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Introduction: Sensory Processing Sensitivity (SPS) describes individual differences in sensitivity to environments, but there is little research on potential positive correlates of SPS. Hereby we investigate whether SPS and its Aesthetic Sensitivity (AES) component are associated with different facets of creativity and empathy. Methods: Questionnaires on SPS, creativity and empathy were administered to 296 participants and data were analyzed using hierarchical multiple regression. Results: Higher SPS total and AES scores were associated with more creative ideas (SPS: β = 0.294, pfdr < 0.001; AES: β = 0.484, pfdr < 0.001). Only AES was associated with more creative activities (AES: β = 0.292, pfdr < 0.001). Furthermore, higher SPS total and AES scores were associated with more overall empathy (SPS: β = 0.428, pfdr < 0.001; AES: β = 0.373, pfdr < 0.001), affective empathy (SPS: β = 0.507, pfdr < 0.001; AES: β = 0.331, pfdr < 0.001), cognitive empathy (SPS: β = 0.2692, pfdr < 0.001; AES: β = 0.347, pfdr < 0.001), and less emotional disconnection (SPS: β = 0.234, pfdr β 0.001; AES: β = 0.210, pfdr β 0.001). Most associations remained significant after controlling for openness to experience, and the other SPS components of ease of excitation and low sensory threshold and gender, age, and education. Discussion: We conclude that SPS and AES are associated with creativity and empathy. Strengthening these positive aspects might help highly sensitive people flourish. [ABSTRACT FROM AUTHOR]

"Pathological Demand Avoidance" is a term increasingly used by practitioners in the United Kingdom. It was coined to describe a profile of obsessive resistance to everyday demands and requests, with a tendency to resort to "socially manipulative" behaviour, including outrageous or embarrassing acts. Pathological demand avoidance is thought to share aspects of social impairment with autism spectrum disorders, but autism spectrum disorder-appropriate strategies, such as routine and repetition, are described as unhelpful. Outrageous acts and lack of concern for their effects draw parallels with conduct problems and callous-unemotional traits. However, reward-based techniques, effective with conduct problems and callous-unemotional traits, seem not to work in pathological demand avoidance. Despite increasing interest and controversy over the pathological demand avoidance label, there is only one published study to date. We present the first systematic comparison of the behavioural profile of children receiving the term pathological demand avoidance (N = 25) to children with autism spectrum disorders (N = 39) or conduct problems and callous-unemotional traits (N = 28), using parent-report indices of psychopathology. The pathological demand avoidance group displayed comparable levels of autistic traits and peer problems to the autism spectrum disorders group and anti-social traits approaching those seen in the conduct problems and callous-unemotional traits group. Emotional symptoms in pathological demand avoidance exceeded both comparison groups. Findings highlight the extreme behavioural impairment associated with pathological demand avoidance and the need to explore whether behavioural overlap reflects a similar neurocognitive basis to existing groups.

Background: Attention-deficit/hyperactivity disorder (ADHD) symptoms and mathematics ability are associated, but little is known about the genetic and environmental influences underlying this association. Methods: Data came from more than 6,000 twelve-year-old twin pairs from the UK population-representative Twins Early Development Study. Parents rated each twin's behaviour using a DSM-IV-based 18-item questionnaire of inattentive and hyperactive-impulsive ADHD symptoms. Mathematics tests based on the UK National Curriculum were completed by each twin. The twins also completed standardised tests of reading and general cognitive ability. Multivariate twin model fitting was applied. Results: Inattentive and hyperactive-impulsive ADHD symptoms were highly heritable (67% and 73% respectively). Mathematics ability was moderately heritable (46%). Mathematics ability and inattentiveness showed a significantly greater phenotypic correlation (r[subscript p] = -0.26) and genetic correlation (r[subscript A] = -0.41) than mathematics ability and hyperactivity-impulsivity (r[subscript p] = -0.18; r[subscript A] = -0.22). The genetic correlation between inattentiveness and mathematics ability was largely independent from hyperactivity-impulsivity, and was only partially accounted for by genetic influences related to reading and general cognitive ability. Conclusions: Results revealed the novel finding that mathematics ability shows significantly stronger phenotypic and genetic associations with inattentiveness than with hyperactivity-impulsivity. Genetic associations between inattentiveness and mathematics ability could only partially be accounted for by hyperactivity-impulsivity, reading and general cognitive ability. Results suggest that mathematics ability is associated with ADHD symptoms largely because it shares genetic risk factors with inattentiveness, and provide further evidence for considering inattentiveness and hyperactivity-impulsivity separately. DNA markers for ADHD symptoms (especially inattentiveness) may also be candidate risk factors for mathematics ability and vice versa.

Background: Attention deficit hyperactivity disorder (ADHD) is a common and highly heritable neurodevelopmental disorder with a complex aetiology. The identification of candidate intermediate phenotypes that are both heritable and genetically linked to ADHD may facilitate the detection of susceptibility genes and elucidate aetiological pathways. Very low-frequency (VLF; less than 0.5 Hz) electroencephalographic (EEG) activity represents a promising indicator of risk for ADHD, but it currently remains unclear as to whether it is heritable or genetically linked to the disorder. Methods: Direct-current (DC)-EEG was recorded during a cognitive activation condition in 30 monozygotic and dizygotic adolescent twin pairs concordant or discordant for high ADHD symptom scores, and 37 monozygotic and dizygotic matched-control twin pairs with low ADHD symptom scores. Structural equation modelling was used to quantify the genetic and environmental contributions to the phenotypic covariance between ADHD and VLF activity. Results: Attention deficit hyperactivity disorder was significantly associated with reduced VLF power during cognitive activation, which suggests reduced synchronization of widespread neuronal activity. Very low-frequency power demonstrated modest heritability (0.31), and the genetic correlation (-0.80) indicated a substantial degree of overlap in genetic influences on ADHD and VLF activity. Conclusions: Altered VLF activity is a potential candidate intermediate phenotype of ADHD, which warrants further investigation of underlying neurobiological and genetic mechanisms.

Background: Attention deficit hyperactivity disorder (ADHD) and reading disability commonly co-occur because of shared genetic risk factors. However, the stability and change of these genetic influences and the predictive relationships underlying this association longitudinally remain unclear. Methods: ADHD symptoms and reading were assessed as continuous dimensions in a UK general population sample of approximately 7,000 twin pairs. Parent ratings of ADHD symptoms and teacher ratings of reading were obtained at two ages: middle childhood (ages 7-8 years) and early adolescence (ages 11-12 years). Cross-lagged quantitative genetic analyses were applied. Results: ADHD symptoms and reading significantly predicted each other over time. However, ADHD symptoms were a significantly stronger predictor of reading than vice versa. Inattentive and hyperactive-impulsive symptoms of ADHD both contributed to the prediction of reading, but inattentiveness was a significantly stronger predictor. Furthermore, ADHD symptoms and reading were highly heritable, and their association was primarily attributable to shared genetic influences. Despite notable genetic innovation for each trait, genetic factors involved in the association of ADHD symptoms and reading over time were highly stable. Conclusions: ADHD symptoms may put children at increased risk for reading problems and vice versa. Moreover, enduring genetic mechanisms appear to be important in the association of ADHD symptoms and reading over time.

DSM-IV distinguishes two symptom domains of attention deficit hyperactivity disorder (ADHD): inattentiveness and hyperactivity-impulsivity. The present study examines the aetiologies and developmental relations underlying the associations between inattentiveness and hyperactivity-impulsivity over time, based on a representative population sample from the United Kingdom of approximately 7,000 twin pairs. ADHD symptoms were assessed as continuous dimensions using the DSM-IV items from the Conners' Parent Rating Scale at two ages: middle childhood (age 1) and early adolescence (age 2). Quantitative genetic cross-lagged analyses showed that the association of the ADHD dimensions over time is influenced by stable as well as newly developing genetic factors. Moreover the longitudinal relationship between the ADHD dimensions appears to be unidirectional, with hyperactivity-impulsivity in middle childhood predicting the presence of inattentiveness in early adolescence, but not vice versa. Thus, hyperactivity-impulsivity may serve to exacerbate inattentiveness over time. Findings are discussed in the context of developmental changes in ADHD symptoms.

A previous paper in this journal revealed substantial genetic overlap between the ADHD dimensions of hyperactivity-impulsivity and inattentiveness in a sample of 8-year old twins drawn from a UK-representative population sample. Four years later, when the twins were 12 years old, more than 5,500 pairs drawn from the same sample were rated again on the DSM-IV based Revised Conners' Parent Rating Scale to assess symptoms on both ADHD dimensions. Heritabilities were high (around 70%) for both hyperactivity-impulsivity and inattentiveness and evidence for etiological sex differences was absent. The critical finding was a genetic correlation of 0.55, indicating that hyperactivity-impulsivity and inattentiveness are substantially influenced by the same genes but that the two dimensions also show large and significant unique genetic effects. These results in early adolescence confirm our findings in middle childhood, providing evidence for substantial genetic overlap as well as genetic heterogeneity of the ADHD dimensions. Future genetic studies should investigate the ADHD dimensions separately.

This paper examines the longitudinal causal relationship between self-perceived abilities (SPA) and academic achievement (Ach) while controlling for cognitive ability (CA). In all, 5957 UK school children were assessed on SPA, Ach and CA at ages 9 and 12. Results indicated that SPA and Ach at age 9 independently affected both SPA and Ach at age 12, even when CA was considered. Moreover the effects of previous Ach on subsequent SPA were of similar magnitude to the effects of prior SPA on subsequent Ach, suggesting that the link between SPA and Ach independent of CA is reflective of both "insight" (children's accounts of their previous performance) and self-efficacy (the self-fulfilling or motivational effects of self-beliefs). Practical and theoretical implications for the study of SPA are discussed. (Contains 2 tables and 3 figures.)

Research in Attention-deficit/hyperactivity disorder (ADHD) has had a clear focus on treatment and the dysfunction in specific situation associated with the condition. However, self-report, observational and anecdotal evidence indicates that there are also positive aspects associated with ADHD. Research on the potential positive features in individuals with an ADHD diagnosis is still limited, especially studies with larger representative samples. Here we performed qualitative research to identify positive aspects and strengths associated with ADHD in a large convenience sample from the Dutch organization for people with ADHD, dyslexia and dyscalculia. We sent out open-ended questionnaires to the members of the organization, asking what they consider to be positive aspects of their ADHD. From the responses of individuals with ADHD (n = 206), we extracted 116 codes, which were assigned to thirteen subthemes, which in turn led to five themes. These themes were: Creativity, Being dynamic, Flexibility, Socio-affective skills, and Higher-order cognitive skills. Core symptoms of ADHD such as impulsivity and hyperactivity were also considered positive aspects of ADHD by a minority of participants. After showing our results to a group of additional individuals with ADHD (focus group) they confirmed the identified positive aspects of ADHD. They also helped us with the interpretation of our findings and mentioned certain positive aspects to be a consequence of living with ADHD (being open minded and being honest). In conclusion, experiencing positive aspects seems to be common in ADHD as almost all participants reported positive aspect of ADHD, these aspects cover many different domains. Awareness about ADHD's strengths might help individuals with ADHD and their environment to better cope with, accept or embrace their diagnosis and for example make educational or occupational choices that fit them well. To incorporate these positive aspects in the understanding of ADHD, future research should focus on quantifying strengths in ADHD, and on investigating the link between these aspects and clinical characteristics and how this new knowledge can be implemented in psychoeducation and find its way to education and occupational settings. [ABSTRACT FROM AUTHOR]

Attention-Deficit Hyperactivity Disorder (ADHD) is a complex and heterogeneous neurodevelopmental condition for which curative treatments are lacking. Whilst pharmacological treatments are generally effective and safe, there is considerable interindividual variability among patients regarding treatment response, required dose, and tolerability. Many of the non-pharmacological treatments, which are preferred to drugtreatment by some patients, either lack efficacy for core symptoms or are associated with small effect sizes. No evidence-based decision tools are currently available to allocate pharmacological or psychosocial treatments based on the patient's clinical, environmental, cognitive, genetic, or biological characteristics. We systematically reviewed potential biomarkers thatmay help in diagnosing ADHD and/or stratifying ADHD into more homogeneous subgroups and/or predict clinical course, treatment response, and long-term outcome across the lifespan. Most work involved exploratory studies with cognitive, actigraphic and EEG diagnostic markers to predict ADHD, along with relatively few studies exploring markers to subtype ADHD and predict response to treatment. There is a critical need for multisite prospective carefully designed experimentally controlled or observational studies to identify biomarkers that index inter-individual variability and/or predict treatment response. [ABSTRACT FROM AUTHOR]

Background: Family mindfulness‐based intervention (MBI) for child attention‐deficit/hyperactivity disorder (ADHD) targets child self‐control, parenting and parental mental health, but its effectiveness is still unclear. Methods: MindChamp is a pre‐registered randomised controlled trial comparing an 8‐week family MBI (called 'MYmind') in addition to care‐as‐usual (CAU) (n = 55) with CAU‐only (n = 48). Children aged 8–16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post‐treatment parent‐rated child self‐control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher‐rated Conners' and SWAN; teacher‐rated BRIEF), other psychological symptoms (parent/teacher‐rated), well‐being (parent‐rated) and mindfulness (self‐rated). Secondary parent outcomes included self‐ratings of ADHD symptoms, other psychological symptoms, well‐being, self‐compassion and mindful parenting. Assessments were conducted at post‐treatment, 2‐ and 6‐month follow‐up. Results: Relative to CAU‐only, MBI+CAU resulted in a small, statistically non‐significant post‐treatment improvement on the BRIEF (intention‐to‐treat: d = 0.27, p =.18; per protocol: d = 0.33, p =.11). Significantly more children showed reliable post‐treatment improvement following MBI+CAU versus CAU‐only (32% versus 11%, p <.05, Number‐Needed‐to‐Treat = 4.7). ADHD symptoms significantly reduced post‐treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent‐rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6‐month follow‐up. Post‐treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non‐significant; no significant differences were found at follow‐ups. Regarding parent outcomes, significant post‐treatment improvements were found for their own ADHD symptoms, well‐being and mindful parenting. At follow‐ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self‐compassion) and others disappeared/remained non‐significant. Conclusions: Family MBI+CAU did not outperform CAU‐only in reducing child self‐control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition. [ABSTRACT FROM AUTHOR]

Objective: We describe qualitative results on facilitators and barriers to participating in a family mindfulness-based intervention (MBI) for youth with ADHD and their parents and perceived effects on child and parent. Method: Sixty-nine families started the 8-week protocolized group-based MBI called "MYmind." After the MBI, individual semi-structured interviews were conducted with a purposive sample of parents (n = 20), children (n = 17, ages 9–16 years), and mindfulness teachers (n = 3). Interviews were analyzed using Grounded Theory. Results: Facilitators and barriers regarding contextual factors (e.g., time investment), MBI characteristics (e.g., parallel parent–child training), and participant characteristics (e.g., ADHD-symptoms) are described. Perceived effects were heterogeneous: no/adverse effects, awareness/insight, acceptance, emotion regulation/reactivity, cognitive functioning, calmness/relaxation, relational changes, generalization. Conclusion: MYmind can lead to a variety of transferable positively perceived effects beyond child ADHD-symptom decrease. Recommendations on MYmind participant inclusion, program characteristics, mindfulness teachers, and evaluating treatment efficacy are provided. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to identify early childhood risk factors for de novo and subthreshold late-onset ADHD. Method: ADHD symptoms were assessed in 9,875 participants from the Twins Early Development Study (TEDS) using the Conners' Parent Rating Scale at ages 8, 12, 14, and 16 years, along with other childhood characteristics and adolescent outcomes. Multinomial logistic regressions were implemented to identify early childhood predictors of late-onset ADHD and childhood-onset persistent ADHD, with non-ADHD controls as the reference category. Results: Male sex, increased childhood conduct problems, and low socioeconomic status predicted de novo late-onset ADHD. Additional risk factors predicted subthreshold late-onset ADHD and childhood-onset persistent ADHD. Late-onset ADHD symptoms were also accompanied by increased co-occurring behavioral and emotional problems. Conclusion: Findings of different childhood predictors between subthreshold and de novo late-onset ADHD suggest further investigation into time-varying environmental and biological factors driving psychopathological changes is warranted to fully characterize late-onset ADHD. [ABSTRACT FROM AUTHOR]

Oppositional defiant disorder, conduct disorder (ODD/CD), and autism spectrum disorder (ASD) share poor empathic functioning and have been associated with impaired emotional processing. However, no previous studies directly compared similarities and differences in these processes for the two disorders. A two-choice emotional valence detection task requiring differentiation between positive, negative, and neutral IAPS pictures was administered to 52 adolescents (12–19 years) with ODD/CD, 52 with ASD and 24 typically developing individuals (TDI). Callous–unemotional (CU) traits were assessed by self- and parent reports using the Inventory of callous–unemotional traits. Main findings were that adolescents with ODD/CD or ASD both performed poorer than TDI in terms of accuracy, yet only the TDI—not both clinical groups—had relatively most difficulty in discriminating between positive versus neutral pictures compared to neutral–negative or positive–negative contrasts. Poorer performance was related to a higher level of CU traits. The results of the current study suggest youth with ODD/CD or ASD have a diminished ability to detect emotional valence which is not limited to facial expressions and is related to a higher level of CU traits. More specifically, youth with ODD/CD or ASD seem to have a reduced processing of positive stimuli and/or lack a 'positive perception bias' present in TDI that could either contribute to the symptoms and/or be a result of having the disorder and may contribute to the comorbidity of both disorders. [ABSTRACT FROM AUTHOR]

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Background: Available evidence points towards lower birth weight as a risk factor for the development of attention deficit/hyperactivity disorder (ADHD) symptoms. We probed the causal nature of this putative effect of birth weight on ADHD symptoms using the twin differences design, which accounts for genetic and shared environmental confounds. Method: In a large population‐based twin sample – 3,499 monozygotic (MZ) and 6,698 dizygotic (DZ) pairs – parents, teachers or twins rated the twins’ ADHD symptoms at nine assessment waves (2–16 years). We implemented the twin differences design, which completely accounts for shared environmental and genetic confounding in MZ twins. We tested whether: (a) the lighter‐born twins had elevated ADHD symptoms compared to the heavier‐born twins, by regressing within‐pair differences of ADHD symptoms on within‐pair differences of birth weight among MZ twins; (b) the effect of birth weight on ADHD was moderated by gender, gestational age and low birth weight; (c) this effect changed with age at ADHD assessment using adapted latent growth curve models; and (d) results differed for inattention and hyperactivity/impulsivity. Results: Birth weight significantly predicted ADHD symptoms from early childhood to late adolescence. The lighter‐born twin had more ADHD symptoms than the heavier‐born cotwin among MZ twins across assessment waves and raters. No moderation effect was detected. The magnitude of the effect of birth weight decreased significantly across time for hyperactivity/impulsivity, but the decrease failed to reach significance for inattention. Estimates for inattention were significantly larger than for hyperactivity/impulsivity at each time point, implying stronger effect of birth weight on inattention symptoms. Conclusions: Our findings provide stringent evidence for environmental effect of lower birth weight on the causal pathway to elevated ADHD symptoms. Effect of birth weight persists across a 14‐year period from childhood into late adolescence, in particular for inattention symptoms. [ABSTRACT FROM AUTHOR]

Background: Integration of positive psychology into clinical research and treatment has been slow. This integration can be facilitated by the conceptualisation of mental disorders as the high, symptomatic extreme of continuous normal variation. This assumes that there is also a low, positive extreme, which is, however, unchartered territory. This study aims to examine how well current measures capture the low extreme of mental disorder continua, using attention‐deficit hyperactivity disorder (ADHD) as an example. Methods: The ability of three validated scales to capture ADHD as a continuous trait was examined using Item Response Theory in a sample of 9,882 adolescents from the UK population‐representative Twins Early Development Study. These scales were: the Strengths and Weakness of ADHD Symptoms and Normal behaviour scale (SWAN), Strength and Difficulties Questionnaire (SDQ – hyperactivity subscale), and Conners’ Parent Rating Scale (Conners). Results: Only the SWAN reliably differentiated interindividual differences between participants lying at any level of the continuous ADHD latent trait, including the extreme low, positive end (z‐scores from −3 to +3). The SDQ showed low reliability across the ADHD latent trait. In contrast, the Conners performed best at differentiating individuals scoring at or above the mean to the high symptomatic range (z‐scores from 0 to +3). The SWAN was the only measure to provide indicators of ‘positive mental health’, endorsed in the presence of particularly good attentive abilities. Conclusions: Scales such as the SWAN that reliably capture ADHD as a continuous trait, including the positive end, are important for not missing meaningful variation in population‐based studies. Indicators of positive mental health may be helpful in clinical practice, as positive attributes have been shown to directly influence as well as buffer negative effects of psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) symptoms frequently occur in individuals with attention-deficit/hyperactivity disorder (ADHD). While there is evidence that both ADHD and ASD have differential structural brain correlates, knowledge of the structural brain profile of individuals with ADHD with raised ASD symptoms is limited. The presence of ASD-like symptoms was measured by the Children's Social Behavior Questionnaire (CSBQ) in a sample of typically developing controls (n = 154), participants with ADHD (n = 239), and their unaffected siblings (n = 144) between the ages of 8 and 29. Structural magnetic resonance imaging (MRI) correlates of ASD ratings were analysed by studying the relationship between ASD ratings and grey matter volumes using mixed effects models which controlled for ADHD symptom count and total brain volume. ASD ratings were significantly elevated in participants with ADHD relative to controls and unaffected siblings. For the entire group (participants with ADHD, unaffected siblings and TD controls), mixed effect models revealed that the left caudate nucleus volume was negatively correlated with ASD ratings (t = 2.83; P = 0.005). The current findings are consistent with the role of the caudate nucleus in executive function, including the selection of goals based on the evaluation of action outcomes and the use of social reward to update reward representations. There is a specific volumetric profile associated with subclinical ASD-like symptoms in participants with ADHD, unaffected siblings and controls with the caudate nucleus and globus pallidus being of critical importance in predicting the level of ASD-like symptoms in all three groups. [ABSTRACT FROM AUTHOR]