J Atten Disord [JOURNAL]
Sun
200 papers
Prevalence of ADHD in Preschool Children: A community-based Study from Turkey.
Yavuz Ozturk S, Cakin Memik N, Balci S … +1 more , Karaca E
J Atten Disord · 2025 Sep · PMID 40577343 · Publisher ↗
OBJECTIVE: This study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD), considering both parents' and teachers' reports and clinical diagnosis, and to examine the relationship between A...
OBJECTIVE: This study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD), considering both parents' and teachers' reports and clinical diagnosis, and to examine the relationship between ADHD prevalence and measurement tools, sex, age, and clinical presentations. METHOD: This two-phase epidemiological study was conducted on 689 preschoolers aged 3 to 6 years in Kocaeli, Turkey. In the first phase, the Conners Rating Scale-Revised Long Form and the ADHD Rating Scale-IV Preschool Version were administered to teachers after parents. In the second phase, diagnostic evaluation was performed using DSM-5 ADHD criteria for children scoring above the 93rd percentile on any scale, according to either parent or teacher reports. RESULTS: The prevalence of ADHD was estimated to range from 2% to 12.6%, depending on the measurement method. The prevalence of ADHD diagnosis was 3.3%, with a male-to-female ratio of 1.9:1. The hyperactive-impulsive presentation (1.62%) was more common than the combined presentation (1.32%) and the inattentive presentation (0.44%). CONCLUSION: Our findings are consistent with the literature, emphasizing the importance of ADHD screening in preschool children for early diagnosis. Measurement tools used in ADHD screening and parent-teacher responses should be evaluated carefully.
Rates of Depression in Children and Adolescents With ADHD: A Systematic Review and Meta-Analysis.
Wang S, Stewart TM, Ozen I … +2 more , Mukherjee A, Rhodes SM
J Atten Disord · 2025 Sep · PMID 40577247 · Full text
OBJECTIVE: Accumulating evidence indicates high rates of major depressive disorder (MDD) in children and adolescents with ADHD. This systematic review and meta-analysis aimed to examine the rate of depression in children...
OBJECTIVE: Accumulating evidence indicates high rates of major depressive disorder (MDD) in children and adolescents with ADHD. This systematic review and meta-analysis aimed to examine the rate of depression in children and adolescents with ADHD who are without intellectual disability (ID). METHOD: A comprehensive search of six databases identified 20,745 studies. After screening based on inclusion and exclusion criteria, 24 studies were retained. A meta-analysis estimated the pooled depression rate in this population, and subgroup analyses examined differences based on sex, pubertal status, ADHD medication use, recruitment settings, depression assessment tools, informants, and risk of bias rating. Depression rates in children and adolescents with ADHD were compared with neurotypical peers in the retained case-control studies. RESULTS: Depression rates in children and adolescents with ADHD across the included studies ranged from 1.7% to 60%, with the meta-analysis estimating a pooled depression rate of 11.31% (95% CI [0.07, 0.16]). Subgroup analyses indicated significant differences by sex, with females showing higher rates than males. Differences were also noted by assessment methods, with the highest rates observed when both questionnaires and interviews were used. While other factors did not significantly affect rates, notable trends were identified and reported in the current article. CONCLUSION: Depression is a common co-occurrent psychiatric condition in children and adolescents with ADHD, with rates observed in this review and meta-analysis being higher than those reported for neurotypical children and adolescents. This review underscores the importance of combining multiple assessment methods to capture a comprehensive picture of depression in this population, as well as ensuring balanced demographic representation. This review also suggests that further research should explore the depression developmental patterns in children and adolescents with ADHD and identify whether patterns are similar to the neurotypical population.
Social Preference of Children at Risk for ADHD in Schools: Do They Have Limited Social Resources and can Friends Protect Against Peer Rejection?
F S, B V, J O … +1 more , M L
J Atten Disord · 2025 Aug · PMID 40576270 · Full text
OBJECTIVE: This cross-sectional study investigated social opportunities in children at risk for ADHD in regular primary education classrooms. First, we aimed to compare social preference of children at risk for ADHD and...
OBJECTIVE: This cross-sectional study investigated social opportunities in children at risk for ADHD in regular primary education classrooms. First, we aimed to compare social preference of children at risk for ADHD and of their unilateral friends, with their classmates. Second, we hypothesized that for the at risk-group higher levels of problem behaviors would be related to having friends with lower social preference, via own lower preference (limited social resources-hypothesis). Third, we hypothesized that having friends with higher social preference could buffer against lower social preference of children in the at-risk group (interpersonal contact-hypothesis). METHOD: Our sample consisted of 112 Dutch primary school children at risk for ADHD (84% boys, = 8.89, = 1.85), and 2,526 classmates serving as controls. Social preference and preference of unilateral friends was assessed with peer nominations of friendships and peer ratings of preference. Behavioral problems of children at risk for ADHD were assessed by teacher questionnaires. RESULTS: T-tests revealed that children at risk for ADHD and their unilateral friends had lower social preference than their classmates. Children at risk for ADHD nominated classmates with higher preference than themselves as friends, while they were nominated by classmates with similar preference. A path model and two linear regression models showed that higher levels of conduct problems were indirectly related to lower social preference of received unilateral friends, via own lower preference. We found no evidence that interpersonal contact could protect against lower social preference. CONCLUSION: Clearly, children at risk for ADHD suffer from problems in their relationships with classmates.
Association Between ADHD and Pediatric Asthma: Results From a Large-Sample Cross-Sectional Study of National Surveys and Mendelian Randomization Analyses.
Zhuoran Z, Xiaoman W, Rui Y … +1 more , Qingjiu C
J Atten Disord · 2025 Oct · PMID 40576263 · Publisher ↗
BACKGROUND: ADHD often overlaps with pediatric asthma, leading to difficulties in treatment and management in clinical work. Previous research has explored their correlations but gained different conclusions. Thus, this...
BACKGROUND: ADHD often overlaps with pediatric asthma, leading to difficulties in treatment and management in clinical work. Previous research has explored their correlations but gained different conclusions. Thus, this work aims to fill this evidence gap. METHODS: Initially, we conducted a cross-sectional study based on data from the National Health and Nutrition Survey (NHANES) 2001 to 2004. The association between ADHD and pediatric asthma was explored by the weighted multivariate-adjusted logistic regression. Then, the bidirectional univariate Mendelian randomization (UVMR) analyses were performed to estimate the causal effects and then investigate if risk factors of pediatric asthma mediated in the causal pathways. Last, we conducted multivariable MR (MVMR) analyses adjusting for these mediating/confounding factors to determine the direct causality between ADHD and pediatric asthma. RESULTS: In the cross-sectional analysis, ADHD was positively associated with pediatric asthma both before (OR = 1.79, 95% CI [1.26, 2.53], = .008) and after adjusting for all covariates (OR = 1.62, 95% CI [1.10, 2.39], = .048). In the UVMR analysis using the inverse-variance weighting (IVW) method, ADHD was found to increase the risk of pediatric asthma (OR = 1.070, 95% CI [1.029, 1.112], = 6.566 × 10⁻⁴). This association remained significant after adjusting for confirmed mediating factors (obesity traits and smoking exposures) using MVMR (OR = 1.088, 95% CI [1.021, 1.160], = .009). Another adjustment for remaining potential confounders (atopic dermatitis, allergic rhinitis, and inflammatory bowel diseases) via MVMR maintained the significant causal link (OR = 1.272, 95% CI [1.159, 1.396], < .001). CONCLUSIONS: ADHD increased the onset of pediatric asthma with mediating factors including obesity and smoke exposure.
Symptom and Performance Validity Measures in the Clinical Assessment of Adult ADHD: What Do We Learn from Network Analysis?
Fuermaier ABM, Hirsch O, Albrecht B … +2 more , Chavanon ML, Christiansen H
J Atten Disord · 2025 Nov · PMID 40576251 · Full text
BACKGROUND: First-time diagnoses of attention-deficit/hyperactivity disorder (ADHD) in adults can be challenging due to diverse methodologies available for assessment, and the choices clinicians need to make about how to...
BACKGROUND: First-time diagnoses of attention-deficit/hyperactivity disorder (ADHD) in adults can be challenging due to diverse methodologies available for assessment, and the choices clinicians need to make about how to interpret diagnostic criteria. Network analysis is a statistical approach that has received growing attention in clinical research of recent years. It has the potential to aid visualization and illustrate the intricate relationships between the wide range of clinical measures. AIM: The goal of the present study is to examine the value of network analysis on a sample of = 896 adults newly diagnosed with ADHD in an outpatient referral context. METHOD AND RESULTS: The network depicts the interrelationship of a comprehensive set of measures and test variables, including symptom self- and other-reports, cognitive tests, motor activity, as well as measures of symptom and performance validity. CONCLUSION: Our network analysis supports ADHD symptom clusters with distinct networks of motor activity and attention/impulsivity and reflects the mode of assessment, i.e., neuropsychological versus self- and observer-ratings. The network further depicts the dissociable role of symptom and performance validity measures, and the different nature of embedded and freestanding validity tests. We discuss the future application of network analysis in clinical research on ADHD.
Cognitive Disengagement Syndrome is Clinically Distinct from ADHD Presentations within Childhood and Adolescence.
Burns GL, Becker SP, Montaño JJ … +2 more , Sáez B, Servera M
J Atten Disord · 2025 Sep · PMID 40575940 · Publisher ↗
OBJECTIVE: The objective was to determine the differential validity of a cognitive disengagement syndrome-only (CDS-only) group from ADHD-inattentive presentation-only (IN-only), ADHD-hyperactive-impulsive presentation-o...
OBJECTIVE: The objective was to determine the differential validity of a cognitive disengagement syndrome-only (CDS-only) group from ADHD-inattentive presentation-only (IN-only), ADHD-hyperactive-impulsive presentation-only (HI-only), and ADHD-combined presentation (C-only) groups within childhood (ages 5-10) and adolescence (ages 11-16). METHODS: Parents of a nationally representative sample of 5,525 Spanish youth (ages 5-16, 56.1% boys) completed measures of CDS, ADHD-inattention (IN), and ADHD-hyperactivity/impulsivity (HI) and other measures. Scores greater/less than the top 5% on CDS, IN, and HI were used to create: (1) control, (2) CDS-only, (3) ADHD-IN-only, (4) ADHD-HI-only, (5) ADHD-C-only, (6) CDS + ADHD-IN, (7) CDS + ADHD-HI, and (8) CDS + ADHD-C groups within childhood and adolescence. RESULTS: Within childhood, the CDS-only group had higher scores than the three ADHD presentations on anxiety, depression, somatization, daytime sleep-related impairment, nighttime sleep disturbance, social impairment, and peer withdrawal, whereas CDS-only, ADHD-IN-only, and ADHD-HI-only groups did not differ on oppositional defiant disorder (ODD) and academic impairment (ADHD-C-only higher). Within adolescence, the CDS-only group again had higher scores than the three ADHD presentations on somatization and daytime sleep-related impairment but was now lower than the three ADHD presentations on ODD as well as lower on academic impairment than the ADHD-IN-only and ADHD-C-only groups. Within adolescence, the CDS-only group and the three ADHD presentations did not differ on depression, social impairment, or peer withdrawal. CONCLUSION: The CDS-only group had strong differential validity from ADHD-IN-only, ADHD-HI-only, and ADHD-C-only groups within childhood with less striking differences in adolescence. In addition to more studies with adolescents, etiological models with multi-informant longitudinal data are needed to better understand the differences in CDS and ADHD dimensions and their changes across development.
Social Skill Profiles in ADHD and Comorbid Disorders.
Miller CE, Arnold LE, Chronis-Tuscano A … +7 more , Hechtman L, Hinshaw SP, Kofler MJ, Molina BSG, Normand S, Pfiffner LJ, Mikami AY
J Atten Disord · 2025 Aug · PMID 40552614 · Full text
BACKGROUND: Many children with attention-deficit/hyperactivity disorder (ADHD) demonstrate impairment in social skills. However, ADHD rarely occurs in isolation, with approximately one-third of children with ADHD having...
BACKGROUND: Many children with attention-deficit/hyperactivity disorder (ADHD) demonstrate impairment in social skills. However, ADHD rarely occurs in isolation, with approximately one-third of children with ADHD having one additional disorder, and another third having two or three comorbidities. Few studies have considered the global and specific patterns of social skill performance based on comorbidity status. METHOD: Using a large dataset containing 1400 carefully phenotyped children with ADHD (ages 7-12; 28% girls) in the United States and Canada, we characterized social skill deficit profiles associated with the presence of internalizing comorbidity (depression and/or anxiety), externalizing comorbidity (oppositional defiant or conduct disorder), and both internalizing + externalizing comorbidities. All children had parent and teacher ratings of social skills on a consistent measure, and we took a nuanced approach that considered both global social skills and specific subdomains of skills. RESULTS: Parent ratings indicated main and interaction effects of each comorbidity on lower social skill performance in a varied pattern. Both comorbidities were associated with poorer global social skills, responsibility, and self-control. In addition, internalizing was associated with poorer assertion, while externalizing was associated with poorer communication, cooperation, and empathy. Interaction effects suggested that the impact of externalizing overshadowed internalizing for poor responsibility and self-control; however, internalizing comorbidity attenuated the negative association between externalizing comorbidity and empathy. On teacher ratings, only externalizing comorbidity was associated with poorer global social skills, communication, cooperation, assertion, responsibility, empathy, and self-control. In addition, girls and younger children tended to have poorer global social skills (using a gender-normed standard score), while girls and older children showed better specific social skills (using a raw, not gender-normed score). CONCLUSION: Children with ADHD and these comorbidities had poorer social skills relative to children with ADHD only, as perceived by parents and teachers. There also may be different social skill profiles depending on the comorbid condition and informant. These findings may inform more personalized social skill interventions for children with ADHD.
Health Risk Factors and ADHD: New Findings From the Community-Based Replication Project to Learn About Youth-Mental Health (Re-PLAY-MH).
Katz SM, de Arellano A, Rother Y … +4 more , Levine S, Claussen AH, Danielson ML, Flory K
J Atten Disord · 2025 Oct · PMID 40542668 · Full text
OBJECTIVE: ADHD is a commonly diagnosed neurodevelopmental disorder in the U.S., with symptoms including hyperactivity, inattention, and impulsivity. These symptoms can lead to increased engagement in unhealthy behaviors...
OBJECTIVE: ADHD is a commonly diagnosed neurodevelopmental disorder in the U.S., with symptoms including hyperactivity, inattention, and impulsivity. These symptoms can lead to increased engagement in unhealthy behaviors. The current study examined the associations between health risk factors and ADHD among a community-based sample of 345 students (4th-12th grade) by ADHD alone or with co-occurring disorders, ADHD medication use, and ADHD symptom count. Distinct from prior studies, our analysis also examined associations among pairs of health risk factors by ADHD diagnostic criteria. METHOD: Data came from the Replication Project to Learn About Youth-Mental Health, using a two-stage design, incorporating teacher, parent, and student reported data. RESULT: Students with ADHD experienced a higher prevalence of not using a bike helmet (prevalence ratio [PR] = 1.17, 95% confidence interval [CI] [1.01, 1.35]), being bullied, threatened, or feeling unsafe at school (PR = 1.83, 95% CI [1.02, 3.30]) carrying a weapon (PR = 7.02, 95% CI [2.58, 19.08]), and feeling sad or hopeless within the past 2 weeks (PR = 2.74, 95% CI [1.01, 7.47]) compared to those with no disorder. Students with ADHD exhibited different risk associations compared to those with no disorder, specifically for interpersonal violence risk. Medication treatment for ADHD was not associated with fewer health risks, except that students taking ADHD medication were less likely to skip breakfast (PR = 0.40, 95% CI [0.20, 0.78]) compared to those without ADHD. Higher ADHD symptom counts were associated with elevated television screen time, stimulant medication misuse, physical fight involvement, and carrying a weapon ( < .05). CONCLUSION: Evaluating participation in health risk factors and developing tailored interventions may benefit youth with ADHD, regardless of treatment status.
Emilio Mira y López's Perspectives on Understanding ADHD.
Escamilla Lerner J, de Castro-Manglano P, León Sanz P
J Atten Disord · 2026 Jan · PMID 40542666 · Publisher ↗
OBJECTIVE: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to...
OBJECTIVE: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to contextualize his ideas within broader historical, pedagogical, and psychiatric developments in Spain and internationally. METHOD: A historical-analytical approach was employed, reviewing Mira y López's publications , as well as related psychiatric and educational literature from the early 20th century. His work was analyzed alongside contributions from contemporaries and predecessors, with a focus on terminology, neurophysiological concepts, and early treatment strategies. RESULTS: Mira y López described the "unstable child" or "butterfly child" with symptoms that align closely with modern ADHD: impulsivity, distractibility, and lack of sustained attention. He proposed that these children suffer from an imbalance between excitatory and inhibitory brain functions, suggesting early therapeutic interventions including behavioral techniques and opotherapeutic (hormonal) medications. His research emphasized a medical and pedagogical approach to learning difficulties and prefigured ideas found in the emerging field of child psychopharmacology. CONCLUSION: Emilio Mira y López's understanding of childhood instability reflected the influence of French and Anglo-American psychiatry and anticipated key elements of today's ADHD frameworks. His physiological model of inhibition mirrors Charles Bradley's "inhibition hypothesis," which led to the use of stimulants for hyperactivity. Mira's early proposals contributed to shaping a more comprehensive, interdisciplinary view of childhood mental health and learning difficulties in Spain and Latin America.
Factor Structure of the Conners Continuous Performance Test Third Edition (CCPT-3): Exploratory Factor Analysis in a Mixed Clinical Sample.
Lund O, Raudeberg R, Johansen H … +4 more , Myhre ML, Walderhaug E, Poreh A, Egeland J
J Atten Disord · 2025 Nov · PMID 40535991 · Publisher ↗
OBJECTIVE: The Conners Continuous Performance Test-3 (CCPT-3) is a computerized test of attention frequently used in clinical neuropsychology. In the present factor analysis, we seek to assess the factor structure of the...
OBJECTIVE: The Conners Continuous Performance Test-3 (CCPT-3) is a computerized test of attention frequently used in clinical neuropsychology. In the present factor analysis, we seek to assess the factor structure of the CCPT-3 and evaluate the suggested dimensions in the CCPT-3 Manual. METHOD: Data from a mixed clinical sample of 931 adults referred for neuropsychological assessment across four centers were analyzed. Nine standard and eight experimental measures were subjected to an exploratory factor analysis to evaluate factor models ranging from one to six factors. RESULTS: The analysis supported a four-factor model with one overall attention factor and three factors of distinct mechanisms underlying inattention: impulsivity, vigilance, and sustained attention. This closely aligns with the four dimensions outlined in the CCPT-3 Technical Manual and the factor analyses from the CCPT-II. There were some differences between the four-factor model and the interpretations recommended in the Technical Manual. Perseverations were associated with the inattention factor rather than the impulsivity factor, and reaction time was exclusively linked to impulsivity. Incorporating error measures into the vigilance factor suggests that decreases in responsivity, rather than decreases in correct responses, underpin vigilance decrements. Including response bias by inter-stimulus interval (ISI) and by blocks in the analysis indicates that a decrease in arousal may also explain impairments in sustained attention. CONCLUSION: This study supports the notion in the Technical Manual that CCPT-3 measures both overall attention and three different mechanisms that mediate inattention: impulsivity, vigilance and sustained attention.
Gene-Environment Interplay Between Perceived Stress and ADHD Symptoms in Adults.
Hur YM
J Atten Disord · 2025 Oct · PMID 40524637 · Publisher ↗
OBJECTIVE: The association between perceived stress (PS) and ADHD symptoms in adulthood is well established, yet the underlying mechanisms remain unclear. This study employed a genetically informative design to investiga...
OBJECTIVE: The association between perceived stress (PS) and ADHD symptoms in adulthood is well established, yet the underlying mechanisms remain unclear. This study employed a genetically informative design to investigate the roles of gene-environment (GE) correlation and gene-environment interaction (G × E) in explaining this association. Three G × E interaction models were considered: the diathesis-stress model, the bioecological model, and the differential sensitivity model. METHOD: In total, 1,270 twins (mean age: 23.3 ± 2.4 years) participated in an online survey, which included ADHD symptoms and PS scales. The PS scale measured stress across five categories: Friendship Stress (FS), Family Conflicts (FC), Financial Difficulties (FD), Academic Stress (AS), and Future Career Concerns (FCC). RESULTS: Bivariate Cholesky model-fitting analyses revealed significant genetic correlations between ADHD symptoms and all five PS categories, indicating a pervasive influence of GE correlations on these associations. Further bivariate G × E model-fitting analyses showed that G × E interaction effects were not significant for FS or FC but were significant for FD, AS, and FCC. Specifically, the relationship between FD and ADHD symptoms aligned with the differential sensitivity model, where genetic variance was heightened at extreme levels of FD. The association between AS and ADHD symptoms followed the bioecological model, characterized by increased shared environmental variance at higher stress levels. Finally, the association between FCC and ADHD symptoms was consistent with the diathesis-stress model, where genetic influences amplified with increasing stress levels. CONCLUSION: These findings underscore the complex interplay of genetic and environmental factors in the ADHD symptoms-PS relationship and suggest the importance of incorporating these mechanisms into intervention strategies for ADHD symptoms.
Do Infant Heart Rate Variability and Visual Attention Predict Autism and Concerns for ADHD?
Jaisle EM, Musser ED, Yon M … +3 more , Garcia S, Piergies AMH, Miller M
J Atten Disord · 2025 Sep · PMID 40524614 · Publisher ↗
OBJECTIVE: Investigate whether patterns of heart rate variability (indexed via respiratory sinus arrhythmia) and visual attention at 12 to 18 months of age predict elevated ADHD symptoms, autism, or neither during the pr...
OBJECTIVE: Investigate whether patterns of heart rate variability (indexed via respiratory sinus arrhythmia) and visual attention at 12 to 18 months of age predict elevated ADHD symptoms, autism, or neither during the preschool period. METHOD: Ninety infants 12 to 18 months of age ( = 17.27, = 1.93; 36 females; 82.2% non-Hispanic) participated in a split-screen eye-tracking task of dynamic social and non-social moving objects. Respiratory sinus arrhythmia was derived from heart rate data collected at baseline and during the task condition. Between 24 and 65 months of age ( = 38.22, = 11.14), participants were evaluated and classified into one of three outcome groups: ADHD Concerns ( = 21), Autism ( = 12), or Comparison (i.e., non-Autism/non-ADHD Concerns; = 57). RESULTS: The ADHD Concerns group exhibited significantly less whole-screen looking time ((76) = -2.98, = .004, = 0.82) and spent a significantly lower proportion of time attending to the social portion of the stimulus ((76) = -2.53, = .01, = 0.67) than the Comparison group. Respiratory sinus arrhythmia reactivity moderated the association between proportion of time spent looking at the social portion of the stimulus in infancy and ADHD symptoms during the preschool period ( = 0.004, 95% CI [0.0001, 0.01], (89) = 2.11, = .04), such that greater quantity/intensity of ADHD symptoms was associated with a smaller proportion of look time to the social portion of the stimulus for infants engaging in HRV withdrawal, but not HRV augmentation. Hypotheses focused on autism were not supported. CONCLUSIONS: Infants demonstrate distinct patterns of visual attention predictive of elevated ADHD symptoms in the preschool period. Heart rate variability may also demonstrate predictive utility in the context of early ADHD when examined in relation to social attention, but not independently.
Enhancing Goal Achievement in Adults With ADHD: A Participant-Centered Evaluation of Transcranial Direct Current Stimulation From the TUNED Trial.
Schneider M, Ferrazza CP, da Silva Bomber RF … +11 more , Picon F, Rovaris DL, Sanches PRS, Pereira D, Brunoni AR, Camprodon JA, Caumo W, Bau CHD, Grevet EH, Rohde LA, Leffa DT
J Atten Disord · 2025 Oct · PMID 40524600 · Publisher ↗
OBJECTIVE: Few trials in ADHD incorporate participant-centered outcomes that evaluate the impact of interventions on meaningful life activities. Additionally, in psychiatry, the translation of changes in symptom rating s...
OBJECTIVE: Few trials in ADHD incorporate participant-centered outcomes that evaluate the impact of interventions on meaningful life activities. Additionally, in psychiatry, the translation of changes in symptom rating scales into meaningful impacts on participants' lives has been questioned. The Transcranial Direct Current Stimulation (tDCS) for the Treatment of Inattention Symptoms in Adult Patients with ADHD (TUNED) trial demonstrated improved inattention symptoms, assessed using a clinician-administrated scale, after a 4-week treatment with daily home-based tDCS in adults with ADHD. Here, our primary objective was to evaluate the impact of tDCS in ADHD using a participant-centered and clinically relevant outcome. METHOD: We analyzed data from the TUNED trial (ClinicalTrials.gov Identifier: NCT04003740), a randomized, double-blind, parallel, sham-controlled study testing tDCS in adults with ADHD. At the baseline assessment, all participants were instructed to select up to three goals they desired to achieve during the trial period. The goals had to be specific, measurable, achievable, relevant, and time-bound. Our main outcome was the number of goals achieved at the end of the intervention. RESULTS: Of the 64 participants randomized, 55 completed the trial and were included in the analyses (26 [47%] inattentive presentation and 29 [53%] combined presentation; mean () age, 38.1 [9.8] years; 40% women). In the active tDCS group ( = 25), eight participants (32%) achieved one goal, 5 (20%) achieved two goals, 3 (12%) achieved all three goals, and 9 (36%) achieved no goals. In the sham tDCS group ( = 30), 3 (10%) participants achieved one goal, 3 (10%) achieved two goals, 3 (10%) achieved all three goals, and 21 (70%) achieved no goals. Ordinal logistic regression analyses showed that participants in the active tDCS group were more likely to achieve a higher number of goals compared to those in the tDCS sham group (OR = 3.05, 95% CI [1.06, 8.75], = .03]). CONCLUSION: This study demonstrated that tDCS can significantly enhance the ability to achieve personal goals in adults with ADHD. By using a participant-centered approach, our findings not only support tDCS as a promising treatment for ADHD but also align with the growing emphasis on personalized medicine and clinically relevant, participant-reported outcomes in clinical research.
Unraveling ADHD Through Eye-Tracking Procedures: A Scoping Review.
Andreou G, Argatzopoulou A
J Atten Disord · 2025 Sep · PMID 40524599 · Publisher ↗
OBJECTIVE: This scoping review aimed to examine the application of eye-tracking technology in children with Attention-Deficit/Hyperactivity Disorder (ADHD), focusing on the scientific fields involved, methodologies emplo...
OBJECTIVE: This scoping review aimed to examine the application of eye-tracking technology in children with Attention-Deficit/Hyperactivity Disorder (ADHD), focusing on the scientific fields involved, methodologies employed, research goals, and outcomes related to its effectiveness. METHOD: Following PRISMA guidelines for Scoping Reviews, a total of 22 studies using eye-tracking with children diagnosed with ADHD were identified and analyzed. Data were extracted regarding study aims, methodological approaches, disciplinary origins, and key findings. RESULTS: The majority of studies originated from neuroscience and psychiatry, with contributions from artificial intelligence, machine learning, virtual reality, and biomedical engineering. Eye-tracking technology was used for three main purposes: (1) identification and diagnosis of ADHD, (2) investigation of cognitive and behavioral mechanisms-particularly attention and inhibitory control, and (3) as an intervention tool to improve cognitive functions. Findings indicated that eye-tracking, especially when integrated with virtual reality or machine learning, may support efficient ADHD diagnosis. Moreover, studies reported that distinct eye movement patterns are associated with attention deficits, inhibitory control issues, impaired working memory, and challenges in emotional and social processing. Interventions using eye-tracking demonstrated potential in training attention control and motor coordination. CONCLUSION: Eye-tracking technology holds promise as both a diagnostic and interventional tool for children with ADHD. Future research should address methodological limitations, explore long-term effectiveness, and further investigate multimodal integration with emerging technologies.
Pre-Service Teachers Lack Knowledge of ADHD, But Report Optimism for Supporting Students With ADHD.
Henley AC, Braun SS
J Atten Disord · 2025 Aug · PMID 40448549 · Publisher ↗
OBJECTIVE: Reports estimate at least one child in every general education classroom in the U.S. has ADHD. Thus, teachers should enter the classroom with an accurate working knowledge of ADHD and the skills to respond eff...
OBJECTIVE: Reports estimate at least one child in every general education classroom in the U.S. has ADHD. Thus, teachers should enter the classroom with an accurate working knowledge of ADHD and the skills to respond effectively to support the development of these students. The present study tested the following research questions (RQs): (RQ1) How knowledgeable are preservice teachers about ADHD? (RQ2) What are pre-service teachers' naturalistic responses to students with ADHD? Are pre-service teachers' (RQ3) knowledge of ADHD, (RQ4) stress, and (RQ5) mindfulness skills associated with three types of responses to working with students with ADHD: evaluation of social/behavioral problems, emotional distress, and investment in treatment and classroom practices? (RQ6) Does mindfulness moderate the association between stress and teachers' responses to students with ADHD? METHOD: Participants were 101 education majors in a teacher education program at a large Southeastern university in the United States. Multivariate regressions were employed to assess RQs 3-6. RESULTS: Pre-service teachers correctly answered 52% of items ( = 0.15) measuring knowledge of ADHD. There were no significant associations between knowledge of ADHD, stress, and mindfulness skills and pre-service teachers' responses to students with ADHD, nor did mindfulness moderate the association between stress and outcomes. However, pre-service teachers with previous experience teaching students with ADHD perceived students' behavioral challenges as more serious than those without experience. CONCLUSION: Results indicated that pre-service teachers lacked comprehensive knowledge of ADHD but responded to students with ADHD in a supportive manner. Notably, these findings indicate that teachers entering the workforce within the next two years are willing to implement supportive practices for students with ADHD. Implications for research and practice are discussed.
Does Stimulant Medication Status Moderate the Association Between Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms and Rumination?
Reiner AI, Greenberg AJ, Jarrett MA … +5 more , Becker SP, Kofler MJ, Luebbe AM, Burns GL, Garner AA
J Atten Disord · 2025 Jul · PMID 40384229 · Full text
Previous research suggests that college students with attention-deficit/hyperactivity disorder (ADHD) symptoms are at risk for experiencing ruminative thinking. Although research has shown that stimulant medications redu...
Previous research suggests that college students with attention-deficit/hyperactivity disorder (ADHD) symptoms are at risk for experiencing ruminative thinking. Although research has shown that stimulant medications reduce ADHD symptoms, no research has looked at whether stimulant medication moderates the association between ADHD symptoms and rumination. Given this gap in the literature, the current study examined whether stimulant medication status moderates the association between ADHD symptoms and rumination. Participants ( = 4,751) were undergraduate psychology students from six universities (70.0% female; = 19.08; = 1.36) who participated in a larger study. College students completed questionnaires related to ADHD symptoms and rumination and indicated whether they were currently taking a stimulant medication. Results of the moderation model indicated a significant main effect for ADHD inattentive symptoms (β = 5.20, < .05, 95% CI [4.43, 5.98]) and a significant interaction effect between ADHD inattentive symptoms and stimulant medication in relation to rumination (β = -2.41, < .05, 95% CI [-4.51, -.30]). Examination of conditional effects revealed significant simple slopes for students both on and off medication but a stronger association for those off (β = 5.20, < .05, 95% CI [4.43, 5.98]) versus on (β = 2.80, < .05, 95% CI [.78, 4.81]) stimulant medication. Stimulant medication status did not moderate the association between ADHD hyperactive/impulsive symptoms and rumination. Future research should continue to explore the potential benefits of stimulant medication for reducing the association between ADHD inattention symptoms and rumination.
An Application of Time Series Analysis to Single-Case Designs in an Intensive Behavioral Intervention for ADHD.
Jusko ML, Smith JN, Hayes T … +8 more , Campez-Pardo M, Timmons AC, Morrow AS, Lozano C, Fosco WD, Little K, Villodas M, Raiker JS
J Atten Disord · 2025 Aug · PMID 40380799 · Publisher ↗
OBJECTIVE: Although treatment research has relied upon group-based methods to understand treatment response, these methods often are unable to detect intraindividual changes in behavior. Single case designs using time se...
OBJECTIVE: Although treatment research has relied upon group-based methods to understand treatment response, these methods often are unable to detect intraindividual changes in behavior. Single case designs using time series analyses, in contrast, may be ideal for examining intraindividual variability in treatment response over time. The current proof-of-concept study applies time series analysis to four youth with attention-deficit/hyperactivity disorder in a behavioral treatment program to characterize how their behavior changes over time. METHOD: Objective behavioral data was collected on a moment-by-moment basis while the youth attended an intensive afterschool treatment program implemented throughout the academic year. Desirable and undesirable behaviors were summed for each day, and trends were fit to the data. RESULTS: The most parsimonious was linear for most children, for both undesirable and desirable behaviors; however, variability in behavioral response limited the ability of time series analysis to optimally characterize behavioral change. Further, a analysis revealed differences in response to intervention depending on the day of the week. Notably, decreases in both desirable and undesirable behavior were observed closer to the week's most salient reinforcer. CONCLUSION: These findings provide a proof-of-concept for implementing time series analysis for clinical scientists intending to utilize moment-by-moment data collection.
ADHD Symptoms and Medical Cannabis Use Among Adults With Chronic Pain.
Saunders D, Slawek D, Zhang C … +6 more , Sohler N, Cunningham C, Minami H, Starrels J, Arnsten J, Levin F
J Atten Disord · 2025 Jul · PMID 40380798 · Full text
OBJECTIVE: We examined whether medical cannabis (MC) use was associated with change in ADHD symptoms across time in a sample of adults with chronic pain. METHODS: We conducted a longitudinal cohort study ( = 223) across...
OBJECTIVE: We examined whether medical cannabis (MC) use was associated with change in ADHD symptoms across time in a sample of adults with chronic pain. METHODS: We conducted a longitudinal cohort study ( = 223) across 12 months, assessing ADHD symptoms and MC use. We used mixed-effects linear regression to test whether MC use (vs. no use) and high THC (vs. low THC) MC was associated with change in ADHD symptoms from baseline to follow-up at quarterly intervals. We stratified by baseline ADHD symptoms and pain catastrophizing. RESULTS: MC use was not associated with change in ADHD symptoms in the full sample or those with moderate/severe ADHD symptoms. Among those with minor/no baseline ADHD symptoms, high-THC MC (vs. low-THC) was associated with a decrease in ADHD symptoms. CONCLUSIONS: The null findings among participants with moderate/severe ADHD symptoms suggests that cannabis is unlikely to be a good treatment for ADHD. The preliminary findings in those with mild ADHD symptoms should be interpreted with caution given the small sample, the modest result, and all participants had chronic pain. These results may temper enthusiasm for MC as a treatment for ADHD, but further studies in larger and more generalizable samples may be justified.
The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Symptoms and Normal Behaviors Scale (SWAN): Diagnostic Accuracy and Clinical Utility.
Alhajji R, Walsh E, Pike KC … +3 more , Liu FF, Oxford M, Stein MA
J Atten Disord · 2025 Nov · PMID 40357753 · Publisher ↗
OBJECTIVE: To examine the Strengths and Weaknesses of ADHD-Symptoms and Normal Behavior scale (SWAN) clinical utility as a diagnostic measure of ADHD in an ADHD clinic sample. METHOD: In a sample of 357 children (6-11 ye...
OBJECTIVE: To examine the Strengths and Weaknesses of ADHD-Symptoms and Normal Behavior scale (SWAN) clinical utility as a diagnostic measure of ADHD in an ADHD clinic sample. METHOD: In a sample of 357 children (6-11 years old) referred for evaluation at an academic medical center, we explored the SWAN's diagnostic and convergent validity with the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ/HI) and concurrent validity with the Impairment Rating Scale (IRS). RESULTS: The averaged (SWAN total) and the SWAN Hyperactivity/Impulsivity subscale (SWAN HI) showed significant and large correlations with the SDQ/HI ( = .69 and .65), respectively. The SWAN Attention Deficit subscale (SWAN AD) had a significant but smaller correlation ( = .49). The SWAN total had moderate correlation with the IRS average score ( = .33). In receiver operating characteristic (ROC) curve analyses (area under the curve (AUC) = 0.71) for the SWAN total, the SWAN distinguished ADHD cases from non-ADHD cases with sensitivity of 83% but specificity of 47%. CONCLUSION: In a clinical sample, the SWAN total scores displayed a near-normal distribution. ADHD cases were distinguished from non-ADHD cases by the SWAN. The SWAN showed adequate convergent and concurrent validity with other symptoms and impairment measures.
Factors Associated With Medication Adherence Among Patients With Attention-Deficit/Hyperactivity Disorder (ADHD).
Nguyen L, Le YL, Reygaerts H … +2 more , Johnson TR, Soutullo CA
J Atten Disord · 2025 Oct · PMID 40357727 · Full text
OBJECTIVE: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common behavioral health condition that impacts 5% to 8% of children and 2.5% of adults worldwide. The symptoms of ADHD are effectively managed with medicat...
OBJECTIVE: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common behavioral health condition that impacts 5% to 8% of children and 2.5% of adults worldwide. The symptoms of ADHD are effectively managed with medication, yet patients with ADHD may inconsistently take their medication. We assessed medication adherence among patients with ADHD and identified factors associated with medication adherence that may be utilized to optimize adherence. METHOD: This is a retrospective, observational study among patients aged 4 years and older with a diagnosis of ADHD at primary care and multispecialty outpatient clinics during May 2021 to May 2023. We assessed sociodemographic characteristics, stratified by medication adherence status (Percentage of Days Covered ≥ 80%) using simple proportion, Student's -test, and Chi-square test. We conducted univariable and multivariable logistic regression analyses to assess potential medication adherence factors, including sociodemographic characteristics, depressive symptoms, suicide risk, health service utilization, and social determinants of health (SDOH). RESULTS: We found 7,661 patients diagnosed with ADHD, with a mean () age of 21.8 (14.8) years. The ADHD prevalence was 5.5% for patients aged 4 to 12, 4.4% for 13 to 17, and 0.8% for 18+ years old. Most patients were male (56.9%), non-Hispanic White (37.6%), and privately insured (55.1%). Among these patients, only 4,242 (55.4%) were treated with medication. Among 4,011 patients with medication adherence information, the average adherence rate was 56%, and only 1,113 patients (27.5%) met our threshold for adherence to ADHD treatment (80%). Adherence was positively associated with being adults, having more BH and PCP visits, and negatively associated with racial and ethnic minorities and more severe depressive symptoms. CONCLUSION: Only half of patients with ADHD were treated with medication. Of those treated, less than a third adhered to medication. Age, race and ethnicity, depressive symptoms, and BH and PCP visits were statistically associated with medication adherence. Healthcare providers may need to address factors such as coexisting depressive symptoms, and unmet SDOH needs to improve medication adherence among patients with ADHD. Also, patients reaching adolescence may need enhanced medication management.
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