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Contains fulltext : 298939.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 248841.pdf (Publisher’s version ) (Open Access), 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 par

Contains fulltext : 248974.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 248884.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, Sensory processing sensitivity (SPS) is a trait characterized by stronger sensitivity to the environment, both for better and for worse. The present study used the Self-Determination Theory (SDT) to judge this environment in terms of basic psychological needs met in a school context. This study aimed to gain insights into the moderating role of SPS in the relationship between students' need satisfaction, motivation and behavioral engagement. A total of 1253 primary school students aged 8 to 13 participated. All students completed questionnaires assessing the degree of SPS, need satisfaction (autonomy, competence and relatedness), motivation (intrinsic, extrinsic and amotivation) and behavioral engagement. Results revealed that SPS did not moderate the relationship between need satisfaction and motivation or the relationship between need satisfaction and behavioral engagement. Our findings show that SPS does not appear to influence the positive or negative effects of the degree of need satisfaction. All students benefit from higher need satisfaction, including those with stronger SPS.

Radboud University, 17 januari 2022, Promotores : Buitelaar, J.K., Speckens, A.E.M., Bögels, S.M., Greven, C.U., Contains fulltext : 241555.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 248974.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 284086.pdf (Publisher’s version ) (Open Access)

Inaugural lecture delivered at the acceptance of the post of Professor of Environmental Sensitivity in Health at the Radboudumc, 16 June 2022, Inaugural lecture, Contains fulltext : 282883.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, Young people with attention deficit hyperactivity disorder (ADHD) are now being treated with psychostimulant medication for longer than was previously the case and are increasingly likely to remain on methylphenidate into adolescence and adulthood. This study was designed to determine whether the long-term use of methylphenidate (MPH, immediate release or extended release) increases blood pressure and left ventricular mass (LVM) identified by echocardiography in adolescents and young adults with ADHD aged 12-25 years. In a five-site cross-sectional design two groups were compared for 24- hour blood pressure and heart rate (HR) registrations and LVM: 1) adolescents and young adults with ADHD who had been treated with MPH for > 2 years (N=162, age mean (SD) 15.6 (3.0)), and 2) adolescents and young adults with ADHD who had never been treated with methylphenidate (N=71, age mean 17.4 (4.2)). The analyses were controlled for propensity scores derived from age, sex, height, weight, and 19 relevant background variables. A blood pressure indicative of hypertension (>95(th) percentile) was observed in 12.2% (95% confidence interval 7.3 - 18.9%) of the participants in the MPH treated group and in 9.6% (95%CI 3.2 - 21.0%) of the MPH naïve group, with overlapping intervals. The 24-hour recorded systolic blood pressure (SBP) and HR were significantly higher during daytime in medicated individuals with ADHD than in those with unmedicated ADHD, but were similar in both groups during the night. 24-hour diastolic blood pressure (DBP) did not differ between both groups during either daytime or at night. LVM, corrected for body-surface area (LVMBSA), also did not differ between the two groups (p=0.20, controlling for confounders). Further, MPH daily dose and duration of treatment were unrelated to LVMBSA, SBP, and DBP. Long-term MPH use in adolescents and young adults with ADHD is associated with small but significant increases of SBP and HR during daytime. Given the current sample s

Contains fulltext : 281503.pdf (Publisher’s version ) (Open Access), 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 inter-individual variability among patients regarding treatment response, required dose, and tolerability. Many of the non-pharmacological treatments, which are preferred to drug-treatment 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 that may 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.

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Contains fulltext : 242453.pdf (Publisher’s version ) (Open Access), The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30-39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods. https://www.trialregister.nl/trial/7955

Contains fulltext : 239199.pdf (Publisher’s version ) (Open Access), Sensory processing sensitivity (SPS) is a personality trait reflecting inter-individual differences in sensitivity to negative and positive environmental information. Being high in SPS is associated with increased stress-related problems if environments are unfavourable but also appears to enhance one’s ability to benefit from health-promoting environments. In understanding SPS, therefore, lies the potential for innovating the ways we use to promote mental health. However, as a young research field, the core characteristics of SPS are yet debated. Qualitative research interviewing highly sensitive adults is important to conduct ecologically valid research connected with the complex realities of people. This study was the first to systematically report the perceptions and experiences of SPS characteristics in adults high in this trait. Semi-structured interviews (n = 26) were analysed thematically and described following consolidated criteria for reporting qualitative research. Six themes emerged: (1) emotional responding; (2) relatedness to others; (3) thinking; (4) overstimulation; (5) perceiving details; and (6) global SPS characteristics. With regards to coping with negative consequences of high SPS, the main themes were: (1) reducing sensory input and (2) psychological strategies. We gained fine-grained information on experiences of adults high in SPS and derived new hypotheses regarding the fostering of well-being related to high SPS.

Radboud University, 21 september 2021, Promotores : Speckens, A.E.M., Spinhoven, P., Greven, C.U. Co-promotor : Huijbers, M.J., Contains fulltext : 236408.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, 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.

Item does not contain fulltext, 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.

Contains fulltext : 238430.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 242453.pdf (Publisher’s version ) (Open Access), The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30-39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods. https://www.trialregister.nl/trial/7955

Contains fulltext : 225979.pdf (Publisher’s version ) (Open Access)

30 april 2020, Contains fulltext : 220957.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 208642.pdf (publisher's version ) (Open Access), To get additional insight into the phenotype of attentional problems, we examined to what extent genetic and environmental factors explain covariation between lack of dispositional mindfulness and attention-deficit/hyperactivity disorder (ADHD) traits in youth, and explored the incremental validity of these constructs in predicting life satisfaction. We used data from a UK population-representative sample of adolescent twins (N = 1092 pairs) on lack of dispositional mindfulness [Mindful Attention Awareness Scale (MAAS)], ADHD traits [Conners' Parent Rating Scale-Revised (CPRS-R): inattentive (INATT) and hyperactivity/impulsivity (HYP/IMP) symptom dimensions] and life satisfaction (Students' Life Satisfaction Scale). Twin model fitting analyses were conducted. Phenotypic correlations (rp) between MAAS and CPRS-R (INATT: rp = 0.18, HYP/IMP: rp = 0.13) were small, but significant and largely explained by shared genes for INATT (% rp INATT-MAAS due to genes: 93%, genetic correlation rA = 0.37) and HYP/IMP (% rp HYP/IMP-MAAS due to genes: 81%; genetic correlation rA = 0.21) with no significant contribution of environmental factors. MAAS, INATT and HYP/IMP significantly and independently predicted life satisfaction. Lack of dispositional mindfulness, assessed as self-reported perceived lapses of attention (MAAS), taps into an aspect of attentional functioning that is phenotypically and genetically distinct from parent-rated ADHD traits. The clinically relevant incremental validity of both scales implicates that MAAS could be used to explore the underlying mechanisms of an aspect of attentional functioning that uniquely affects life satisfaction and is not captured by DSM-based ADHD scales. Further future research could identify if lack of dispositional mindfulness and high ADHD traits can be targeted by different therapeutic approaches resulting in different effects on life satisfaction.

Contains fulltext : 202697.pdf (publisher's version ) (Open Access), Sensory Processing Sensitivity (SPS) is a common, heritable and evolutionarily conserved trait describing inter-individual differences in sensitivity to both negative and positive environments. Despite societal interest in SPS, scientific knowledge is lagging behind. Here, we critically discuss how SPS relates to other theories, how to measure SPS, whether SPS is a continuous vs categorical trait, its relation to other temperament and personality traits, the underlying aetiology and neurobiological mechanisms, and relations to both typical and atypical development, including mental and sensory disorders. Drawing on the diverse expertise of the authors, we set an agenda for future research to stimulate the field. We conclude that SPS increases risk for stress-related problems in response to negative environments, but also provides greater benefit from positive and supportive experiences. The field requires more reliable and objective assessment of SPS, and deeper understanding of its mechanisms to differentiate it from other traits. Future research needs to target prevention of adverse effects associated with SPS, and exploitation of its positive potential to improve well-being and mental health.

Contains fulltext : 208957.pdf (publisher's version ) (Closed access), Aim: To identify moderators of treatment effect for Mindfulness-Based Cognitive Therapy (MBCT) versus Treatment As Usual (TAU) in depressed patients. Methods: An individual patient data-analysis was performed on three randomized-controlled trials, investigating the effect of MBCT + TAU versus TAU alone (N = 292). Patients were either in (partial) remission, currently depressed or had chronic, treatment-resistant depression. Outcomes were depressive symptoms and quality of life. The QUalitative INteraction Trees (QUINT) method was used to identify subgroups that benefited more from either condition. Results: MBCT + TAU outperformed TAU in reducing depressive symptoms. For both conditions, the effect of baseline depressive symptoms on post-treatment depressive symptoms was curvilinear. QUINT analyses revealed that MBCT + TAU was more beneficial than TAU for patients with an earlier onset and higher rumination levels in terms of depressive symptom reduction and for patients with a lower quality of life in terms of improving quality of life. Conclusions: The results suggest that MBCT might be more beneficial for those with earlier onset and higher levels of rumination and for patients with a lower quality of life. Sophisticated analytical techniques such as QUINT can be used in future research to improve personalized assignment of MBCT to patients. Long-term outcome could also be integrated in this.

Contains fulltext : 203257.pdf (publisher's version ) (Open Access), This longitudinal study focused on early behavioural problems and autistic traits. In a stratified, population-derived sample of 119 children, mothers reported through questionnaires on externalizing, internalizing, and social-communicative characteristics of their child in infancy (14 months) and toddlerhood (37 months), and on autistic traits at preschool age (4-5 years). Children with consistently normal behaviour from infancy to toddlerhood showed lower autistic traits at preschool age than children with deviant behaviour on one or both time points. High autistic traits at preschool age were predominantly preceded by problems in interaction, communication, language, play, and affect in infancy and/or toddlerhood, but also by inattention in toddlerhood. Adequate support and specific interventions in these domains are needed in an attempt to diminish further derailment of the child's behaviour and development, and to prevent the full manifestation of ASD or related disorders such as ADHD.

Contains fulltext : 201032pre.pdf (preprint version ) (Open Access)

Contains fulltext : 205889.pdf (publisher's version ) (Closed access), 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.

Contains fulltext : 190184.pdf (publisher's version ) (Closed access), 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.

Contains fulltext : 190645.pdf (publisher's version ) (Closed access), BACKGROUND: Autism spectrum disorders (ASD) are characterized by substantial clinical, etiological and neurobiological heterogeneity. Despite this heterogeneity, previous imaging studies have highlighted the role of specific cortical and subcortical structures in ASD and have forwarded the notion of an ASD specific neuroanatomy in which abnormalities in brain structures are present that can be used for diagnostic classification approaches. METHOD: A large (N = 859, 6-27 years, IQ 70-130) multi-center structural magnetic resonance imaging dataset was examined to specifically test ASD diagnostic effects regarding (sub)cortical volumes. RESULTS: Despite the large sample size, we found virtually no main effects of ASD diagnosis. Yet, several significant two- and three-way interaction effects of diagnosis by age by gender were found. CONCLUSION: The neuroanatomy of ASD does not exist, but is highly age and gender dependent. Implications for approaches of stratification of ASD into more homogeneous subtypes are discussed.

Contains fulltext : 194388.pdf (publisher's version ) (Open Access)

Radboud University, 14 september 2018, Promotor : Buitelaar, J.K. Co-promotores : Greven, C.U., Glennon, J.C., Contains fulltext : 194291.pdf (publisher's version ) (Open Access)

Contains fulltext : 194081.pdf (publisher's version ) (Closed access)

Contains fulltext : 177201pub.pdf (publisher's version ) (Open Access), BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is associated with structural abnormalities in total gray matter, basal ganglia, and cerebellum. Findings of structural abnormalities in frontal and temporal lobes, amygdala, and insula are less consistent. Remarkably, the impact of comorbid oppositional defiant disorder (ODD) (comorbidity rates up to 60%) on these neuroanatomical differences is scarcely studied, while ODD (in combination with conduct disorder) has been associated with structural abnormalities of the frontal lobe, amygdala, and insula. The aim of this study was to investigate the effect of comorbid ODD on cerebral volume and cortical thickness in ADHD. METHODS: Three groups, 16 +/- 3.5 years of age (mean +/- SD; range 7-29 years), were studied on volumetric and cortical thickness characteristics using structural magnetic resonance imaging (surface-based morphometry): ADHD+ODD (n = 67), ADHD-only (n = 243), and control subjects (n = 233). Analyses included the moderators age, gender, IQ, and scan site. RESULTS: ADHD+ODD and ADHD-only showed volumetric reductions in total gray matter and (mainly) frontal brain areas. Stepwise volumetric reductions (ADHD+ODD < ADHD-only < control subjects) were found for mainly frontal regions, and ADHD+ODD was uniquely associated with reductions in several structures (e.g., the precuneus). In general, findings remained significant after accounting for ADHD symptom severity. There were no group differences in cortical thickness. Exploratory voxelwise analyses showed no group differences. CONCLUSIONS: ADHD+ODD and ADHD-only were associated with volumetric reductions in brain areas crucial for attention, (working) memory, and decision-making. Volumetric reductions of frontal lobes were largest in the ADHD+ODD group, possibly underlying observed larger impairments in neurocognitive functions. Previously reported striatal abnormalities in ADHD may be caused by comorbid conduct disorder rather than ODD.

Contains fulltext : 174510.pdf (publisher's version ) (Closed access), Callous-unemotional (CU) traits have mainly been studied in relation to conduct disorder (CD), but can also occur in other disorder groups. However, it is unclear whether there is a clinically relevant cut-off value of levels of CU traits in predicting reduced quality of life (QoL) and clinical symptoms, and whether CU traits better fit a categorical (taxonic) or dimensional model. Parents of 979 youths referred to a child and adolescent psychiatric clinic rated their child's CU traits on the Inventory of Callous-Unemotional traits (ICU), QoL on the Kidscreen-27, and clinical symptoms on the Child Behavior Checklist. Experienced clinicians conferred DSM-IV-TR diagnoses of ADHD, ASD, anxiety/mood disorders and DBD-NOS/ODD. The ICU was also used to score the DSM-5 specifier 'with limited prosocial emotions' (LPE) of Conduct Disorder. Receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the ICU and LPE regarding QoL and clinical symptoms was poor to fair, and similar across diagnoses. A clinical cut-off point could not be defined. Taxometric analyses suggested that callous-unemotional traits on the ICU best reflect a dimension rather than taxon. More research is needed on the impact of CU traits on the functional adaptation, course, and response to treatment of non-CD conditions.

Contains fulltext : 169788.pdf (publisher's version ) (Closed access), BACKGROUND: This meta-analysis evaluates the efficacy of nonpharmacological treatments for conduct disorder (CD) problems in children and adolescents, based on child, parent and teacher report. METHODS: PubMed, PsycINFO and EMBASE were searched for peer-reviewed articles published between January 1970 and March 2015. Main inclusion criteria were nonpharmacological treatment, participants younger than 18 years, clinical CD problems/diagnosis, randomized controlled trials and inclusion of at least one CD problem-related outcome. Treatment efficacy is expressed in effect sizes (ESs) calculated for each rater (parent, teacher, self and blinded observer). RESULTS: Of 1,549 articles retrieved, 17 (published between June 2004 and January 2014) describing 19 interventions met the inclusion criteria. All studies used psychological treatments; only three studies included a blinded observer to rate CD problems. Most studies were of very poor to fair quality. ESs were significant but small for parent-reported outcomes (0.36, 95% CI = 0.27-0.47), teacher-reported outcomes (0.26, 95% CI = 0.12-0.49) and blinded observer outcomes (0.26, 95% CI = 0.06-0.47), and they were nonsignificant for self-reported outcomes (-0.01, 95% CI = -0.25 to 0.23). Comorbidity, gender, age, number of sessions, duration, intervention type, setting, medication use or dropout percentage did not influence the effect of treatment. CONCLUSIONS: Psychological treatments have a small effect in reducing parent-, teacher- and observer-rated CD problems in children and adolescents with clinical CD problems/diagnosis. There is not enough evidence to support one specific psychological treatment over another. Future studies should investigate the influence of participant characteristics (e.g. age of CD onset), use more homogeneous outcome measures and allow better evaluation of study quality. Many reports failed to provide detailed information to allow optimization of psychological treatment strategies.

Contains fulltext : 181186.pdf (publisher's version ) (Closed access), Background: High intelligence may be associated with positive (adaptive, desired) outcomes, but may also come with disadvantages. Aims: To contribute empirically to the debate concerning whether a trade-off in IQ scores exists in relation to attention-deficit hyperactivity disorder (ADHD) and related problems, suggesting that high intelligence - like low intelligence - increases the risk of ADHD. Method: Curves of the relation between IQ score and ADHD problems were fitted to questionnaire data (parent, teacher, self-report} in a population-based study of 2221 children and adolescents aged 10-12 years. Externalising and internalising problems were included for comparison purposes. Results: Higher IQ score was most strongly related to fewer attention problems, with more rater discrepancy in the high v. average IQ range. Attention problems - but only minimally hyperactivity/impulsivity problems - predicted functional impairment at school, also in the higher IQ range. Conclusions: Attention problems in highly intelligent children are exceptional and affect school performance; they are therefore a reason for clinical concern.

Radboud University, 4 juli 2017, Promotor : Buitelaar, J.K. Co-promotores : Lambregts-Rommelse, N.N.J., Greven, C.U., Contains fulltext : 173468.pdf (publisher's version ) (Open Access)

Contains fulltext : 176621.pdf (publisher's version ) (Closed access)

Contains fulltext : 176577.pdf (publisher's version ) (Closed access)