Search

This study examined whether the association between cybervictimization and internalizing symptoms was moderated by adolescents' emotional connectedness to their social media. Participants were 288 adolescents (54.9% male participants) with (n = 151) and without (n = 137) attention-deficit/hyperactivity disorder (ADHD) between the ages of 13 and 15 years (M = 14.09, SD = 0.36). Adolescents reported on social integration and emotional connection (SIEC) to social media and parents reported on their impression of their adolescent's SIEC to social media. Adolescents also reported on cybervictimization experiences and internalizing symptoms. Adolescents with ADHD had higher cybervictimization scores than adolescents without ADHD and were also more likely to report multiple experiences of cybervictimization over the past month. Emotional investment in social media moderated the relations between cybervictimization and internalizing symptoms such that cybervictimization was associated with higher anxiety and depression symptoms at higher levels of emotional investment in social media. Results were consistent across both parent and adolescent report of social integration and emotional connection to social media. These findings indicate that cybervictimization may be associated with negative outcomes specifically among adolescents with a strong emotional connection to their social media use. [This paper was published in "Research on Child and Adolescent Psychopathology" v50 p363-374 2022.]

Objectives/Background: This study examined whether dispositional mindfulness moderates the association between brooding rumination and sleep problems in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Participants/Methods: Participants were 137 adolescents (ages 13-15 years; 64% male). Approximately half (47.4%; n=65) were diagnosed with ADHD. Adolescents provided ratings of their dispositional mindfulness and brooding rumination. Both adolescents and parents provided ratings of adolescents' sleep problems. Results: In analyses controlling for sex, race, study site, and group (ADHD vs. comparison), brooding rumination was associated with more adolescent- and parent-reported sleep problems only at low levels of dispositional mindfulness. This effect did not differ for adolescents with or without ADHD and was also unchanged when controlling for internalizing psychopathology symptoms. Conclusions: Our findings showed that dispositional mindfulness might buffer against the negative impact of brooding rumination on adolescent sleep. These findings may have important clinical implications and underscore the potential benefit of including mindfulness and other cognitive-behavioral approaches when treating sleep problems in adolescents. [This paper was published in "Sleep Medicine" v90 p131-134 2023.]

It is unknown whether sluggish cognitive tempo (SCT) is prospectively associated with depression in adolescence, and possible processes linking SCT to depression remain unexamined. Using a longitudinal study with three timepoints over a two-year period, the current study tested the indirect effects of SCT on depression via peer victimization, specifically physical, relational, and verbal victimization. Participants were 302 adolescents (M[subscript age] = 13.17 years; 44.7% female participants; 81.8% White; 52% with ADHD). In the fall of 8th grade, adolescents and parents completed measures of adolescents' SCT and ADHD symptoms. Adolescents completed a measure of peer victimization in spring of 8th grade and a measure of depressive symptoms in 10th grade. Models examining indirect effects were conducted with and without control of baseline ADHD and/or depressive symptoms. Across analyses, adolescent and parent ratings of SCT symptoms uniquely predicted greater depressive symptoms two years later when controlling for adolescent sex, study site, and either 8th grade depressive or ADHD symptoms. Further, adolescents' self-reported 8th grade SCT symptoms predicted 10th grade depressive symptoms via verbal victimization when controlling for 8th grade ADHD symptoms, but not in analyses incorporating 8th grade depressive symptoms. Findings underscore the predictive association of SCT on depressive symptoms, the possible role of adverse peer relationships as a mechanism linking SCT to depression, and the importance of considering ADHD and depressive symptoms in research on longitudinal correlates of SCT. [This paper was published in "Research on Child and Adolescent Psychopathology" v50 p809-822 2022.]

Objective: Researchers have speculated that the COVID-19 pandemic may expand the academic performance gap experienced by at-risk students. We examined learning experiences during the 2020-2021 school year and the impact the pandemic has had on high school student grade point average (GPA), including predictors of change in GPA from 2019-2020 to 2020-2021. Method: Participants were 238 adolescents (55.5% male), 49.6% with attention-deficit/hyperactivity disorder (ADHD), in the United States. Adolescents reported on their GPAs via online surveys. Results: GPA significantly decreased on average from 2019-2020 to 2020-2021 school year. ADHD status and biological sex significantly moderated change--students with ADHD and male students reported decreased GPA, whereas students without ADHD and female students' GPA did not change. Low income and Black/Latinx students had lower GPAs in both school years. Conclusion: It is imperative that additional supports be provided for at-risk students to help them catch up on missed learning during the pandemic. [This paper was published in "Journal of Attention Disorders" v26 p1011-1017 2022.]

Study Objectives: To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD. Methods: Participants were 122 adolescents (ages 15-17; 61% male; 48% with ADHD). Parents reported on adolescents' sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019-February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19. Results: Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically-elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19. Conclusions: COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep. [This paper was published in "SLEEP" v44 Article zsab054 2021.]

Background: The impact of chronic stressors like the COVID-19 pandemic is likely to be magnified in adolescents with pre-existing mental health risk, such as attention-deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID-19 pandemic in the Southeastern and Midwestern United States. Methods: Participants include 238 adolescents (132 males; ages 15-17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID-19 pandemic and in spring and summer 2020. Results: Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre-COVID-19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre-COVID-19 emotion regulation abilities were at-risk for experiencing increases in all mental health symptoms relative to adolescents with better pre-COVID-19 emotion regulation abilities. Interactive risk based on ADHD status and pre-COVID-19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre-COVID-19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms. Conclusions: The early observed increases in adolescent mental health symptoms during the COVID-19 pandemic do not on average appear to be sustained following the lift of stay-at-home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample. [This paper was published in "Journal of Child Psychology and Psychiatry" v62 p1132-1139 2021.]

Objective: Although peer difficulties and sluggish cognitive tempo (SCT) are related, studies have yet to examine environmental factors that may advance further understanding this association. The current study tested whether peer difficulties, specifically social competence and peer victimization, interacted with school support, a component of school climate, in relation to adolescents' SCT symptoms. Further, we explored whether these relations would be differentially associated with SCT in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Method: Adolescents (N = 288; M[subscript age] = 14.08, 45% female, 82.6% White; 52% with ADHD) completed measures of social competence, peer victimization, school climate support, and SCT and ADHD inattentive (IN) symptoms. Parents also reported on adolescents' social competence, SCT, and ADHD-IN symptoms. Results: Results indicated that adolescent and parent ratings of lower social competence were both associated with higher adolescent-reported SCT symptoms in the context of low, but not high, school support. Relational and non-physical victimization were associated with higher self-reported SCT symptoms in the context of low school support. Lower adolescent- and parent-reported social competence were also related to higher parent-reported SCT symptoms, with these associations not moderated by school support. These results remained after controlling for demographics and ADHD-IN symptoms and were similar across adolescents with and without ADHD. Conclusions: Findings from the current study are the first to provide evidence that peer difficulties and school climate are jointly related to adolescents' self-reported SCT and underscore the importance of continued research investigating social adversity and environmental factors in relation to SCT. [This paper will be published in the "Journal of Clinical Child & Adolescent Psychology."]

The Adult Concentration Inventory (ACI) is an adult self-report measure of sluggish cognitive tempo (SCT) developed following a meta-analysis identifying items distinguishing SCT from ADHD inattention. To date, only one study conducted in college students has examined the structural and external validity of the ACI. The current study evaluated the convergent and discriminative validity of the ACI in a community sample of adults, in addition to testing unique associations with internalizing symptoms, daily life executive functions, and sleep. Adults (N = 286; M[subscript age] = 44.45; 83.6% female) completed ratings of SCT, ADHD symptom dimensions, and external correlates. An a priori two-factor model with cross-loadings found 10 of the 16 SCT items to have high loadings on the SCT factor and low loadings on the ADHD inattention factor. SCT was uniquely associated with higher internalizing symptoms, time management and self-organization difficulties, poorer sleep quality, shorter sleep duration, lower sleep efficiency, and more daytime sleepiness. These findings replicate and extend support for the ACI in assessing SCT in adults. [This paper will be published in "Assessment."]

Objective: The current study reports functional outcomes from a multi-site randomized trial of a cognitive-behavioral treatment program for college students diagnosed with ADHD. Methods: A sample of emerging adults (N = 250; ages 18 to 30) currently attending college were comprehensively evaluated and diagnosed with ADHD (M age = 19.7; 66% female, 6.8% Latino, 66.3% Caucasian). Participants were randomized to either a two-semester intervention (Accessing Campus Connections and Empowering Student Success (ACCESS)) or a delayed treatment condition. Participants were assessed with measures of academic, daily life, and relationship functioning prior to treatment, at the end of the first semester, and after the second semester of treatment. Results: Multi-group latent growth curve models revealed moderate effect size improvements on self-report measures of study skills and strategies, as well as on self-report measures of time management, daily functioning, and overall well-being for participants in ACCESS. Importantly, treatment effects were maintained or increased in some cases from the end of the first semester to the end of the second semester. Improvements in self-reported interpersonal functioning were not significantly different across condition and neither condition demonstrated significant change over time in educational record outcomes (GPA and number of credits earned). Conclusions: ACCESS appears to promote improvements in self-reported general well-being and functioning, time management, and study skills and strategies. However, improvements in interpersonal relationships and objective academic outcomes such as GPA were not observed. Clinical implications and future directions for treating ADHD on university and college campuses are discussed. [This is the online version of an article published in "Journal of Clinical Child & Adolescent Psychology."]

This study aimed to examine changes in depression and anxiety symptoms from before to during the first six months of the COVID-19 pandemic in a sample of 1,339 adolescents (9-18 years old, 59% female) from three countries. We also examined if age, race/ethnicity, disease burden, or strictness of government restrictions moderated change in symptoms. Data from 12 longitudinal studies (10 U.S., 1 Netherlands, 1 Peru) were combined. Linear mixed effect models showed that depression, but not anxiety, symptoms increased significantly (median increase=28%). The most negative mental health impacts were reported by multiracial adolescents and those under 'lockdown' restrictions. Policy makers need to consider these impacts by investing in ways to support adolescents' mental health during the pandemic. [This paper was published in "Journal of Research on Adolescence."]

Objective: This longitudinal study investigated the predictors of and changes in psychological trauma during the COVID-19 pandemic. Method: Participants included 236 adolescents (130 males; M age = 16.74 years in spring 2020; 49.6% diagnosed with attention-deficit hyperactivity disorder; 16.1% diagnosed with an anxiety or depressive disorder) in the United States who completed online questionnaires at four timepoints (spring 2020, summer 2020, fall 2020, spring 2021). Results: Repeated measures ANOVA showed that psychological trauma was highest during stay-at-home orders in spring 2020, and decreased for a majority of adolescents by the summer of 2020. However, [approximately]20% of adolescents exhibited moderate-to-clinical levels of psychological trauma at each timepoint. Four groups were identified based on the presence of psychological trauma symptoms: (1) "resilient group" (normal range across all timepoints; 60.6%), (2) "moderate fluctuating group" (moderate range at one or more timepoints; 18.2%), (3) "severe fluctuating group" (clinical range at one or more timepoints; 14.0%), and (4) "chronic psychological trauma group" (moderate or clinical range across all timepoints; 7.2%). Females, adolescents with pre-existing internalizing disorders, and participants whose families were most impacted by the pandemic were more susceptible to experiencing psychological trauma symptoms. Conclusions: Findings highlight at-risk populations and suggest that the COVID-19 pandemic resulted in psychological trauma symptoms for approximately 20% of adolescents at some point during the first year of the pandemic. There is critical need to provide mental health services to adolescents, such as through school-based services, to reduce the negative long-term psychological impact of the pandemic. [This paper was published in "Psychological Trauma: Theory, Research, Practice, and Policy."]

Introduction: This study examined whether adolescents with and without attention-deficit/hyperactivity disorder (ADHD) differed in affect variability and whether variability in positive and negative affect was associated with functional outcomes. Method: Participants were 302 adolescents (12-14 years, "M"age=13.17, 55% male; 54% diagnosed with ADHD; 82% white) and their caregivers who each completed the 10-item Positive and Negative Affect Scale via daily diaries for approximately two weeks. Multi-informant ratings of emotional, behavioral, social, and academic outcomes were assessed. Results: Adolescents with ADHD were found to experience greater variability in self- and parent-reported positive affect, fear, and distress. For adolescents with ADHD, greater variability in self- and parent-reported positive affect, fear, and distress were associated with more internalizing symptoms, greater variability in parent-reported positive affect was associated with worse social functioning, and greater variability in self- and parent-reported fear was associated with more externalizing symptoms. In contrast, greater variability in self- and parent-reported positive affect, fear, and distress were associated with better social functioning in adolescents without ADHD. Limitations: Future work should examine affect variability in adolescents with ADHD within the same day rather than across days. The limited age range and demographic diversity of our sample may limit generalizability of findings. Conclusions: Findings suggest the significant affect variability found among children with ADHD is also present in adolescents with ADHD and is associated with social and behavior impairment. Interventions for adolescents with ADHD should target emotion regulation abilities to help reduce the extremes of and shifts in affective experiences in this population. [This paper was published in "Journal of Affective Disorders" v274 p500-507 2020.]

Objective: The objective of this study was to compare caffeine consumption in the morning, afternoon, and evening in adolescents with and without ADHD and examine associations with sleep functioning. Methods: Participants were 302 adolescents (ages 12-14) with (n=140) and without (n=162) ADHD. Adolescents wore actigraph watches to assess total sleep time and wake after sleep onset and reported on sleep-wake problems and the number of caffeinated beverages consumed per day in the morning, afternoon, and evening. Parents reported on adolescents' difficulties initiating and maintaining sleep. Chi-square analyses, odds ratios, and path analyses were conducted. Results: Analyses controlled for sex, medication status, and pubertal development. Adolescents with ADHD were 2.47 times more likely to consume caffeine in the afternoon and evening than adolescents without ADHD. Path analyses indicated significant associations between afternoon caffeine use and more self-reported sleep problems for adolescents with and without ADHD, and an association between evening caffeine use and self-reported sleep problems only in adolescents with ADHD. Afternoon caffeine use was associated with parent-reported sleep problems in adolescents with ADHD but not in adolescents without ADHD. Caffeine use was not associated with actigraphy-assessed sleep. Conclusions: This is the first study to show that adolescents with ADHD consume more caffeine than peers during later times of the day. Additionally, caffeine use is more consistently associated with poorer subjective sleep functioning in adolescents with ADHD compared to adolescents without ADHD. Pediatricians and mental health professionals should assess for caffeine use in adolescents with ADHD and co-occurring sleep problems. [This paper was published in "Journal of Pediatric Psychology" v45 n6 p643-653 2020.]

A growing number of studies support the internal and external validity of youth self-reported sluggish cognitive tempo (SCT) symptoms. However, no study has examined SCT in adolescents without ADHD, examined whether adolescent self-reported SCT is distinct from adolescent self-reported ADHD inattention (ADHD-IN), or evaluated whether links between SCT and internalizing problems differ for adolescents with or without ADHD. The present study is the first to (1) determine the convergent and discriminant validity of self-reported SCT and ADHD-IN symptoms in both adolescents with and without ADHD, (2) test the invariance of SCT and ADHD-IN symptoms across ADHD and comparison groups, (3) examine SCT as uniquely related to a range of internalizing-relevant domains, and (4) evaluate if the association between SCT with internalizing correlates differs for adolescents with or without ADHD. Participants were adolescents (M[subscript age]=13 years) with (n=162) and without (n=140) ADHD. Adolescents and parents completed measures of internalizing symptoms and emotion dysregulation; adolescents completed measures of rumination and suicidal ideation. Analyses indicated that 13 of the 15 SCT items demonstrated convergent and discriminant validity from ADHD-IN, and SCT and ADHD-IN demonstrated invariance across the ADHD and comparison groups and across sex. SCT, but not ADHD-IN, was uniquely associated with greater adolescent-reported internalizing symptoms and suicidal ideation. Both SCT and ADHD-IN were uniquely associated with adolescent-reported emotion dysregulation and parent-reported internalizing symptoms. Only ADHD-IN was uniquely associated with parent-reported emotion dysregulation. Findings support the differentiation of adolescent-reported SCT and ADHD-IN and demonstrate associations between SCT and increased internalizing problems in adolescents with and without ADHD. [This article is published in "Journal of Abnormal Child Psychology" v48 p391-406 2020.]

The present study evaluates differences in self-reported intrinsic and extrinsic academic motivation and amotivation between eighth-grade adolescents with (n = 162) and without (n = 140) ADHD. This study also examines associations between motivation and academic functioning with objective (i.e., grade point average, standardized reading and math scores) and cross-rater measurement (i.e., parent-reported homework performance). Multivariate analysis of variance controlling for sex, intelligence, and medication status found that adolescents with ADHD exhibited a significant motivational deficit compared to adolescents without ADHD across all areas of academic motivation, including intrinsic motivation (d = 0.49), extrinsic motivation (d = 0.43), and amotivation (d = 0.42). To examine whether motivation was differentially associated with academic impairment in the ADHD and comparison groups, a multi-group path analysis was conducted controlling for sex, intelligence, and medication status. Findings showed that motivation was differentially associated with academic impairment for adolescents with and without ADHD. For the comparison group, higher amotivation was associated with poorer homework performance and lower intrinsic motivation was associated with lower reading accuracy. In the ADHD group, higher amotivation was associated with poorer homework performance and math fluency, higher extrinsic motivation was associated with better homework performance and higher GPA, and higher intrinsic motivation was associated with higher reading accuracy. This study builds upon previous research in demonstrating that adolescents with ADHD have academic motivational deficits when compared to their peers without ADHD. Research is needed to understand the longitudinal interplay of academic motivation and academic functioning, with an eye towards developing or modifying interventions to increase academic motivation and academic success. [This paper was published in "Journal of Abnormal Child Psychology" v48 p237-249 2020.]

Purpose: To examine remote learning practices and difficulties during initial stay-at-home orders during the COVID-19 pandemic in adolescents with and without ADHD. Methods: Participants were 238 adolescents (132 males; 118 with ADHD) ages 15.64-17.99 years and their parents. Adolescents and parents completed questionnaires in May/June 2020 when in-person schools were closed in the United States. Results: Twenty-two percent of families incurred financial costs to support remote learning, and only 59% of school-based services received prior to COVID-19 continued during COVID-19 remote learning. Adolescents with ADHD had fewer routines and more remote learning difficulties than adolescents without ADHD. Parents of adolescents with ADHD had less confidence in managing remote learning and more difficulties in supporting home learning and home-school communication. Thirty-one percent of parents of adolescents with ADHD with an Individualized Education Program (IEP) or receiving academic accommodations (504 Plan) reported remote learning to be very challenging, compared to 18% of parents of adolescents with ADHD without an IEP/504 Plan and only 4% of parents of adolescents with neither ADHD nor an IEP/504 Plan. Fewer adolescent routines, higher negative affect, and more difficulty concentrating because of COVID-19 were each associated with greater adolescent remote learning difficulties only in adolescents with ADHD. Conclusions: This study provides initial findings of the nature and impact of remote learning during the COVID-19 pandemic. It is imperative for schools and communities to provide the necessary supports to adolescents, particularly those with mental health and/or learning difficulties, and to their parents. Implications and Contributions: The start of the COVID-19 pandemic included the near-universal closing of schools. This study describes the remote learning practices, continuation of school services, financial burden to families, and remote learning difficulties in adolescents with and without ADHD when initial stay-at-home orders were in place in the United States. [This paper was published in "Journal of Adolescent Health" v67 n6 p769-777 2020.]

The Positive and Negative Affect Schedule (PANAS) has been widely used to assess affect expression. Shortened and adolescent versions of the measure have been created, such as the 10-item PANAS for Children (PANAS-C). However, affect expression often involves substantial intraindividual variability, and no research has examined within-person differences using the 10-item PANAS-C. Moreover, intraindividual variability is a key characteristic of attention-deficit hyperactivity disorder (ADHD), and emotion dysregulation is a key feature of ADHD. The present study examined the factor structure of the 10-item PANAS-C in a sample of adolescents (M[subscript age] = 13.17 years) with (n = 156) and without (n = 139) ADHD. A 3-factor (Positive Affect, Fear, Distress) within and a 2-factor (Positive Affect, Negative Affect) between model was found to be best fitting using both parent- and adolescent-report. The model demonstrated configural invariance for the adolescent-report and scalar invariance for the parent-report. These results support the multidimensionality of negative affect in youth with ADHD, even when assessed via the short-version PANAS-C. In future work, it will be important to consider the implications of more discrete types of negative affect expression (fear and distress) found across time at the individual level for assessment and intervention practice. [This paper will be published in "Psychological Assessment."]

Background: Prior studies examining the sleep of adolescents with and without attention-deficit/hyperactivity disorder (ADHD) have relied on mean values such as average sleep duration, which masks intraindividual variability. The objective was to investigate whether adolescents with ADHD have greater intraindividual variability of sleep/wake patterns than adolescents without ADHD using actigraphy and daily sleep diaries. Method: Adolescents (ages 13.17±0.40 years; 45% female) with (n=162) and without (n=140) ADHD were recruited from middle schools at two sites. Participants wore actigraphs and completed sleep diaries for an average of two weeks. Results: Multilevel models were conducted with sex, sleep medication use, ADHD medication use, number of days with data, and social jetlag controlled for in analyses. For actigraphy, adolescents with ADHD had greater variability for time in bed, sleep onset and offset, and wake after sleep onset than adolescents without ADHD. For sleep diary data, adolescents with ADHD had greater variability in bedtime, wake time, sleep duration, sleep onset latency, sleep quality, and night wakings than adolescents without ADHD. Social jetlag was a significant predictor of variability in sleep measures based on both actigraph and daily diaries; however, ADHD status was not associated with social jetlag. Conclusions: This is the first study to show that adolescents with ADHD have more variable sleep/wake patterns than their peers using both objective and subjective sleep measures. Intraindividual variability of sleep/wake patterns may be important for clinicians to assess and monitor as part of treatment. Research is needed to understand the mechanisms underlying increased intraindividual variability of sleep/wake patterns in adolescents with ADHD and potential consequences for daytime functioning. [This article was published in "Journal of Child Psychology and Psychiatry" v60 p1219-1229 2019.]

Background: Children with attention-deficit/hyperactivity disorder (ADHD) experience greater sleep problems than their peers. Although adolescence is generally a developmental period characterized by insufficient sleep, few studies have used a multi-informant, multi-method design, to examine whether sleep differs in adolescents with and without ADHD. Methods: Targeted recruitment was used to enroll an approximately equal number of eighth-grade adolescents (mean age = 13 years) with (n = 162) and without ADHD (n = 140). Adolescents and parents completed global ratings of sleep problems; adolescents, parents, and teachers completed ratings of daytime sleepiness. Adolescents wore actigraphs and completed a daily sleep diary for approximately 2 weeks. Results: Adolescents with ADHD were more likely than adolescents without ADHD to obtain insufficient sleep on school days (per diary) and weekends (per diary and actigraphy). Adolescents with ADHD were also more likely to report falling asleep in class and to have stayed up all night at least twice in the previous 2 weeks (14% and 5% reported all-nighters for ADHD and comparison, respectively). In regression analyses controlling for a number of variables known to impact sleep (e.g. pubertal development, sex, medication use, having an externalizing, anxiety, or depression diagnosis), ADHD remained associated with shorter diary and actigraphy school night sleep duration, adolescent- and parent-reported daytime sleepiness, and parent-reported difficulties initiating and maintaining sleep and total sleep disturbance. Controlling for other variables, the odds of being classified with clinically elevated parent-reported sleep disturbance were 6.20 times greater for adolescents with ADHD. Conclusions: Findings provide some of the clearest evidence yet that adolescents with ADHD experience more sleep problems and sleepiness than their peers without ADHD. It may be especially important to assess for sleep problems in adolescents with ADHD and to evaluate whether existing sleep interventions are effective, or can be optimized, for use in adolescents with ADHD who also have sleep problems. [This paper was published in "Journal of Child Psychology and Psychiatry" v60 p1021-1031 2019.]

Objectives: This study used a multi-informant approach to examine differences in types and rates of technology used by adolescents with and without attention-deficit/hyperactivity disorder (ADHD), associations between technology use and sleep/daytime sleepiness, and whether technology use was differentially related to sleep/daytime sleepiness in adolescents with and without ADHD. Methods: Eighth graders with (n=162) and without (n=140) ADHD were recruited. Adolescents completed questionnaires assessing time spent using technology, sleep-wake problems, school-night time in bed, and daytime sleepiness. Parents and teachers reported on adolescents' technology use and daytime sleepiness, respectively. Results: Adolescents with ADHD had significantly greater total technology, television/movie viewing, video game, and phone/video chatting use than adolescents without ADHD. Adolescents with ADHD engaged in twice as much daily video game use compared to those without ADHD (61 vs. 31 min). Controlling for medication use, ADHD status, pubertal development, sex, and internalizing symptoms, greater parent- and adolescent-reported technology use was associated with more sleep-wake problems and less time in bed. ADHD status did not moderate the relations between technology use and these sleep parameters. In contrast, ADHD status moderated the association between parent-reported technology use and teacher-reported daytime sleepiness, such that this association was significant only for adolescents with ADHD. Conclusions: Technology use, although more prevalent in adolescents with ADHD, is linked with more sleep problems and reduced school-night sleep duration regardless of ADHD status. Technology use is associated with teacher-rated daytime sleepiness only in adolescents with ADHD. Clinicians should consider technology usage when assessing and treating sleep problems. [This paper was published in "Journal of Pediatric Psychology."]

Identifying factors that influence adolescent intentions for COVID-19 vaccination is essential for developing strategic interventions to increase uptake, particularly in subgroups of at-risk adolescents. Attention-deficit/hyperactivity disorder (ADHD) in adolescence is characterized by difficulties regulating attention and behavior, social impairment, and impulsive risk-taking behaviors, which may impact vaccine hesitancy and vaccine uptake. This study examined hesitancy toward COVID-19 vaccines among adolescents with and without ADHD, and explored how ADHD status interacted with malleable social mechanisms and other social determinants of health in predicting vaccine hesitancy. Participants were 196 U.S. adolescents (44.4% male), 45.6% diagnosed with ADHD. Adolescents reported their confidence and willingness toward COVID-19 vaccines from March to May 2021. Adolescents with ADHD reported greater hesitancy and less confidence in COVID-19 vaccine safety compared to adolescents without ADHD (p< 0.01). Only 61.8% of adolescents with ADHD reported vaccine acceptance, compared to 81.3% of adolescents without ADHD. For all adolescents, those who identified as Black or Latinx and with lower family income had greater hesitancy and reduced confidence, whereas greater COVID-19 concerns, media use, and perceived negative impact on relationships was associated with greater vaccination willingness. Social contextual processes significantly interacted with ADHD status such that for adolescents without ADHD, concerns about COVID-19 were associated with increased confidence in vaccine safety. Being noncompliant with social distancing guidelines was associated with greater vaccine hesitancy, only for adolescents with ADHD. A concerted effort is needed to increase trust, confidence, and social relevance among adolescents, especially those with ADHD and from lower socio-economic backgrounds. [This paper was published in "Journal of Psychiatric Research" v152 p25-30 2022.]

Emotion dysregulation is associated with attention deficit/hyperactivity disorder (ADHD) and confers risk for behavior problems and functional impairment; however, there is little guidance on best practices for measurement in adolescents. We developed a parent-report version of the Difficulties in Emotion Regulation Scale (DERS-P)). Evidence of reliability and validity was evaluated in a large community online sample (Study 1: n = 978; M[subscript age] = 13.52 years; SD = 1.93) and in two samples of adolescents with ADHD (Study 2, Sample 1: n = 78; M[subscript age] = 12.12 years, SD = 0.91; Sample 2: n = 206; M[subscript age] = 15.35 years; SD = 0.85). A four-factor solution of the DERS-P was obtained in Study 1 and confirmed in Study 2, with factors demonstrating acceptable internal consistency. The community sample was generally rated as less dysregulated than the ADHD samples. Support was obtained for convergent, concurrent, and incremental validity evidence. These findings provide preliminary evidence for the DERS-P as a psychometrically sound parent-report measure of emotion dysregulation in 11- to 17-year-old adolescents. [This is the online version of an article published in "Assessment."]

Objectives/Background: Objectives were to (1) examine previous night's sleep in relation to next day performance on standardized academic achievement and neurocognitive assessments in adolescents, and (2) explore whether previous night's sleep is differentially associated with testing performance for adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Participants/Methods: Participants were 300 adolescents (ages 12-14 years; 55% male). Approximately half (53.6%) were diagnosed with ADHD. Adolescents provided ratings of their previous night's sleep quality, sleep duration, and number of night wakings and were administered standardized tests of processing speed and working memory, as well as word reading, numerical operations, and math fluency academic achievement. Results: In analyses controlling for sex, race, medication use, time of testing, and ADHD group status, more night wakings the previous night were associated with significantly lower numerical operations and math fluency achievement scores and marginally lower working memory scores. Previous night's sleep was not associated with processing speed or reading achievement. ADHD status did not moderate sleep in relation to academic/neurocognitive performance. Participants reporting =2 night wakings the previous night had slightly over half a standard deviation lower scores on average compared to participants reporting 0 night wakings. Conclusions: This preliminary study suggests that previous night's wakings are associated with poorer mathematics performance the next day, regardless of ADHD status. This may be due to the detrimental effect of interrupted and fragmented sleep on attention and executive control. These findings have implications for clinicians and educators when considering contextual factors that may impact academic and neurocognitive testing performance. [This paper was published in "Sleep Medicine" v52 p75-79 2018.]

Objective: To evaluate the effectiveness of 2 brief school-based interventions targeting the homework problems of adolescents with attention-deficit/hyperactivity disorder (ADHD)--the Homework, Organization, and Planning Skills (HOPS) intervention and the Completing Homework by Improving Efficiency and Focus (CHIEF) intervention, as implemented by school mental health providers during the school day. A secondary goal was to use moderator analyses to identify student characteristics that may differentially predict intervention response. Method: Two-hundred and eighty middle school students with ADHD were randomized to the HOPS or CHIEF interventions or to waitlist, and parent and teacher ratings were collected pre, post, and at a 6-month follow-up. Results: Both interventions were implemented with fidelity by school mental health providers. Participants were pulled from elective periods and sessions averaged less than 20 min. Participants in HOPS and CHIEF demonstrated significantly greater improvements in comparison with waitlist on parent ratings of homework problems and organizational skills and effect sizes were large. HOPS participants also demonstrated moderate effect size improvements on materials management and organized action behaviors according to teachers. HOPS participants made significantly greater improvements in parent- and teacher-rated use of organized actions in comparison with CHIEF, but not on measures of homework problems. Moderation analyses revealed that participants with more severe psychopathology and behavioral dysregulation did significantly better with the HOPS intervention as compared to the CHIEF intervention. Conclusions: Brief school-based interventions implemented by school providers can be effective. This type of service delivery model may facilitate overcoming the oft cited research-to-practice gap. [At the time of submission to ERIC, this article was in press with "Journal of Consulting and Clinical Psychology."]

Objective: The primary objective of this study was to evaluate the prevalence of multiple types of sleep problems in young adolescents with ADHD. Method: 262 adolescents comprehensively diagnosed with ADHD and their caregivers completed well-validated measures of sleep problems and daytime sleepiness. Participants also completed measures related to medication use, comorbidities, and other factors that could predict sleep problems. Results: Daytime sleepiness was by far the most common sleep problem, with 37% of adolescents meeting the clinical threshold according to parent report and 42% according to adolescent report. In contrast, prevalence rates for specific nighttime sleep problems ranged from 1.5-7.6 percent. Time spent in bed, bedtime resistance, ADHD inattentive symptoms, and SCT symptoms were significant in the final model predicting daytime sleepiness. Conclusion: Adolescents with ADHD commonly experience problems with daytime sleepiness that may significantly impact their functioning, but this may not be directly attributable to specific sleep problems. [This paper was published in the "Journal of Attention Disorders" Feb 2017.]

Interest in understanding the association between attention-deficit/hyperactivity disorder (ADHD) and sleep is nothing new. In fact, restless sleep was a symptom criterion for attention deficit disorder in the Third Edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-III), and the negative impact of inadequate or insufficient sleep on attentional functioning has likewise been noted for some time. Despite the large body of research examining sleep and ADHD, our understanding of this association is far from being put to bed, so to speak. Recently, research has shifted away from simply documenting differences in sleep functioning between individuals with and without ADHD, which while important, does little to inform our understanding of the causes, correlates, and consequences of these sleep difficulties. An emerging body of research using longitudinal methodologies is revealing that the associations between sleep and ADHD are complex, and that the clinical implications of sleep difficulties in individuals with ADHD likely varies across development. [This paper was published in "The ADHD Report" v25 p7-13, 16 2017.]