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Abstract: Objective: There is substantial symptomatic overlap between attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults, but the nature of the relationship between these disorders needs further clarification. The role of temperament and character traits in the differentiation of classes of patients with similar ADHD and BPD symptom profiles was examined and possible pathways between early temperament and future ADHD and/or BPD were hypothesized. Methods: Structured diagnostic interviews were conducted in 103 female patients to assess current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptoms of ADHD and BPD, and parent interviews were used to assess ADHD symptoms in childhood. Classes of subjects with homogeneous symptom profiles were identified using latent class analysis. Temperament and character traits were assessed using the Temperament and Character Inventory of Cloninger et al; scores were then compared across the latent classes. Results: Latent class analysis revealed 4 mutually exclusive classes of patients: 1 with only ADHD symptoms; 1 with BPD symptoms and ADHD symptoms of hyperactivity; 1 with BPD symptoms and ADHD symptoms of inattention, hyperactivity, and impulsivity; and 1 with BPD symptoms and ADHD symptoms of inattention and hyperactivity. High Novelty Seeking was found in all classes except for the class with symptoms of BPD and only the hyperactivity aspect of ADHD. The highest Novelty Seeking temperament scores were found in that class of patients with both symptoms of BPD and symptoms in all areas of ADHD. High Harm Avoidance, low Cooperativeness, and low Self-directedness were specifically related to classes containing BPD symptoms. Conclusions: Classes of ADHD and BPD symptoms are associated with specific temperament and character configurations. Novelty Seeking was associated with the inattention symptoms of ADHD. An outspoken Novelty Seeking temperament suggests vulnerability for the development of ADHD and co-occurring BPD. Contrary to patients with combined ADHD and BPD symptoms, patients with only symptoms of ADHD showed normal character development and thus an absence of a personality disorder. Assessment of temperament and character traits can improve our understanding of the complex relationship between ADHD and BPD. [Copyright &y& Elsevier]

The aim of this study was to identify risk factors for benzodiazepine (BZD) dependence, such as sociodemographic variables, characteristics of BZD use, and psychiatric parameters, which to date have been found to relate inconsistently to indicators of BZD dependence such as chronic BZD use and BZD withdrawal symptoms. The Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ), Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and Symptom Checklist-90 (SCL-90) were administered to 599 outpatients using BZDs. Regression analyses were conducted using BZD dependence diagnoses and severity scales as dependent variables. BZD dependence diagnoses were only predicted by being a self-help patient and long BZD elimination half-life (for only the DSM-III-R). The main predictors of BZD dependence severity, as measured by the ICD-10, DSMIII-R scales, and Bendep-SRQ Rasch scales, were in decreasing order: (1) being a self-help patient; (2) higher BZD dose, longer duration of BZD use, younger age; and (3) non-native cultural origin, lower level of education, being in outpatient treatment for alcohol and/or drug dependence, and the interaction of BZD dose with duration of BZD use. We conclude that a limited number of recognizable risk factors appear to predict the severity of BZD dependence. Additional administration of a specific BZD dependence instrument is recommended to confirm suspected BZD dependence and guide further clinical decision-making. [ABSTRACT FROM AUTHOR]

The aim of the present study was to compare the possible dependence potential of antidepressants (ADs) to benzodiazepines (BZDs). The Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ) and the Symptom Checklist-90 (SCL-90) were administered to 70 psychiatric outpatient BZD users and 54 psychiatric outpatient AD users. Significantly more Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R) as well as International Classification of Disease, Tenth Edition (ICD-10) past year (PY) and lifetime (LT) dependence diagnoses were made in the BZD group than in the AD group. Bendep-SRQ scale scores for Problematic Use, Preoccupation and Lack of Compliance were significantly higher in the BZD group than in the AD group. The BZD group also had a higher rating on the Withdrawal scale, but this difference was not statistically significant. According to DSM-III-R and ICD-10 criteria ADs do have some dependence liability in psychiatric outpatients, but clearly to a lesser extent than BZDs. Further research is needed to differentiate the dependence potential among the various classes of ADs. [Copyright &y& Elsevier]

• The first systematic review examining cognitive biases in individuals with ASD. • Results show no differences between groups, or less negative bias in individuals with ASD. • Theory of Mind and developmental age may partially have influenced the results. • Only a few studies consider the role of depressive and/or anxiety symptoms. • Cognitive biases may not explain the high prevalence of depression in ASD, more research specifically designed for ASD symptomatology is needed. Cognitive theories of major depressive disorder (MDD) assume that cognitive biases engender and maintain depressive symptoms. Given the higher prevalence of MDD in autism spectrum disorders (ASD) than in the general population, we performed a structured review of the empirical literature on cognitive biases in ASD to examine the possible role of biases in the increased cognitive vulnerability for MDD. We reviewed the recent literature on cognitive biases in individuals with ASD. Literature searches were conducted by using the databases PubMed and PsycInfo consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The 31 identified studies meeting our inclusion criteria were evaluated for quality using a modified version of the Systematic Assessment of Quality in Observational Research (SAQOR) rating system. The results show that half of the studies included did not find differences in cognitive biases in individuals with ASD compared to controls. In the studies that did establish differences in cognitive bias, individuals with ASD were reported to show less pronounced negative biases. A closer inspection reveals that Theory of Mind demands of the task and developmental age might partially have influenced these results. Importantly, most of the studies included did not control for symptoms of depression and/or anxiety. Although, based on the current literature, differential cognitive biases may not be a marker for MDD in ASD, more research is needed taking specific potential confounders, and distorting influences into account. [ABSTRACT FROM AUTHOR]

Highlights: [•] Mindfulness-based cognitive therapy (MBCT) suggests enacting comparable neurophysiological effects related to attention and self-regulation as pharmacological treatments for ADHD. [•] Enhanced error-positivity (Pe) amplitudes indexing error saliency/awareness were associated with ameliorated inattention symptoms. [•] Increased NoGo-P3 amplitude reflecting greater inhibitory control correlated with attenuated hyperactivity/impulsivity symptomatology. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems in directing and sustaining attention. Recent findings suggest that alpha oscillations (8–12 Hz) are crucially involved in gating information between brain regions when allocating attention. The current study investigates whether aberrant modulation of alpha oscillations contributes to attention problems in ADHD patients. Methods: Magnetoencephalographic signals were recorded in adults with ADHD (n = 17) and healthy control subjects (n = 18) while they performed a visuospatial attention task. Cues directed attention to the left or right visual hemifield with an 80% validity with respect to the upcoming target. Results: Unlike the control group, subjects with ADHD showed a higher accuracy for invalidly cued right targets compared with invalidly cued left targets (p = .04). This coincided with an inability of the ADHD subjects to sustain the posterior hemispheric alpha lateralization in the period before the target for the left cue condition (p = .011). Furthermore, the control group showed a strong correlation between the degree of alpha lateralization and the magnitude of the cueing effect assessed in terms of accuracy (r s = .71, p = .001) and reaction times (r s =−.81, p<.001). These correlations were absent in the ADHD group. Conclusions: Our results demonstrate that subjects with ADHD have a failure in sustaining hemispheric alpha lateralization when cued to the left, resulting in an attentional bias to the right visual hemifield. These findings suggest that aberrant modulations of alpha oscillations reflect attention problems in ADHD and might be related to the neurophysiological substrate of the disorder. [Copyright &y& Elsevier]

Abstract: Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are frequently comorbid. To contribute to a better understanding of the associations regularly found between ADHD and BPD, on the one hand, and the developmental pathways for these disorders, on the other hand, latent class analyses (LCA) were undertaken to identify classes differing in profiles of childhood symptoms of ADHD and adult symptoms of ADHD and BPD. Diagnostic interviews with 103 female outpatients meeting the criteria for ADHD and/or BPD were used to assess current DSM-IV symptoms; childhood symptoms of ADHD were assessed in parent interviews. The latent classes were examined in relation to the DSM-IV conceptualizations of ADHD and BPD. And relations between childhood and adult classes were examined to hypothesize about developmental trajectories. LCA revealed an optimal solution with four distinct symptom profiles: only ADHD symptoms; BPD symptoms and only ADHD symptoms of hyperactivity; BPD symptoms and ADHD symptoms of inattention and hyperactivity; BPD symptoms and ADHD symptoms of inattention, hyperactivity and impulsivity. All patients with BPD had some ADHD symptoms in both adulthood and childhood. Hyperactivity was least discriminative of adult classes. Adult hyperactivity was not always preceded by childhood hyperactivity; some cases of comorbid ADHD and BPD symptoms were not preceded by significant childhood ADHD symptoms; and some cases of predominantly BPD symptoms could be traced back to combined symptoms of ADHD in childhood. The results underline the importance of taking ADHD diagnoses into account with BPD. ADHD classification subtypes may not be permanent over time, and different developmental pathways to adult ADHD and BPD should therefore be investigated. [Copyright &y& Elsevier]

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder that often persists into adulthood. While several studies have identified altered functional connectivity in brain networks during rest in children with ADHD, few studies have been performed on adults with ADHD. Existing studies have generally investigated small samples. We therefore investigated aberrant functional connectivity in a large sample of adult patients with childhood-onset ADHD, using a data-driven, whole-brain approach. Adults with a clinical ADHD diagnosis (N = 99) and healthy, adult comparison subjects (N = 113) underwent a 9-minute resting-state fMRI session in a 1.5 T MRI scanner. After elaborate preprocessing including a thorough head-motion correction procedure, group independent component analysis (ICA) was applied from which we identified six networks of interest: cerebellum, executive control, left and right frontoparietal and two default-mode networks. Participant-level network maps were obtained using dual-regression and tested for differences between patients with ADHD and controls using permutation testing. Patients showed significantly stronger connectivity in the anterior cingulate gyrus of the executive control network. Trends were also observed for stronger connectivity in the cerebellum network in ADHD patients compared to controls. However, there was considerable overlap in connectivity values between patients and controls, leading to relatively low effect sizes despite the large sample size. These effect sizes were slightly larger when testing for correlations between hyperactivity/impulsivity symptoms and connectivity strength in the executive control and cerebellum networks. This study provides important insights for studies on the neurobiology of adult ADHD; it shows that resting-state functional connectivity differences between adult patients and controls exist, but have smaller effect sizes than existing literature suggested. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, sagittal stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity. [ABSTRACT FROM AUTHOR]

Abstract: This study examined whether cognitive measures of response inhibition derived from the AX-CPT are able to differentiate between adult attention deficit/hyperactivity disorder (ADHD), borderline personality disorder (BPD), and healthy controls (HC). Current DSM-IV-TR symptoms of ADHD and BPD were assessed by structured diagnostic interviews, and parent developmental interviews were used to assess childhood ADHD symptoms. Patients (14 ADHD, 12 BPD, 7 ADHD and BPD, and 37 HC) performed the AX-CPT. Seventy percent of AX-CPT trials were target (AX) trials, creating a bias to respond with a target response to X probes in the nontarget (AY, BX, BY) trials. On BX trials, context, i.e. the non-‘A’ letter, must be used to inhibit this prepotent response tendency. On AY trials context actually causes individuals to false alarm. The effects of ADHD and BPD on AX-CPT outcome were tested using two-way ANOVA. BPD was associated with higher percentage of errors across the task and more errors and slower responses on BX trials, whereas ADHD was associated with slower responses on AY trials. The findings suggest response inhibition problems to be present in both ADHD and BPD, and patients with BPD to be particularly impaired due to poor context processing. [Copyright &y& Elsevier]

Abstract: While autism is one of the most intensively researched psychiatric disorders, little is known about reasoning skills of people with autism. The focus of this study was on defeasible inferences, that is inferences that can be revised in the light of new information. We used a behavioral task to investigate (a) conditional reasoning and (b) the suppression of conditional inferences in high-functioning adults with autism. In the suppression task a possible exception was made salient which could prevent a conclusion from being drawn. We predicted that the autism group would have difficulties dealing with such exceptions because they require mental flexibility to adjust to the context, which is often impaired in autism. The findings confirm our hypothesis that high-functioning adults with autism have a specific difficulty with exception-handling during reasoning. It is suggested that defeasible reasoning is also involved in other cognitive domains. Implications for neural underpinnings of reasoning and autism are discussed. [Copyright &y& Elsevier]