 41267417 · Publisher ↗
OBJECTIVE: The goal of this review was to more clearly understand what encourages or discourages treatment adherence in individuals with ADHD across different points in life. Instead of simply listing barriers, we set ou...
OBJECTIVE: The goal of this review was to more clearly understand what encourages or discourages treatment adherence in individuals with ADHD across different points in life. Instead of simply listing barriers, we set out to identify true, evidence-based strategies that could help patients and clinicians maximize long-term dedication to care. METHOD: Following PRISMA guidelines, we systematically reviewed 52 peer-reviewed articles between 2014 and 2024. The primary sources used were five electronic databases (Scopus, Science Direct, PubMed, and Taylor & Francis). The studies included heterogeneous age groups-children, adolescents, and adults-and had diverse methodologies ranging from randomized controlled trials to qualitative interviews. RESULTS: Adherence to treatment for ADHD remains a problem, especially among teenagers. We organized the influencing factors into five main areas: sociodemographic, psychological/clinical features, medication-related issues, beliefs and attitudes, and broader systemic or environmental challenges. Conversely, interventions like pharmacological strategies, digital interventions and mobile-based reminders, psychoeducational and behavioral approaches, multimodal and long-term interventions, and consent-based strategies were all linked to improved adherence. CONCLUSION: Improving adherence in ADHD requires a multifaceted, personalized approach that considers clinical, psychological, and contextual factors. Interventions that integrate pharmacologic and psychosocial strategies, while addressing barriers such as stigma, system fragmentation, and cultural mismatch, are essential to achieving better treatment outcomes and quality of life for individuals with ADHD.
Visceral Adipose Tissue Accumulation in Children With Obesity and Co-occurring ADHD: A Case-Control Analysis of Body Fat Distribution Patterns.
Li M, Li S, Hu Y … +2 more , Yang C, Liang A
J Atten Disord · 2026 Jun · PMID 41255268 · Publisher ↗
OBJECTIVE: ADHD and obesity frequently co-occur in children, yet differences in visceral adipose tissue (VAT) distribution between co-occurring ADHD + Obesity and obesity alone are incompletely characterized. This study...
OBJECTIVE: ADHD and obesity frequently co-occur in children, yet differences in visceral adipose tissue (VAT) distribution between co-occurring ADHD + Obesity and obesity alone are incompletely characterized. This study compared depot-specific adiposity between these groups. METHODS: This cross-sectional analysis (December 2022-2024, Beijing Children's Hospital) included 306 children (6-12 years) stratified into: ADHD + Obesity ( = 65), obesity-only ( = 77), and Control ( = 164). Body composition was assessed using bioelectrical impedance. Group comparisons for depot-specific adiposity and metabolic markers were performed using multivariable linear regression, adjusting for age, sex, and BMI -score. RESULTS: The ADHD + Obesity group exhibited significantly greater visceral adiposity than the Obesity-only group, as reflected by a 16.84 cm larger visceral fat area (VFA) and a 1.03 kg/m higher fat mass index (FMI). The ADHD + Obesity group also showed a more adverse metabolic profile, including elevated liver enzymes and fasting glucose. CONCLUSION: Excess visceral adiposity represents a distinct phenotypic feature of ADHD + Obesity. These findings support the need for integrated clinical management addressing both neurobehavioral and metabolic domains and inform future mechanistic investigations.
Narrative and Non-Narrative Discourse Skills in ADHD Across the Lifespan: A Systematic Review of the Literature.
Hill E, Wells R, Chen W
J Atten Disord · 2026 May · PMID 41250857 · Full text
OBJECTIVE: Discourse-level language abilities are critical for successful participation in social, academic, and vocational pursuits. These abilities encompass both narrative and non-narrative genres, each serving distin...
OBJECTIVE: Discourse-level language abilities are critical for successful participation in social, academic, and vocational pursuits. These abilities encompass both narrative and non-narrative genres, each serving distinct communicative functions. Narrative discourse involves spoken accounts of events or experiences, typically with a setting, characters, and a sequence of actions. Non-narrative discourse includes genres like explanations, arguments, and descriptions that convey information or ideas without a temporal structure. The aim of this review was to synthesise extant literature on discourse abilities of children and adults with ADHD across these genres. METHODS: Systematic searches were conducted via CINAHL, PsycINFO, Medline, and ProQuest. The review adhered to PRISMA guidelines and was registered with PROSPERO [CRD 42022377007]. RESULTS: Thirty-nine studies were included in our review. Most studies investigated the narrative abilities of children with ADHD. ADHD was associated with atypical verbal output, characterised by atypical brevity and verbosity, dysfluency, reduced syntactic complexity, and grammatical errors. Individuals with ADHD produced fewer pronouns and conjunctions. Additionally, their discourse was less coherent and included more frequent topic changes. Similarly, speakers with ADHD omitted critical components of discourse genres. The effect of ADHD on discourse varied between adults and children with ADHD and was evident in both narrative and non-narrative discourse. CONCLUSION: Published evidence to date indicates that ADHD affects micro-linguistic to super-structural discourse features in children and adults, likely impacting communication success in social and academic environments. Assessing the structure and content of narrative and non-narrative genres should form routine functional evaluation in ADHD for adults and children. More research is indicated given current major gaps in areas reviewed.
Dissecting the Mediating Role of Cortical Structures in the Pathogenesis of Socioeconomic Status to ADHD: A Mendelian Randomization Study and Mediation Analysis.
Xie W, Yu J, Wang P
J Atten Disord · 2026 May · PMID 41220056 · Publisher ↗
BACKGROUND: Research has consistently demonstrated a negative correlation between socioeconomic status (SES) and the prevalence of ADHD, with SES exerting a significant influence on brain development. ADHD, closely inter...
BACKGROUND: Research has consistently demonstrated a negative correlation between socioeconomic status (SES) and the prevalence of ADHD, with SES exerting a significant influence on brain development. ADHD, closely intertwined with neurological development, often manifests as impairments within brain regions associated with memory, executive function, and emotion regulation. Nevertheless, the specific brain structural mediators linking SES to ADHD remain unclear. METHOD: We explored whether the brain surface area (SA) and thickness (TH) mediated the relationship between SES indicators (Townsend deprivation index at recruitment, average total household income before tax, and job involves heavy manual or physical work) and ADHD utilizing two-step Mendelian Randomization (MR) and multivariate MR method. RESULTS: The MR analysis indicated that higher SES corresponds to a lower prevalence of ADHD. Genetically predicted household income was positively correlated with the SA of insula (β = .31, = 1.02 × 10), and physical work was positively correlated with the TH of entorhinal cortex (β = .74, = 3.73 × 10). Mediation analysis showed that the SA of insula was identified as a partial mediator in the protective effect of household income against ADHD prevalence, with a mediation ratio of 5.6%. Concerning potential causal relationships between IDPs and ADHD, reduced total brain SA increased ADHD risk (OR = 0.77, = 5.60 × 10), while reduced the TH of lateral occipital was protective (OR = 1.54, = 2.02 × 10). CONCLUSIONS: SES influences ADHD through brain structural changes, offering insights for prevention and intervention strategies.
Bridging the Gap: Digital CBT for Adults Managing ADHD Challenges.
Antshel KM, McBride H, Knouse LE
J Atten Disord · 2026 Mar · PMID 41220055 · Publisher ↗
OBJECTIVE: Cognitive behavioral therapy (CBT) is an efficacious treatment for adult ADHD, yet access and availability concerns limit scalability. Mobile health apps are promising tools for delivering scalable CBT. The cu...
OBJECTIVE: Cognitive behavioral therapy (CBT) is an efficacious treatment for adult ADHD, yet access and availability concerns limit scalability. Mobile health apps are promising tools for delivering scalable CBT. The current study reports findings from a randomized controlled trial (RCT) of a CBT-informed health app for adults with ADHD. METHODS: A sample of assessed adults with ADHD ( = 154; ages 18-55 years) were recruited to participate and randomized to either 8 weeks of use of the CBT-informed app or a waitlist control condition. Participants in both groups completed measures of ADHD symptoms and functioning at baseline, at 4 weeks, and at 8 weeks. RESULTS: Linear mixed-effects models for repeated measurements revealed significant group x time interactions for inattentive symptoms (η = .15), hyperactive-impulsive symptoms (η = .05), and ADHD associated quality of life (η = .04) in favor of the CBT-informed app relative to participants who knew they were not receiving help; however, these results did not extend to a measure of functional impairment. Changes in organizational, time management, and planning behaviors and ADHD-related cognitions partially mediated the association between group and inattentive symptom changes. ADHD inattentive symptom reductions were positively associated with the total number of app exercises completed. CONCLUSIONS: The confidence in our results is limited by our use of a waitlist control design. However, participants who used the CBT-informed app perceived improvements in inattentive and hyperactive-impulsive symptoms and quality of life relative to participants who knew they were not receiving help.
Cognitive Profile of ADHD in Older Adults: A Systematic Review.
Pardo-Palenzuela N, Onandia-Hinchado I, Diaz-Orueta U
J Atten Disord · 2026 Jan · PMID 41146423 · Full text
OBJECTIVES: ADHD is now recognized as a common condition in adulthood, but the evidence supporting a separate characterization of a cognitive profile for ADHD in older adults is scarce. Consequently, the goal of the curr...
OBJECTIVES: ADHD is now recognized as a common condition in adulthood, but the evidence supporting a separate characterization of a cognitive profile for ADHD in older adults is scarce. Consequently, the goal of the current study was to conduct a systematic review that helps clarify the cognitive characteristics of ADHD in older individuals. METHOD: We conducted a systematic review with narrative synthesis, considering studies on older adults with ADHD and research on cognitive domains involved in adults 50 years old and older with a confirmed diagnosis of ADHD, in three electronic databases (PubMed, Web of Science, and Embase). Ten studies (3 longitudinal and 7 cross-sectional) with clearly separated cognitive data for older adults with ADHD were included in this review. RESULTS: Results showed an overall worse performance in attention and episodic memory for older adults with ADHD compared to their younger counterparts and older healthy controls. Evidence concerning executive functions was mixed, with some studies showing a worse performance in working memory compared to older healthy controls, but with other studies showing a similar or even better performance than younger adults with ADHD. CONCLUSIONS: A cognitive characterization of ADHD in older adults requires further research to clarify whether it can be considered a separate entity and how to establish a differential diagnosis with other age-related conditions. Moreover, there is a need for internationally agreed common neuropsychological assessment protocols that set boundaries between younger and older adults with ADHD.
The Effects of Sleep Treatment on Symptoms of ADHD, Sleep Quality, Fatigue, and Depressive Symptoms in Adults.
van der Ham M, Bijlenga D, Molenaar N … +6 more , Starreveld DEJ, Böhmer MN, Wettstein R, Dumont G, Beekman ATF, Kooij S
J Atten Disord · 2026 Mar · PMID 41140200 · Publisher ↗
BACKGROUND: Sleep problems are highly prevalent in adults with ADHD. Sleep problems and ADHD symptoms can cause, amplify, and maintain each other. We studied the effects of additive treatment for sleep problems on self-r...
BACKGROUND: Sleep problems are highly prevalent in adults with ADHD. Sleep problems and ADHD symptoms can cause, amplify, and maintain each other. We studied the effects of additive treatment for sleep problems on self-reported symptoms of ADHD as primary outcome, with subscales of inattention and hyperactivity-impulsivity, objective, performance-based ADHD symptoms, sleep quality, fatigue, and depressive symptoms as secondary outcomes. METHODS: Preliminary open-label randomized controlled trial of adult patients diagnosed with ADHD and a positive screening for at least one sleep disorder. Participants were recruited between March, 2020 and May, 2023, during the COVID-19 pandemic. Seventy patients (60% female, mean age 27.9 years [ = 8.2]) were randomized to a 12-week period of: (1) ADHD treatment as usual (TAU, = 25), (2) ADHD TAU + sleep treatment ( = 22), or (3) stand-alone sleep treatment ( = 33). Outcome measures were assessed at baseline, and after 6 and 12 weeks of treatment. A total of 20% of participants did not complete the post-treatment assessment. Primary analyses compared changes between groups 1 and 2. Exploratory within-group analyses were conducted to assess improvements in the stand-alone sleep treatment group. All performed analyses were pre-specified. RESULTS: Primary analysis showed no significant difference in the reduction of subjective ADHD symptoms between the ADHD TAU + sleep treatment group and the ADHD TAU group (β = -1.30, 95% CI [-5.57, 2.96], = 0.21). The ADHD TAU + sleep treatment group did show significantly larger improvements in subjective sleep quality (β = -1.98, 95% CI [-3.65, -0.30], = 0.42) and fatigue (β = -6.52, 95% CI [-12.33, -0.70], = 1.59) compared to the ADHD TAU group. Pre-specified, exploratory within-group analysis showed a significant reduction in subjective ADHD symptoms in the stand-alone sleep treatment group (β = -4.80, 95% CI [-7.60, -2.01], = 0.62). CONCLUSION: Adding sleep treatment to standard ADHD treatment did not lead to significantly greater reductions in subjective or objective, performance based ADHD symptoms. However, combined treatment showed the largest improvements in sleep quality and fatigue, suggesting that such an approach may offer additional benefits. Subjective ADHD symptoms improved in the stand-alone sleep treatment group, but to a lesser extent than the other groups. Future studies with greater statistical power are needed, with long-term effects and quality of life as important outcomes.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe