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Meyer, J., Ramklint, M., Hallerbäck, M. U., Lööf, M. & Isaksson, J. (2019). Evaluation of a structured skills training group for adolescents with attention deficit/hyperactivity disorder (ADHD) - study protocol of a randomised controlled trial.. BMC Psychiatry, 19(1), Article ID 171.
Open this publication in new window or tab >>Evaluation of a structured skills training group for adolescents with attention deficit/hyperactivity disorder (ADHD) - study protocol of a randomised controlled trial.
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2019 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 19, no 1, article id 171Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) has a negative impact on several domains of life. However, there is a shortage of evidence-based non-pharmacological treatments for adolescents with ADHD. A structured skills training group (SSTG) based on dialectical behaviour therapy (DBT) has been used in adult patients with ADHD with some promising results, although the treatment has not yet been adapted or evaluated for adolescents with ADHD. This study protocol describes how this treatment was adapted for an adolescent population and how the efficacy of the SSTG will be evaluated using a randomised controlled trial (RCT) design.

METHODS: A sample of 184 adolescents (15-18 years of age) with a diagnosis of ADHD has been recruited from seven child and adolescent psychiatric outpatient units and randomised to either the SSTG or an active control group based on psychoeducation. Measures are conducted weekly during the treatment, as well as 2 weeks before treatment and 2 weeks and 6 months after treatment. The primary outcome measures are ADHD symptoms, functional impairment, quality of life and mindfulness. Secondary outcome measures are symptoms of comorbid psychopathology, perceived stress and sleep problems. This article describes the design, methods and analysis plan for evaluating the efficacy of the SSTG.

DISCUSSION: The study will be the first RCT to examine the acceptability and efficacy of a SSTG based on DBT adapted for adolescents with ADHD. We believe that the study will extend the current knowledge base about psychological treatment for adolescents with ADHD.

TRIAL REGISTRATION: ISRCTN registry ( ISRCTN17366720 ). Retrospectively registered May 112,016.

Keywords
ADHD, Adolescents, DBT, Group treatment, Psychoeducation, RCT, Therapy
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-385232 (URN)10.1186/s12888-019-2133-4 (DOI)000471000200001 ()31182047 (PubMedID)
Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-07-05Bibliographically approved
Ghosh, E., Nilsson, K. W. & Isaksson, J. (2019). Own-gender bias in school staff's recognition of children with ADHD. Acta Paediatrica, 108(6), 1165-1166
Open this publication in new window or tab >>Own-gender bias in school staff's recognition of children with ADHD
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1165-1166Article in journal, Editorial material (Other academic) Published
Abstract [en]

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by impairments in attention, hyperactivity and impulsivity. A higher proportion of boys than girls are diagnosed with ADHD, although girls seek care for ADHD at an older age, and almost to the same extent as men by adulthood (1). The sex difference in prevalence rates during childhood may hypothetically reflect a bias in referral patterns, where adults perceive and value girls' symptoms differently to boys' symptoms. Consistent with this finding, the gender bias is attenuated when self-reports and community-based samples are used (1).

National Category
Psychiatry
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-376618 (URN)10.1111/apa.14738 (DOI)000467867900031 ()30715763 (PubMedID)
Funder
The Swedish Brain Foundation
Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-06-19Bibliographically approved
Isaksson, J., Van't Westeinde, A., Cauvet, É., Kuja-Halkola, R., Lundin, K., Neufeld, J., . . . Bölte, S. (2019). Social Cognition in Autism and Other Neurodevelopmental Disorders: A Co-twin Control Study. Journal of autism and developmental disorders, 49(7), 2838-2848
Open this publication in new window or tab >>Social Cognition in Autism and Other Neurodevelopmental Disorders: A Co-twin Control Study
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2019 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 49, no 7, p. 2838-2848Article in journal (Refereed) Published
Abstract [en]

Alterations in social cognition (SC) are hypothesized to underlie social communication and interaction challenges in autism spectrum disorder (ASD). The aetiological underpinnings driving this association remain unclear. We examined SC in 196 twins with ASD, other neurodevelopmental disorders or typical development using the naturalistic Movie for the Assessment of Social Cognition. Autism and its severity were assessed with the Autism Diagnostic Observation Schedule-2, and autistic traits with the Social Responsiveness Scale-2. Using within twin-pair regression models, controlling for age, sex, IQ, and unmeasured familial confounders such as genetic background and shared-environment, SC correlated with ASD diagnosis, autism severity, and autistic traits. Our findings highlight the importance of SC alterations in autism and suggest a non-shared environmental impact on the association.

Keywords
ADHD, Autism spectrum disorder, Movie for the assessment of social cognition, RATSS, Twins
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-381652 (URN)10.1007/s10803-019-04001-4 (DOI)000474414900016 ()30972652 (PubMedID)
Funder
Swedish Research CouncilVinnovaSwedish Research Council FormasForte, Swedish Research Council for Health, Working Life and WelfareThe Swedish Brain FoundationSwedish Foundation for Strategic Research Sven Jerring FoundationEU, FP7, Seventh Framework Programme
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-08-15Bibliographically approved
Isaksson, J., Tammimies, K., Neufeld, J., Cauvet, É., Lundin, K., Buitelaar, J. K., . . . Bölte, S. (2018). EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort [Letter to the editor]. Molecular Autism, 9, Article ID 26.
Open this publication in new window or tab >>EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort
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2018 (English)In: Molecular Autism, ISSN 2040-2392, Vol. 9, article id 26Article in journal, Letter (Refereed) Published
Abstract [en]

EU-AIMS is the largest European research program aiming to identify stratification biomarkers and novel interventions for autism spectrum disorder (ASD). Within the program, the Longitudinal European Autism Project (LEAP) has recruited and comprehensively phenotyped a rare sample of 76 monozygotic and dizygotic twins, discordant, or concordant for ASD plus 30 typically developing twins. The aim of this letter is to complete previous descriptions of the LEAP case-control sample, clinically characterize, and investigate the suitability of the sample for ASD twin-control analyses purposes and share some 'lessons learnt.' Among the twins, a diagnosis of ASD is associated with increased symptom levels of ADHD, higher rates of intellectual disability, and lower family income. For the future, we conclude that the LEAP twin cohort offers multiple options for analyses of genetic and shared and non-shared environmental factors to generate new hypotheses for the larger cohort of LEAP singletons, but particularly cross-validate and refine evidence from it.

Keywords
ADHD, Autism spectrum disorder, Biomarkers, Brain, Cognition, Europe, Genetics, Intervention, Twins
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-349242 (URN)10.1186/s13229-018-0212-x (DOI)000429970200001 ()29682271 (PubMedID)
Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2018-08-14Bibliographically approved
Isaksson, J., Stickley, A., Koposov, R. & Ruchkin, V. V. (2018). The danger of being inattentive: ADHD symptoms and risky sexual behaviour in Russian adolescents. European psychiatry, 47, 42-48
Open this publication in new window or tab >>The danger of being inattentive: ADHD symptoms and risky sexual behaviour in Russian adolescents
2018 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 47, p. 42-48Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prior research has indicated that attention-deficit/hyperactivity disorder (ADHD) symptoms may be associated with an increased likelihood of engaging in risky sexual behaviour (RSB). However, research on this association among adolescents has been comparatively limited and mainly confined to North America. The aim of this study was to examine if inattention and hyperactivity/impulsivity symptoms were linked to RSB in a community cohort sample of Russian adolescents.

METHODS: The study was based on a group of 537 adolescents from Northern Russia. Information on inattention and hyperactivity/impulsivity as well as conduct problems was obtained through teacher ratings, while information on RSB (previous unprotected sex, number of sexual partners, sex while intoxicated and partner pregnancies), substance use, perception of risk, and parenting behaviour was based on students' self-reports. Binary logistic regression analysis was used to examine associations between the variables.

RESULTS: Teacher-rated inattention symptoms predicted RSB, independently of co-morbid conduct problems, substance use, risk perception, and different parenting styles (parental warmth, involvement and control). In addition, male sex, binge drinking and a lower assessment of perceived risk were all significantly associated with RSB in an adjusted model. Neither teacher-rated hyperactivity/impulsivity symptoms nor conduct problems were linked to RSB in the full model.

CONCLUSIONS: Deficits in planning and organizing behaviours, being easily distracted and forgetful seem to be of importance for RSB in Russian adolescents. This highlights the importance of discriminating between different ADHD symptoms in adolescence to prevent risk behaviours and their potentially detrimental outcomes on health and well-being.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Attention-deficit/hyperactivity disorder, Binge drinking, Conduct problems, Perception of risk, Risky sexual behaviour
National Category
Clinical Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-332998 (URN)10.1016/j.eurpsy.2017.09.004 (DOI)000419527700007 ()29100171 (PubMedID)
Available from: 2017-11-04 Created: 2017-11-04 Last updated: 2019-06-27Bibliographically approved
Isaksson, J., Pettersson, E., Kostrzewa, E., Diaz Heijtz, R. & Bölte, S. (2017). Brief Report: Association Between Autism Spectrum Disorder, Gastrointestinal Problems and Perinatal Risk Factors Within Sibling Pairs.. Journal of autism and developmental disorders, 47(8), 2621-2627
Open this publication in new window or tab >>Brief Report: Association Between Autism Spectrum Disorder, Gastrointestinal Problems and Perinatal Risk Factors Within Sibling Pairs.
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2017 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 8, p. 2621-2627Article in journal (Refereed) Published
Abstract [en]

Autism spectrum disorder (ASD) has been associated with gastrointestinal (GI) problems, but the nature of this association is unclear. Parents to siblings, concordant or discordant for ASD (N = 217), participated in a web survey covering mother's weight gain during pregnancy, maternal viral/bacterial infection and use of antibiotics, duration of breastfeeding, mode of delivery, birth weight and child GI problems. ASD was associated with GI problems and perinatal environmental risk, based on a summation of maternal infection and antibiotic use during pregnancy and/or the breastfeeding period. The association between GI problems and ASD remained within the sibling pairs (β = 1.23; p < .001) in the adjusted model. Our results indicate non-shared environmental effects on the ASD/GI association, but none of the factors examined explained the link.

Keywords
Autism spectrum disorder, Breastfeeding, Cesarean section, Gastrointestinal problems, Infections, Siblings
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-322594 (URN)10.1007/s10803-017-3169-2 (DOI)000405720900028 ()28536957 (PubMedID)
Funder
Swedish Research CouncilEU, FP7, Seventh Framework Programme
Available from: 2017-05-26 Created: 2017-05-26 Last updated: 2017-10-24Bibliographically approved
Isaksson, J., Deyessa, N., Berhane, Y. & Högberg, U. (2017). Early adversity and psychiatric symptoms: a prospective study on Ethiopian mothers and their children. BMC Psychiatry, 17, Article ID 344.
Open this publication in new window or tab >>Early adversity and psychiatric symptoms: a prospective study on Ethiopian mothers and their children
2017 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 344Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Maternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring. The aim of this study was to investigate a possible developmental effect of maternal perinatal stressors on emotional and behavioural symptoms in the offspring in a developing country.

METHODS: We followed an Ethiopian birth cohort (N = 358), assessing intimate partner violence (IPV) and maternal psychiatric symptoms during the perinatal period and at follow-up 10 years later, as a proxy for adversity, and maternal ratings on the Child Behavior Checklist (CBCL) 10 years later as the outcome.

RESULTS: Among the women, exposure to IPV was common (60.6%) during the perinatal period and predicted IPV (29.9% of the mothers) at follow-up (ρ = 0.132; p = 0.012). There was also an association between maternal psychiatric symptoms at the two time points (ρ = 0.136; p = 0.010) and between maternal symptoms and IPV. Current maternal symptoms of anxiety and depression (β = 0.057; p < 0.001), but not during the perinatal period, were associated with child CBCL-scores.

CONCLUSION: Our findings do not support the hypothesis that early adversity increase susceptibility for psychiatric symptoms. However, the findings emphasize the public health problem of IPV in this population, adding to the women's mental health problem.

Keywords
Child psychiatric symptoms, Intimate partner violence, Maternal distress, Perinatal, Programming theory
National Category
Psychiatry
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-331413 (URN)10.1186/s12888-017-1500-2 (DOI)000413023200001 ()29020947 (PubMedID)
Available from: 2017-10-13 Created: 2017-10-13 Last updated: 2018-01-26Bibliographically approved
Loth, E., Charman, T., Mason, L., Tillmann, J., Jones, E. J., Wooldridge, C., . . . Buitelaar, J. K. (2017). The EU-AIMS Longitudinal European Autism Project (LEAP): design and methodologies to identify and validate stratification biomarkers for autism spectrum disorders.. Molecular Autism, 8, Article ID 24.
Open this publication in new window or tab >>The EU-AIMS Longitudinal European Autism Project (LEAP): design and methodologies to identify and validate stratification biomarkers for autism spectrum disorders.
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2017 (English)In: Molecular Autism, ISSN 2040-2392, Vol. 8, article id 24Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The tremendous clinical and aetiological diversity among individuals with autism spectrum disorder (ASD) has been a major obstacle to the development of new treatments, as many may only be effective in particular subgroups. Precision medicine approaches aim to overcome this challenge by combining pathophysiologically based treatments with stratification biomarkers that predict which treatment may be most beneficial for particular individuals. However, so far, we have no single validated stratification biomarker for ASD. This may be due to the fact that most research studies primarily have focused on the identification of mean case-control differences, rather than within-group variability, and included small samples that were underpowered for stratification approaches. The EU-AIMS Longitudinal European Autism Project (LEAP) is to date the largest multi-centre, multi-disciplinary observational study worldwide that aims to identify and validate stratification biomarkers for ASD.

METHODS: LEAP includes 437 children and adults with ASD and 300 individuals with typical development or mild intellectual disability. Using an accelerated longitudinal design, each participant is comprehensively characterised in terms of clinical symptoms, comorbidities, functional outcomes, neurocognitive profile, brain structure and function, biochemical markers and genomics. In addition, 51 twin-pairs (of which 36 had one sibling with ASD) are included to identify genetic and environmental factors in phenotypic variability.

RESULTS: Here, we describe the demographic characteristics of the cohort, planned analytic stratification approaches, criteria and steps to validate candidate stratification markers, pre-registration procedures to increase transparency, standardisation and data robustness across all analyses, and share some 'lessons learnt'. A clinical characterisation of the cohort is given in the companion paper (Charman et al., accepted).

CONCLUSION: We expect that LEAP will enable us to confirm, reject and refine current hypotheses of neurocognitive/neurobiological abnormalities, identify biologically and clinically meaningful ASD subgroups, and help us map phenotypic heterogeneity to different aetiologies.

Keywords
Biomarkers, Cognition, EEG, Eye-tracking, Genetics, MRI, Neuroimaging
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-325671 (URN)10.1186/s13229-017-0146-8 (DOI)000404099400001 ()28649312 (PubMedID)
Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2017-11-29Bibliographically approved
Isaksson, J., Högberg, U., Valladares, E. & Lindblad, F. (2016). Associations between psychiatric symptoms and cortisol levels in Nicaraguan young school-age children. Psychiatry Research, 240, 376-380
Open this publication in new window or tab >>Associations between psychiatric symptoms and cortisol levels in Nicaraguan young school-age children
2016 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 240, p. 376-380Article in journal (Refereed) Published
Abstract [en]

The regulation of the Hypothalamus-Pituitary-Adrenal axis (HPA-axis) with its end product cortisol seems to be affected in several psychiatric disorders. Although findings are not conclusive, internalizing symptoms have primarily been associated with higher diurnal cortisol levels and externalizing symptoms with lower cortisol levels. In this study on nine-year-olds in Nicaragua (n=111), we investigated associations between child psychiatric symptoms, using the Child Behavior Check List (CBCL), and saliva cortisol levels collected in the morning and afternoon, also adjusting for potential confounders. In line with previous findings, internalizing symptoms were significantly associated with higher morning, but not afternoon cortisol levels. Surprisingly, externalizing symptoms were also significantly associated with higher morning cortisol levels. Possibly, this association between externalizing symptoms and cortisol levels may be characteristic of early ages, representing a higher exposure to external stressors. The study highlights the need for prospective studies, following the development of the HPA-axis and its association with psychiatric symptoms.

National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-292594 (URN)10.1016/j.psychres.2016.04.069 (DOI)000378359500060 ()27138834 (PubMedID)
Funder
Sida - Swedish International Development Cooperation AgencySwedish Research Council, K 2002-27 x 14290-01A
Available from: 2016-05-04 Created: 2016-05-04 Last updated: 2017-11-30Bibliographically approved
Isaksson, J., Comasco, E., Åslund, C., Rehn, M., Tuvblad, C., Andershed, H. & Nilsson, K. W. (2016). Associations between the FKBP5 haplotype, exposure to violence and anxiety in females. Psychoneuroendocrinology, 72, 196-204
Open this publication in new window or tab >>Associations between the FKBP5 haplotype, exposure to violence and anxiety in females
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2016 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 72, p. 196-204Article in journal (Refereed) Published
Abstract [en]

The gene that encodes the FK506-binding protein 5 (FKBP5) is regarded as a candidate for investigating how negative life events interact with a genetic predisposition to stress-related disorders, such as depression and anxiety. Given the role of FKBP5 as an important regulator of stress responses, we aimed to investigate if single-nucleotide polymorphisms (SNPs) in FKBP5-in the presence/absence of exposure to violence-are associated with symptoms of depression and anxiety. Data from two community-based samples of adolescents (n=1705) and young adults (n=1800) regarding ratings on depression, anxiety, exposure to violence and FKBP5 genotype were collected. A risk haplogenotype including the minor alleles of seven common SNPs in the FKBP5 (rs3800373, rs9296158, rs7748266, rs1360780, rs9394309, rs9470080 and rs4713916) conferred higher ratings on anxiety among females, but not males, in the presence of violence. Exposure to violence and female sex were associated with higher ratings on both depression and anxiety, with the exception of ratings on depression among young adults, on which sex had no effect. Ratings on depression were not associated with the haplogenotype. These findings may correspond to differences in the regulation of the HPA axis and with the higher vulnerability to anxiety in females.

Keywords
FKBP5; Anxiety; Depression; Exposure to violence; Sex differences
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-299873 (URN)10.1016/j.psyneuen.2016.07.206 (DOI)000382594600026 ()27448712 (PubMedID)
Funder
The Swedish Brain FoundationÅke Wiberg FoundationForte, Swedish Research Council for Health, Working Life and WelfarePublic Health Agency of Sweden , 2011-0627 2015-00897
Available from: 2016-07-28 Created: 2016-07-28 Last updated: 2017-11-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1033-2618

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