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  • 1.
    Brocki, Karin C.
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Forslund, Tommie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Frick, Matilda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Do Individual Differences in Early Affective and Cognitive Self-Regulation Predict Developmental Change in ADHD Symptoms From Preschool to Adolescence?2019In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, ISSN 1087-0547, Vol. 23, no 13, p. 1656-1666Article in journal (Refereed)
    Abstract [en]

    Objective: The role of heterogeneous self-regulation deficits in ADHD has long been emphasized. Yet, longitudinal studies examining distinct self-regulation processes as prospective predictors of developmental change in ADHD symptoms spanning wide developmental periods are scarce. The aim of the current study was to examine affective and cognitive self-regulation as predictors of developmental change in ADHD symptoms from preschool to adolescence in a sample with one third of the children being at risk for developing an ADHD and/or ODD diagnosis.

    Method: At 5 years laboratory measures for hot and cool executive function (EF) and parental and teacher ratings were used for regulation of positive and negative emotionality. Symptoms of ADHD and ODD were measured at 5 and 13 years using parental and teacher ratings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV).

    Results: Converging developmental paths in hyperactivity/impulsivity across time were found for those high versus low in early cognitive self-regulation, whereas the development of inattention symptoms diverged across time for those high versus low in early affective self-regulation.

    Conclusion: These results support the idea that different aspects of self-regulation are important for developmental change in the two separate ADHD symptom domains from preschool to adolescence.

  • 2.
    Forssman, Linda
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Eninger, Lilianne
    Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden.
    Tillman, Carin
    Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden.
    Rodriguez, Alina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Biostat, London, England; Kings Coll London, Inst Psychiat, MRC Social Genet Dev Psychiat Ctr, London WC2R 2LS, England.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Cognitive Functioning and Family Risk Factors in Relation to Symptom Behaviors of ADHD and ODD in Adolescents2012In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 16, no 4, p. 284-294Article in journal (Refereed)
    Abstract [en]

    Objective: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. Method: A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. Results: The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. Conclusion: These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

  • 3.
    Frick, Matilda
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hedqvist, Maria
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Brocki, K. C.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Temperament and Cognitive Regulation During the First 3 Years of Life as Predictors of Inattention and Hyperactivity/Impulsivity at 6 Years2019In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 23, no 11, p. 1291-1302Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: With a wish to identify early markers of inattention and hyperactivity/impulsivity, we examined effects of temperament and cognitive regulation, during the first 3 years of life, on later inattentive and hyperactive/impulsive behavior.

    METHOD: Temperament and cognitive regulation were assessed at 12, 18, 24, and 36 months in 66 typically developing children. Teachers rated inattention and hyperactivity/impulsivity at 6 years.

    RESULTS: Temperamental activity at all studied time points was predictive of later hyperactive/impulsive behavior, thus appearing as a stable marker thereof. Activity at 12 months was also predictive of inattention, whereas temperamental persistence was correlated with inattention and hyperactivity/impulsivity, but with no independent contributions. No significant relations between cognitive regulation and the outcome measures were found.

    CONCLUSION: Our findings add to the scarce literature proposing that markers of inattentive and hyperactive/impulsive behavior in early school age can be found within the first years of life, using parental ratings of child temperament.

  • 4.
    Holmberg, Kirsten
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Bölte, Sven
    Karolinska Institutet, Stockholm, Sweden.
    Do Symptoms of ADHD at Ages 7 and 10 Predict Academic Outcome at Age 16 in the General Population?2014In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 18, no 8, p. 635-645Article in journal (Refereed)
    Abstract [en]

    Objective:

    To examine the value of the Conners 10-item scale to predict academic outcomes at age 16 years in schoolchildren aged 7 and 10 years.

    Method:

    A cohort study of N = 544 children in a municipality of Stockholm County was conducted. Using the parent and teacher version of the Conners 10-item scale, 7- and 10-year-olds were screened for ADHD symptoms and followed-up for school outcome at age 16 years.

    Results:

    The best predictors for school outcome at age 16 years were the Conners items, "child failing to finish tasks" and "being inattentive, easily distracted," with a high specificity (90%-97%) but low sensitivity (18%-39%).

    Conclusion:

    This study indicates a considerable association between certain symptoms of inattentiveness in young schoolchildren and academic underachievement at age 16 years. Screening for one to two symptoms of inattention in schoolchildren identifies 30% to 40% of participants at risk for later poor school attainment.

  • 5.
    Isaksson, Johan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Department of Women’s and Children’s Health, Pediatric Neuropsychiatry Unit, Center for Neurodevelopmental Disorders.
    Ruchkin, Vladislav
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Yale Child Study Center, Yale University USA; Säter Psychiatric Clinic.
    Lindblad, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Unseen and Stressed? Gender Differences in Parent and Teacher Ratings of ADHD Symptoms and Associations With Perceived Stress in Children With ADHD.2016In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In this study, we investigate the differences between parent and teacher ADHD ratings, and how these ratings relate to perceived stress in children with ADHD.

    METHOD: Ratings by parents and teachers with the Swanson, Nolan and Pelham ADHD symptom rating scale (SNAP-IV) were collected from children with a clinical diagnosis of ADHD (n = 137). Also, information on medication was collected. Children (≥11 years of age; n = 64) were invited to complete the Pressure-Activation-Stress scale.

    RESULTS: Among girls, but not boys, teacher ratings were significantly lower than parental ratings on all symptom scales. Lower teacher ratings on hyperactivity symptoms were associated with higher levels of perceived stress.

    CONCLUSION: The findings suggest a potential gender bias in ratings among teachers. Underrated, and hence underidentified, ADHD problems in the school setting seem to increase the perception of stress in the sense of pressure for both girls and boys.

  • 6. Konstenius, Maija
    et al.
    Larsson, Henrik
    Lundholm, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Philips, Bjorn
    van de Glind, Geurt
    Jayaram-Lindstrom, Nitya
    Franck, Johan
    An Epidemiological Study of ADHD, Substance Use, and Comorbid Problems in Incarcerated Women in Sweden2015In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 19, no 1, p. 44-52Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to examine the prevalence of ADHD and psychiatric comorbidity, including substance use in incarcerated women. Method: This was a cross-sectional study, consisting of two parts: (a) screening using the ADHD Self-Rating Scale (ASRS) and (b) diagnostic assessment using a structured interview. Results: A sample of 96 incarcerated women was screened and 56 underwent the diagnostic assessment. Twenty-nine percent of the women met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic criteria for adult ADHD in the diagnostic assessment. Forty-four of the women had misuse of alcohol, and 83% had misuse of narcotics the year prior to the incarceration. The ASRS showed sensitivity of 1.0 and specificity of 0.66. Conclusion: The prevalence rate of ADHD in incarcerated women was high and comparable to that in male offenders. Illicit stimulant use and antisocial personality disorder were significantly more common in women with ADHD. ASRS is useful as a screener in this population.

  • 7.
    Nehlin Gordh, Christina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Nyberg, Fred
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Öster, Caisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    The patient´s perspective on the link between ADHD and substance use: A qualitative interview study2015In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 19, no 4, p. 343-350Article in journal (Refereed)
    Abstract [en]

    Object

    The primary aim of this study was to investigate how adult individuals with ADHD perceive the role of alcohol and drugs in their lives. A secondary aim was to identify factors that those individuals consider useful in the treatment and prevention of co-occurring ADHD and substance use disorders.

    Method

    A qualitative interview study with ADHD outpatients (n=14) at a psychiatric clinic. Data were analyzed based on pre-defined areas of interest using a deductive content analysis method.

    Results

    The yearning for belongingness was identified as an important driving force underlying substance use. The participants felt that alcohol/drugs helped them being normal and thus respected and accepted. Early diagnosis of ADHD was perceived essential to avoid SUD.

    Conclusion

    Adults with ADHD may have strong rational and emotional reasons for the use of alcohol and drugs. When planning for the treatment of adult ADHD, investigation of personal reasons for alcohol/drug use deserves a place.

  • 8.
    Pettersson, Richard
    et al.
    Cty Hosp, Neuropsychol Clin NPC, ADHD, Vasteras, Sweden..
    Söderström, Staffan
    Cty Hosp, Neuropsychol Clin NPC, ADHD, Vasteras, Sweden..
    Edlund-Söderström, Kerstin
    Cty Hosp, NPC, Vasteras, Sweden..
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Cty Hosp, Vasteras, Sweden..
    Internet-Based Cognitive Behavioral Therapy for Adults With ADHD in Outpatient Psychiatric Care: A Randomized Trial2017In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 21, no 6, p. 508-521Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD.

    METHOD: Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up.

    RESULTS: Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups.

    CONCLUSION: The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations of the study design and directions for future research are discussed.

  • 9.
    Pettersson, Richard
    et al.
    Cty Hosp, Neuropsychol Clin, Vasteras, Sweden.
    Söderström, Staffan
    Cty Hosp, Neuropsychol Clin, Vasteras, Sweden.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Diagnosing ADHD in Adults: An Examination of the Discriminative Validity of Neuropsychological Tests and Diagnostic Assessment Instruments2018In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 22, no 11, p. 1019-1031Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this study is to investigate the discriminative validity of neuropsychological tests and diagnostic assessment instruments in diagnosing adult ADHD in a clinical psychiatric population.

    METHOD: Of 108 patients, 60 were diagnosed with ADHD. The Diagnostic Interview for ADHD in adults (DIVA 2.0) and Adult ADHD Self-Report Scale (ASRS) v.1.1 together with eight neuropsychological tests were investigated.

    RESULTS: All instruments showed poor discriminative ability except for the DIVA, which showed a relatively good ability to discriminate between the groups (sensitivity = 90.0; specificity = 72.9). A logistic regression analysis model with the DIVA and measures of inattention, impulsivity, and activity from continuous performance tests (CPTs) showed a sensitivity of 90.0 and a specificity of 83.3.

    CONCLUSION: Neuropsychological tests have a poor ability to discriminate between patients diagnosed with ADHD and patients not diagnosed with ADHD, but variables from CPT tests can contribute to increasing the specificity by 10% if used in combination with the DIVA.

  • 10.
    Ruchkin, Vladislav
    et al.
    Yale University.
    Lorberg, Boris
    Koposov, Roman
    Schwab-Stone, Mary
    Sukhodolsky, Denis G
    ADHD symptoms and associated psychopathology in a community sample of adolescents from the European north of Russia.2008In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 12, no 1, p. 54-63Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the prevalence of ADHD symptoms and their relationship to psychopathology in adolescents from the European North of Russia.

    METHOD: The prevalence of ADHD symptoms is assessed by teacher reports in 536 adolescents. Internalizing and externalizing problems are assessed by teacher ratings and student self-reports.

    RESULTS: Prevalence of individual ADHD symptoms ranges between 3.3% and 35%. Only 8.9% of boys and 3.6% of girls have positive ratings on six items in either inattention or hyperactivity subtype. These adolescents fare significantly worse regarding externalizing but not internalizing problems. Compared to girls with ADHD, boys with ADHD report higher levels of violent and nonviolent delinquency and are described by teachers as having more conduct problems. Possible ADHD status is associated with depressive symptoms in boys but not in girls.

    CONCLUSION: The estimates of ADHD prevalence rates obtained in this study are similar to those of other countries, suggesting the need for identification and treatment of the disorder. Evaluation of associated disruptive behavior disorders and depression, particularly in boys, is warranted.

  • 11.
    Scholtens, Sara
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Diamantopoulou, Sofia
    Tillman, Carin M.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Rydell, Ann-Margret
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Effects of Symptoms of ADHD, ODD, and Cognitive Functioning on Social Acceptance and the Positive Illusory Bias in Children2012In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 16, no 8, p. 685-696Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the effects of symptoms of ADHD and ODD and cognitive functioning on social acceptance and positive bias in children. Method: The sample consisted of 86 children (49 girls) between 7 and 13 years old, recruited to reflect a wide range of ADHD symptoms. Parents and teachers reported on ADHD and ODD symptoms and social acceptance. Children reported on social acceptance and were given tasks measuring working memory, inhibition and reaction-time variability. A discrepancy score between child and adult reports of social acceptance was used as a measure of positive bias. Results: Inattention independently explained variance in social acceptance. The cognitive factors were related to social acceptance and the positive bias, but not beyond the ADHD and ODD symptoms. Conclusion: It is primarily disruptive behavior that contributes to external reports of children's social acceptance.

  • 12.
    Tillman, Carin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bohlin, Gunilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents2012In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, no 16, p. 284-294Article in journal (Refereed)
  • 13.
    Tillman, Carin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Brocki, Karin C
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Sørensen, Lin
    Lundervold, Astri J
    A Longitudinal Examination of the Developmental Executive Function Hierarchy in Children With Externalizing Behavior Problems2015In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 19, no 6, p. 496-506Article in journal (Refereed)
    Abstract [en]

    Objective: Using a 4-year longitudinal design, we evaluated two hypotheses based on developmental executive function (EF) hierarchy accounts in a sample of children with externalizing problems. Method: The participants performed EF tasks when they were between 8 and 12 years (M = 9.93), and again approximately 4 years later when they were between 12 and 15 years (M = 13.36). Results: Inhibition in middle childhood predicted working memory (WM) 4 years later. Further, deficits in inhibition and sustained attention were more prominent in middle rather than late childhood, whereas poor WM was salient throughout these periods. Conclusions: These findings support the hypotheses that EFs develop hierarchically and that EF deficits in ADHD are more prominent in actively developing EFs. They also emphasize ADHD as a developmental disorder.

  • 14.
    Tillman, Carin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Granvald, Viktor
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    The Role of Parental Education in the Relation Between ADHD Symptoms and Executive Functions in Children2015In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 19, no 6, p. 542-548Article in journal (Refereed)
    Abstract [en]

    Objective: Using a population-based sample of 9-year-old children, this study examined whether the relation between symptoms of ADHD and executive functions (EFs) depended on socioeconomic status (SES; indexed by parental education). Method: Parents and teachers rated the children's ADHD symptoms, and parents also indicated their educational level in a questionnaire. The children performed a comprehensive set of EF tasks. Results: Whereas working memory was similarly related to ADHD symptoms in the lower and higher parental education group, the relations of inhibition and mental set-shifting with ADHD symptoms were generally stronger in the higher educational group, a pattern that was supported by several significant group differences in correlations. Conclusion: This suggests that the EF pathway in contemporary multiple pathway models of ADHD etiology may be particularly relevant in higher SES parts of the population.

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