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Previous studies have suggested that children prenatally exposed to infections may be more likely than others to develop conditions such as schizophrenia and autism spectrum disorder (ASD), and that this may depend on the timing of prenatal exposure. Emerging literature has explored whether prenatal infections may also be associated with other outcomes such as attention-deficit/hyperactivity disorder (ADHD) as well as more broadly defined psychosocial vulnerabilities. This evidence, however, is scarce and mixed, and there is considerable methodological variability between studies. Further, few studies have examined links with co-occurring conditions, multiple psychosocial outcomes within the same study and psychosocial symptoms assessed on a continuum. The aims of this thesis were to fill these gaps by examining links between prenatal maternal infections and various psychosocial outcomes in childhood and adolescence using data from two UK cohort studies; the Millennium Cohort Study (MCS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Chapter 1 reviews pre-clinical evidence, as well as findings from human epidemiological studies, on the potential links between prenatal maternal infections and children's schizophrenia, ASD, and emerging evidence on links with other outcomes. Chapter 2 examines links between prenatal infections (both maternal-reported and hospital-recorded) and children's ASD, ADHD and co-occurring ASD and ADHD between the ages five and 14 in the MCS. Maternal-reported infections were found to be associated with increased odds of both ASD and ADHD but no links with co-occurring ASD and ADHD were found. Further, no associations were found between hospital-recorded infections and ASD, ADHD or co-occurring ASD and ADHD. Chapter 3 examines links between prenatal maternal infections, assessed using the same measures as Chapter 2, and children's socioemotional outcomes (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, prosocial behaviour) at age three in the MCS. Results showed that maternal-reported infections were associated with increased emotional symptoms (e.g., worries, unhappiness, fearfulness). No other associations were found. Chapter 4 examines trimester-specific links between maternal-reported prenatal infections and children's psychiatric diagnoses (pervasive development disorders, ADHD, behavioural disorders, emotional disorders) at ages seven and 14 in ALSPAC. Findings showed that after adjusting for the effects of other factors, these associations are weak to non-existent. Chapter 5 examines links between prenatal infections, assessed using the same measures as Chapter 4, and children's socioemotional outcomes at age eight in ALSPAC. Findings showed links between first and second trimester infections and increased conduct problems (e.g., temper tantrums, fighting) and hyperactivity/inattention. No other links were found. Lastly, Chapter 6 provides an overall discussion of the findings presented in this thesis. In conclusion, the findings are mixed, which is in line with the overall literature on the potential links between prenatal maternal infections and children's psychosocial outcomes. The associations seem fragile to methodological variation, which emphasises the need for triangulation, i.e., approaching the topic using a range of methods, in order to obtain as accurate estimates as possible.

Applied behavior analysis (ABA) applies principles of learning to problems of social significance. As a therapy, ABA is a treatment of choice for autism spectrum disorders (ASD), with several decades of research demonstrating ABA's effectiveness. However, the effectiveness of ABA for another common neurodevelopmental disorder, attention-deficit/hyperactivity disorder (ADHD), is less well known. Understanding the effectiveness of ABA for ADHD would be important for practitioners, especially for those working with individuals who have a comorbid diagnosis of ASD and ADHD. Thus, the purpose of this paper is to examine the effectiveness of ABA to treat symptoms of ADHD for individuals who are 6-17 years of age using a structured literature review. Using specific keywords, several public databases were searched for articles describing the use of ABA interventions to treat symptoms of ADHD. In total, fourteen articles were found that described the use of ABA to treat symptoms of ADHD. In general, 12 of 14 articles found indicated ABA was effective for treating symptoms of ADHD in children who are 6-17 years of age. Results are discussed for practitioners and consumers looking to make treatment decisions.

This study investigated the relationships among Attention-Deficit Hyperactivity Disorder (ADHD) symptoms and common comorbid struggles for clients, including Generalized Anxiety Disorder (GAD) symptoms, and executive functions, especially emotion regulation. ADHD and GAD are prevalent mental health conditions, are commonly comorbid with each other, and are both correlated with relative deficits in executive functions. Executive functions comprise higher-order cognitive processes like planning, inhibition, initiation, and monitoring, as well as emotion regulation. Prior research established connections among ADHD symptoms, GAD symptoms, and emotion regulation but did not examine which specific facets of emotion regulation were most relevant. The current study aimed to replicate previous research by examining the relationships among ADHD, GAD, and emotion regulation and extend it by exploring the specific facets of emotion regulation implicated, particularly for ADHD. Two hundred twenty-two adults (M age = 25.17, SD = 8.81) from a university student population and online forums completed an online survey of current ADHD and GAD symptoms, executive functions, and emotion regulation. Results showed that ADHD and GAD symptoms correlated positively with each other and with deficits in executive functions and emotion regulation. ADHD symptoms correlated positively with all facets of emotion regulation difficulties, but there were significant differences across the facets in the magnitudes of those correlations. The implications of this research may be informative for researchers, psychologists, and other mental health professionals focused on ADHD and GAD by enhancing the relevance of therapeutic strategies for clients with these diagnoses. By shedding light on the intricate relationships between ADHD, GAD, executive functions, and emotion regulation, the study findings may provide insights that could guide effective design and implementation of emotion regulation-based interventions for clients with ADHD.

The purpose of this phenomenological study was to describe the lived experiences of teachers who have experience working with students diagnosed with ADHD in the K-8 public school system in the Mid-Atlantic United States. The problem is that the number of students diagnosed with ADHD is rapidly increasing, and yet, educators are not being provided with the knowledge or the skills to support these students in the classroom (Dort et al., 2020). Due to the large percentage of students diagnosed with ADHD, research is needed to provide insight into what methods are being used by teachers in an inclusive classroom to enhance classroom management and to help these students with their learning. The study’s central question is: What are the lived experiences of K-8 teachers who have experience educating students diagnosed with ADHD? Expectancy Value Theory (EVT) guided the study. The study used a qualitative design, and data was collected in the form of journal prompts, individual interviews, and two focus groups. All data was transcribed, examined, in vivo, open coded, and placed into themes that developed during the research. The findings of the study showed that formal training in ADHD and support techniques for students diagnosed with ADHD is severely lacking. It also revealed how crucial it is for teachers to make a connection with these students to help them to live up to their potential. Finally, medication was shown to be a strong support method that should not be arbitrarily dismissed when given under proper medical supervision.

Previous research reports that children with attention-deficit/hyperactivity disorder (ADHD) show a deficit in their working memory. Working memory is the ability to temporarily manipulate, store, and retrieve information during cognitive tasks. Working memory is considered a critical deficiency in individuals diagnosed with ADHD. Working memory has been shown to be a mechanism for symptoms of disorganization and inattention in individuals diagnosed with ADHD. This qualitative research study reviewed occupational therapists’ perceptions on their role working with children, aged six to 10 years old, diagnosed with ADHD and low working memory, who have had eye movement therapy. The occupational therapists’ perceptions of the effects of eye movement therapy on working memory, conduct, and academic ability were investigated. ADHD and low working memory have been reported and characterized in two formats. First, children diagnosed with ADHD with hyperactive-impulsive subtype exhibit advanced levels of impulsive behavior, while those diagnosed with ADHD without hyperactive-impulsive subtype show a significant decrease in working memory to reduced reaction times. This research explored the effects of eye therapy treatment on the cognition of children diagnosed with ADHD from an occupational therapist professional perspective. Previous research has shown that eye therapy has improved working memory in children diagnosed with ADHD. Overall, during this study, occupational therapists discovered that integrating EMT with other interventions, such as cognitive-behavioral and sensory integration therapies, with children diagnosed with ADHD resulted in improvements in their working memories, attention, and academic performances.

Background: Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BPD) are neuropsychiatric disorders with high burdens. Despite this, the etiologies of ADHD and BPD are not well understood, and few modifiable risk factors have been identified. Emerging evidence suggests a role for early-life conditions, including pregnancy and neonatal characteristics. Objectives: To evaluate the associations between pregnancy and neonatal characteristics and offspring ADHD and BPD, including preterm birth, small-for-gestational age (SGA), preeclampsia, and placental abruption with ADHD in offspring (aim 1); gestational age, mode of delivery, birth weight-for-gestational age, head circumference-for-gestational age, gestational diabetes, preeclampsia, and placental abruption with BPD in offspring (aim 2); and maternal early pregnancy body mass index and gestational weight gain with BPD in offspring (aim 3). Methods: We conducted population-based cohort studies among non-malformed live-born singleton children in Sweden. Using national registries with prospectively recorded information, we followed 1,212,201 children born in 2002-2014 for an ADHD diagnosis from 3 up to 15 years of age, and we followed 2,059,578 children born in 1983-2004 for a BPD diagnosis from 13 up to 34 years of age. We compared ADHD and BPD risks between exposure categories using hazard ratios with 95% confidence intervals from adjusted Cox proportional hazards models. We also conducted sibling-controlled analyses among 751,464 and 1,467,819 full siblings in the ADHD and BPD cohorts, respectively. Results: There were 27,665 ADHD diagnoses and 14,998 BPD diagnoses in the respective cohorts. We found that preterm birth was associated with ADHD and BPD in a dose-response manner; for BPD, this association was restricted to very/extremely preterm birth (22 to 31 weeks). Both spontaneous and medically indicated preterm birth were associated with ADHD, while only spontaneous preterm birth was associated with BPD. SGA was also positively associated with ADHD and BPD. There was no association between head circumference-for-gestational age and BPD. In addition, we found a positive association between caesarean section birth and BPD. Furthermore, preeclampsia, but not placental abruption, was associated with offspring ADHD, while preeclampsia, placental abruption, and gestational diabetes were not associated with offspring BPD. Lastly, we found that maternal overweight and obesity during early pregnancy and excessive gestational weight gain were positively associated with offspring BPD. Conclusions and significance: Certain pregnancy and neonatal complications are associated with ADHD and BPD in offspring. This highlights the importance of quality prenatal care, which can reduce the risk of complications and promote fetal health. Maternal overweight and obesity are also associated with offspring BPD, underscoring the need for public health interventions to reduce the prevalence of overweight and obesity among women of reproductive age.

Teaching is a stressful profession, and teacher stress has been shown to be associated with job dissatisfaction, attrition from the field, and negative outcomes for teachers and their students. A major contributor to teacher stress is disruptive student behavior. Given that students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) demonstrate high rates of disruptive behaviors and are present in nearly every classroom, studying the connection between student ADHD symptoms and teacher stress may provide useful insights for better supporting teachers and their students. The aims of this study were to (1) assess the replicability of the finding that students with elevated ADHD symptoms are rated by their teachers as more stressful to teach than students without these behavioral problems and (2) explore the extent to which key factors (i.e., overall work-related stress, student-teacher relationship quality, training and use of positive behavioral intervention and supports) moderate the relationship between student ADHD symptoms and related teacher stress. Participants were 97 K-2nd grade teachers who completed online survey questions about themselves and two male students in their classroom. Results showed that teachers report students with elevated levels of ADHD symptoms and impairment to be more stressful to work with than students who do not exhibit these behaviors (d = 1.52). Additionally, overall work-related stress, closeness and conflict in the student-teacher relationship, and prioritization of positive behavioral intervention and supports in the classroom moderated the relationship between student ADHD symptom severity and related teacher stress. Implications of these findings and directions for future research are discussed.

Children with disruptive behaviors routinely have strained relationships with their parents. Longitudinal research has consistently demonstrated that increased levels of disruptive child behaviors predict increased levels of negative parenting behaviors and decreased levels of positive parenting behaviors. However, there is presently a dearth of research examining whether specific child behaviors are differentially associated with specific parenting behaviors, and whether associations vary in strength due to parent ADHD or depressive symptoms. As part of a previous study, 90 parent couples were randomly assigned to interact with a 9- to 12-year-old confederate child exhibiting either typical or disruptive behaviors. Observers coded specific child and parent behaviors in each interaction, and parents reported their own ADHD and depressive symptoms. Following adaptive child behaviors, the frequency of positive parenting behaviors was significantly greater than the frequency of negative parenting behaviors. Following disruptive child behaviors, the frequency of negative parenting behaviors was significantly greater than the frequency of positive parenting behaviors. Parent unlabeled praise, reflections, and labeled praise were each uniquely predicted by adaptive child behaviors more strongly than disruptive child behaviors. Parent indirect commands, direct commands, and negative talk were each uniquely predicted by disruptive child behaviors more strongly than adaptive child behaviors. Exploratory analyses yielded mixed results, with several relationships being moderated by parent ADHD or depressive symptoms. Results extend findings among parent-child dyads to the triad setting, clarify the degree of specificity with which parent behaviors are linked to child behaviors in the coercive cycle, and indicate areas for future research.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder. Clinical practice guidelines established by the American Academy of Pediatrics recommend behavioral treatments as a first-line intervention for preschool and elementary-aged children with ADHD. The Summer Treatment Program (STP) is one such treatment, providing intensive intervention to children with ADHD in the form of an 8-week summer day treatment program. Despite promising outcomes, the STP model remains largely cost-prohibitive for mental health teams and for families. Camp Baker, developed by Judge Baker Children’s Center, is a 6-week adaptation of the STP model intended to be more feasible and accessible to children and families in need than the traditional 8-week program. Despite the preliminary evidence and support for the implementation of this adapted STP, further investigation is needed to understand the overall effectiveness of this treatment model in terms of clinically meaningful and interpretable outcomes and to identify subpopulations of children with particularly strong or poor response to this specific intervention. This is the first study to investigate both program effectiveness and moderators of treatment outcome for participants of a 6-week adaptation of the STP delivered in a community setting.

Co-occurrence of attention-deficit/hyperactivity disorder (ADHD) with depression or anxiety (i.e., internalizing disorders) is a major route to poor outcomes, with temperament traits presenting as potential shared risk markers that underlie these disorders’ development and characterization. Prior work investigating the nature of ADHD-internalizing disorder co-occurrence using structural equation modeling has provided support for both temperament-based common cause (i.e., effortful control and negative affect as liabilities for multiple disorders) and direct causation (i.e., ADHD directly contributing to risk for internalizing disorders) effects separately. Using a network approach, the current study represented the first attempt to integrate these effects into one model while parsing heterogeneity in the trait-symptom and symptom-symptom relations within them. Participants were 799 children and adolescents aged 7-13 years at baseline (61.20% boys, 85.11% White; 59.57% diagnosed with ADHD). Across two measurement points approximately five years apart (i.e., Year 1, Year 6), parents/caregivers provided ratings of participants’ ADHD symptoms and temperament traits and participants provided ratings of depressive and anxiety symptoms. Pertaining to ADHD-depression networks, results suggested effortful control and, particularly, negative affect as transdiagnostic risk markers via relations with symptoms of both disorders. Simultaneously, depressive symptoms associated with reductions in perceived self-competence and difficulty making friends were uniquely related to several ADHD symptoms in Year 1, and ADHD inattentive symptoms (i.e., loses things; does not follow through; has difficulty sustaining attention) were uniquely related to depressive symptoms associated with reductions in perceived self-competence, distress/hopelessness, low self-worth, and difficulty making friends in Year 6. Examination of ADHD-anxiety networks suggested limited heterogeneity in symptom-symptom relations, although negative affect emerged as a core transdiagnostic risk marker via relations with inattentive and hyperactive/impulsive ADHD symptoms and anxiety symptoms associated with somatic problems and peer-related fears. Comparison of network findings with those of structural equation modeling approaches to conceptualizing common cause and direct causation effects suggested consistent and complementary results. No differences were identified in the structure of networks across Years 1 and 6, as well as gender. Continued clarification of specific and unique common cause and direct causation effects in the context of one another may help identify those most influential to the development and characterization of ADHD-internalizing disorder co-occurrence, with a focus on such effects potentially highlighting targets for screening tools and interventions that address and account for symptoms of multiple disorders.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent and impairing childhood disorders (5%; American Psychiatric Association, 2013), yet it is often studied in isolation. Such an approach is at odds with the clinical reality, where ADHD has a high comorbidity with oppositional defiant disorder, anxiety, and depression (Jensen, Martin, & Cantwell, 1997). Based on the possible presentations of ADHD with both externalizing and internalizing symptoms, there may be differences in associated characteristics, areas of impairment, and resulting assessment interventions. Therefore, the present study investigated how ADHD comorbidities manifested in a population of 233 elementary age children and how these profiles varied in already established characteristics (i.e., traits, social behaviors) and areas of deficit for children with ADHD (i.e., social functioning, academics, narrative comprehension). Characteristics and outcomes were examined using rating scales, behavior observations, laboratory tasks, and grades. Based on latent profile analyses, different patterns of comorbidity were identified using both parent and teacher ratings of ADHD. Based on parent and teacher report, those with high ADHD/ODD symptoms had more negative characteristics and outcomes. Network analyses corroborated these results, showing that internalizing symptoms were less relevant for associated characteristics and outcomes compared to ADHD and ODD symptoms. Overall, these results suggest that ADHD comorbidities may be primarily driven by ADHD and ODD symptoms, with this profile displaying more severe negative characteristics and outcomes.

Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are heterogeneous neurodevelopmental disorders with similar functional impairments. Specifically, working memory (WM) deficits have been found in studies of both ADHD and ASD and social competence has been identified as an area in which these individuals also struggle. The purpose of this study was (a) to identify which components of working memory (WM; based on Baddeley's 2000 model) are deficient and (b) to explore how WM deficits contribute to social problems in individuals with varying levels of ADHD symptoms and ASD traits. It was hypothesized that visuospatial (VS) WM deficits would be evident in the three analogue clinical groups, phonological (PH) WM and central executive (CE) deficits would be more evident in groups with high ADHD symptoms, all three analogue clinical groups would have lower social competence, and WM abilities would moderate the relationship between ADHD symptoms and social competence. In Phase I, 1311 undergraduate students participated in an online survey on general psychopathology, ADHD symptoms, and ASD traits. From this sample, a subgroup (n = 60) completed Phase II, an in-lab session that included WM tasks, a brief cognitive assessment, and social conversation task. Although WM deficits were not identified for any group, all participants demonstrated worse performance on the VS WM task than the PH WM task. However, WM abilities did not moderate the relationship between ADHD symptoms and social competence. Exploratory analyses were conducted with similar results. Limitations and suggestions for future research are discussed.

This study examined the relationships among consumer demographic and vocational rehabilitation case service predictor variables and employment/postsecondary educational outcome variables for transition age consumers with ADHD ages 16-19 and 20-24. Utilizing the Rehabilitation Services Administration (RSA) 911 data file from the 2012 fiscal year, logistic regression was used to examine predictors of successful employment outcomes and postsecondary educational attainment at case closure for each age group. Differences in weekly earnings at closure for White, African American and Hispanic/Latino males and females were examined using Analysis of Variance. Independent measures t-tests were used to examine mean earnings between consumers who received college training as a case service and those who were not provided with this service. Results revealed similarities and differences between the two age groups. Nearly 80% percent of transition age consumers with ADHD were in the younger age group. Race was a statistically significant demographic variable with Hispanic/Latino ethnicity related to successful employment and postsecondary educational outcome whereas African American status was negatively related to both successful employment and postsecondary educational outcome. Public support was also negatively related to successful employment outcome in both age groups. Job placement assistance, job search assistance, and on the job supports significantly predicted successful employment outcomes in both age groups. Gender, race/ethnicity and level of education were demographic predictors of postsecondary educational outcomes. Female and Hispanic/Latino consumers were more likely to have attained postsecondary education. Assessment, college training, occupational training, maintenance, rehabilitation technology and information and referral all positively predicted postsecondary educational attainment. On the job supports, job readiness training, job placement assistance, and miscellaneous training had a negative relationship to postsecondary educational attainment. Statistically significant differences were found in weekly earnings across race in both age groups and between men and women in the younger age group only. White males earned more than any other group and Hispanic/Latino consumers earned lower wages, despite having higher levels of education and employment. In both age groups, consumers receiving college training as a case service earned significantly more per week at closure than those who were not provided this service. Implications for practice and future research are discussed.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in school-age children and is the cause of multiple burdens related to healthcare costs, academic performance, and later employment. As such, its etiology represents a major public health concern. While genetics play a large role in the etiology of ADHD, multiple environmental exposures may contribute to risk. Here, we investigate the role of one toxicant, methylmercury (MeHg), measured in hair and blood, and its possible interactions with both other toxicants (lead, Pb) and a series of candidate genes. Additionally, we examined possible associations of MeHg exposure with the acoustic startle reflex (ASR) and the sensorimotor gating process, prepulse inhibition (PPI), in which deficits have been observed in individuals with attention deficits. Participants were recruited from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) study, a longitudinal birth cohort that began in the 1990s. ADHD symptoms were screened using the Conners’ Continuous Performance Test II (CPTII) and the Conners’ Rating Scales-Revised (CRS-R). We found no significant associations between prenatal and postnatal MeHg exposures and ADHD screening scores. No interaction was seen for concurrent exposures to MeHg and Pb. For prenatal exposure, generally, interactions between the two metals corresponded to increasing attention deficits scores in trimester 1, while interactions between the two corresponded to decreasing attention deficits scores in trimester 2, and no pattern was seen in trimester 3. Additionally, we found that associations between hair Hg concentration and attention measures differed by dopamine receptor D4 (DRD4) and catechol-O-methyltransferase (COMT) genotype. ASR without a prepulse was non-linearly associated with MeHg exposure. For ASR response magnitudes with prepulses, higher MeHg generally corresponded to higher ASR magnitudes, especially in the right tail of their respective distributions. No significant associations were seen between MeHg and PPI. This research adds to our understanding of how environmental influences like MeHg can play a role in the development of attention deficits in children and adolescents.

Over 50% of inmates have mental health problems (James & Glaze, 2006) and specific diagnostic labels have been shown to adversely affect sentencing outcomes (e.g., Edens, Desforges, Fernandez, & Palac, 2004). We applied social categorization, attribution theory, and psychological essentialism to clarify the ways diagnostic labels perpetuate stigmatization of defendants by assessing sentencing and facility recommendations, future dangerousness predictions, and defendant controllability and stability attributions. These measures were administered after participants read a vignette describing a crime where the perpetrator varied according to the diagnostic labels: Antisocial Personality Disorder (ASPD), Schizophrenia, Autism Spectrum Disorder (ASD), and Attention-Deficit/Hyperactivity Disorder (ADHD). These labels were associated with more psychiatric facility recommendations compared to a no-label control condition, and ADHD was associated with more prison recommendations compared to the other labels. Controllability attributions were significantly different when ADHD and no-label were compared to ASPD, Schizophrenia, and ASD, and when Schizophrenia was compared to ASD. Stability attributions were significantly different between the no-label condition and each of the diagnostic labels. These findings suggest that jurors may consider certain labels as mitigating evidence when making legal decisions, whereas other labels may be less mitigating.

Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed.

The goals of the present study were to (1) systematically examine aspects of peer functioning that are concurrently and longitudinally associated with ADHD symptoms; (2) investigate differential and independent effects of inattention and hyperactivity/ impulsivity on peer functioning; (3) examine potential mechanisms and processes involved; (4) study longitudinal effects of ADHD symptoms as well as the dynamic interplay between ADHD symptoms and their associated peer impairment over time; (5) explore potential risk and protective factors underlying the link between ADHD symptoms and peer problems; (6) explore the effect of gender; and (7) expand the current literature in this area of research to a non-Western culture (i.e., Taiwan). The sample of this study consisted of 739 preadolescents (239 fourth graders and 500 fifth graders) from northern Taiwan who participated in a short-term longitudinal study across three time points, six months apart. Overall, results indicated that inattention and hyperactivity/impulsivity each showed unique and independent (both concurrent and longitudinal) associations with a variety of peer relationship problems. Moreover, each core domain of ADHD was associated with different patterns of social behaviors (i.e., relational aggression, physical aggression, prosocial behavior), conferring differential pathways and mechanisms underlying peer impairment. Findings also showed a vicious cycle in which ADHD symptoms predicted later peer impairment, which in turn lead to increases in ADHD symptoms. This study further revealed some potential protective factors (e.g., high levels of prosocial behavior and low levels of physical aggression, relational aggression, and depressive symptoms) that may buffer against peer dislike in youth with ADHD symptoms. In addition, ADHD symptoms may affect girls' peer functioning to a greater extent than boys'. Taken together, the present findings from a Taiwanese sample, in comparison to the Western literature, demonstrated both similarities and differences in the associations between children's ADHD symptoms and their peer functioning as well as the mechanisms and the effect of gender involved. Implications of the present findings are discussed from a developmental psychopathology perspective.

Children with Disruptive Behavior Disorders (DBD), including Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) have poorer language skills compared to typically developing children; however, language as a potential risk factor for DBD has received little empirical attention or evaluation. Receptive, expressive, and pragmatic language skills in preschoolers with DBD were examined. Participants were 82 preschool-age children and their primary caregivers. Primary caregivers completed a semi-structured interview and symptom and language questionnaires. Preschoolers completed measures of receptive and expressive language. Results indicated that preschoolers with DBD were more impaired on receptive, expressive, and pragmatic language compared to non-DBD children. Pragmatic language appears particularly impaired in children with DBD, and language problems appear most linked with increased hyperactivity-impulsivity (vs. inattention or oppositional-defiance). This work suggests the need for early assessment of language in preschoolers with DBD, as well as the possibly utility of tailored interventions focusing on improving pragmatic language.

The current study evaluated a treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and anxiety. The experimental treatment involved a combination of parent management training for ADHD and family-based treatment for anxiety. Sessions lasted approximately 90 minutes, and the treatment consisted of 10 weekly sessions. 8 children ages 8-12 with ADHD, Combined Type (ADHD-C) and at least one of three anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia) were selected for the study. Children were assessed with semi-structured diagnostic interviews and other standardized measures to determine study eligibility. The current study utilized a noncurrent multiple baseline design to evaluate treatment efficacy. Upon selection into the study, children were randomized to one of three baseline control conditions (i.e., 2, 3, or 4 weeks of waiting) in order to insure that change in behavior was associated with implementation of the treatment. Treatment commenced after the respective baseline periods. Families were assessed throughout treatment but more comprehensive assessments were conducted at pre-treatment, mid-treatment, and 1-week post-treatment. Results highlighted significant improvement in anxiety-related symptoms but more modest gains for ADHD-related symptoms.

Numerous studies have found evidence to support the presence of a positive illusory bias (PIB) in children with attention-deficit/hyperactivity disorder (ADHD; Diener & Milich, 1997; Hoza et al., 2004; Hoza, Pelham, Dobbs, Owens, & Pillow, 2002; Ohan & Johnston, 2002; Owens & Hoza, 2003). However, the underlying mechanism of the PIB has yet to be determined. Although a number of researchers have hypothesized that underlying executive functioning deficits in children with ADHD may be associated with a PIB (Hoza et al., 2001; Owens & Hoza, 2003), to date, no study has examined the relationship between executive functioning and the PIB in children with ADHD. Thus, the primary purpose of this study is to examine executive functioning as it relates to the PIB in children with ADHD. Participants included 34 children in the ADHD group and 30 children in the CTL group. Participants completed six tests of executive functioning including: a Stop Signal Task, the D-KEFS Color-Word Test, Digit Span, the Stanford-Binet Spatial Working Memory Test, the D-KEFS Tower Test, and the D-KEFS Sorting Test. Following each task, participants completed a task-specific self-evaluation estimate. Participants also completed a set of easy mazes and impossible mazes followed by post-task self-evaluation estimates. In conjunction with a parallel research project, the following measures were also obtained from participants: Self-Perception Profile for Children (SPPC), Teacher Rating Scale of Child's Actual Behavior, Wechsler Abbreviated Scale of Intelligence (WASI), Disruptive Behavior Disorder Rating Scale (DBD), Parent and Teacher Impairment Rating Scale (IRS), Children's Interview for Psychiatric Syndromes' Parent Version (P-ChIPS), and a demographic questionnaire. Consistent with previous studies, group differences in executive functioning and overestimations of competence were found. The ADHD group performed significantly worse than the CTL group on four of six measures of executive functioning, even after controlling for IQ. In support of the PIB, it was hypothesized that children with ADHD would overestimate their performance on executive functioning tasks significantly more than control children. This hypothesis was partially supported by analyses revealing that children with ADHD overestimated their performance more than controls on three of six task-specific self-perception discrepancy scores. Additionally, the relative contributions of depression, executive functioning performance and ADHD symptoms in the self-perceptions of participants were examined by using both traditional SPPC discrepancy scores as well as task-specific discrepancy scores. Results of the current study provide preliminary evidence that executive functioning may influence the self-perceptions of children with ADHD. Specifically, higher executive functioning was found to be related to lower overestimation of competence in one broad domain (e.g., SPPC Scholastic) and a number of task-specific domains.

The current study investigates two recently identified threats to the construct validity of behavioral inhibition as a core deficit of attention-deficit/hyperactivity disorder (ADHD) based on the Stop-signal task: calculation of mean reaction time from go-trials presented adjacent to intermittent stop-trials, and non-reporting of the stop-signal delay metric. Children with ADHD (n=12) and typically developing children (TD) (n=11) were administered the standard stop-signal task and three variant stop-signal conditions. These included a No-Tone condition administered without the presentation of an auditory tone; an Ignore-Tone condition that presented a neutral (i.e., not associated with stopping) auditory tone; and a second Ignore-Tone condition that presented a neutral auditory tone after the tone had been previously paired with stopping. Children with ADHD exhibited significantly slower and more variable reaction times to go-stimuli, and slower stop-signal reaction times (SSRT) relative to TD controls. Stop-signal delay (SSD) was not significantly different between groups, and both groups' go-trial reaction times slowed following meaningful tones. Collectively, these findings corroborate recent meta-analyses and indicate that previous findings of stop-signal performance deficits in ADHD reflect slower and more variable responding to visually presented stimuli and concurrent processing of a second stimulus, rather than deficits of motor behavioral inhibition.

Hyperactivity is currently considered a core and ubiquitous feature of attention-deficit/hyperactivity disorder (ADHD); however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory (WM) and activity level. The current study investigated whether children s activity level is functionally related to WM demands associated with the domain-general central executive and subsidiary storage/rehearsal components using tasks based on Baddeley s (2007) WM model. Activity level was objectively measured 16 times per second using wrist- and ankle-worn actigraphs while 23 boys between 8 and 12 years of age completed control tasks and visuospatial/phonological WM tasks of increasing memory demands. All children exhibited significantly higher activity rates under all WM relative to control conditions, and children with ADHD (n=12) moved significantly more than typically developing children (n=11) under all conditions. Activity level in all children was associated with central executive but not storage/rehearsal functioning, and higher activity rates exhibited by children with ADHD under control conditions were fully attenuated by removing variance directly related to central executive processes.

The purpose of this study was to empirically evaluate the diagnostic utility of the Conners CPT and the P ASAT as a laboratory-based measures of attention, vigilance, working memory, and sustained mental effort in clinic-referred adults with and without ADHD. Moreover, the study was conducted in order to obtain additional evidence in ongoing efforts to clarify the classification and phenomenological status of ADHD in adults. Subjects were adults seeking psychological evaluation for a variety of presenting problems including, emotional, occupational, relational, and/or adjustment, difficulties. Standardized clinical evaluations were conducted and structured clinical interviews were used to determine clinical diagnosis and group membership (ADHD vs. Non-ADHD). It was hypothesized that ADHD adults would exhibit significantly more comorbid psychopathology, learning problems, and verbal memory deficits than non-ADHD adults. It was also hypothesized that the findings from the CPT (Conners, 1992) and P ASAT (Gronwall, 1977) would reliably discriminate these groups (ADHD and non-ADHD) of clinic-referred adults. While ADHD adults did not exhibit a higher frequency of learning disabilities, they did have significantly more comorbid psychopathology and were much more likely to experience clinically impairing deficits in verbal memory functioning. The combined results of the laboratory tasks accurately identified diagnostic group status in over 9 of 10 cases for ADHD adults and in approximately 8 of 10 cases for non-ADHD adults. The relevance of these findings for the psychiatric classification and experiential nature of ADHD in adults, as well as the clinical diagnostic utility of these laboratory measures for adult ADHD is discussed.