Contextual variability of ADHD symptoms: embracement not erasement of a key moderating factor

Rommelse, Nanda; Bunte, Tessa; Matthys, Walter; Anderson, Erica; Buitelaar, Jan K.; Wakschlag, Lauren S.

doi:10.1007/s00787-014-0665-1

Cited by 20 publications

(23 citation statements)

References 26 publications

(30 reference statements)

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“…This should be addressed in future research using multiple raters such as peers, parent, and self-reports, in addition to teacher reports. In particular, as there may be important contextual influences on the expression of ADHD symptoms (e.g., Rommelse et al, 2015), it will be important to obtain ratings from individuals who observe the target in different environments (e.g., home vs. school). Finally, ratings in the present study may have been affected by a “halo effect”: an inflation of intercorrelations because of a tendency to falsely ascribe symptoms to an individual who displays conceptually related symptoms (e.g., Hartung et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Developmental Relations Between ADHD Symptoms and Reactive Versus Proactive Aggression Across Childhood and Adolescence

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Developmental Relations Between ADHD Symptoms and Reactive Versus Proactive Aggression Across Childhood and Adolescence

et al. 2016

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“…This will enable to assess contextual variability of ADHD symptoms (Rommelse et al . 2015). Next, feedback can be provided to the patient, based on the sampled and processed data.…”

Section: Optimising Treatment Strategies In Adolescencementioning

confidence: 99%

Optimising treatment strategies for ADHD in adolescence to minimise ‘lost in transition’ to adulthood

Buitelaar

2017

Epidemiol Psychiatr Sci

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The persistence of attention-deficit hyperactivity disorder (ADHD) from adolescence to adulthood is not matched by continuity of care in this transition period. Many adolescents with ADHD have poor medication adherence or even stop medication treatment, and use of behavioural interventions is also suboptimal. The present commentary focuses on treatment strategies that might improve effects of ADHD medication treatment by improving adherence in adolescents with ADHD and/or optimise behavioural interventions for ADHD in adolescence. Most treatment strategies in adolescents with ADHD are merely copied from treatments offered to children. Instead however treatment should be focused on what makes adolescents special and vulnerable, such as poor insight into own functioning and poor decision making. Techniques that offer promise for adolescents are motivational interviewing, use of ecological momentary assessments and interventions, mindfulness-based training and serious games. Systematic studies into the effects of these techniques alone and in combination with medication are lacking. First published online 17 April 2017Key words: Attention-deficit hyperactivity disorder, transition, adolescence, mental health services.Attention-deficit hyperactivity disorder (ADHD) is a rather common neurodevelopmental disorder with an estimated prevalence of at least 5% in children and adolescents and 2.5% in adults (Polanczyk et al. 2007;Simon et al. 2009). Onset of the disorder is mostly during the preschool years or in childhood. From the three defining symptoms of ADHD, inattentiveness tends to be rather stable over development, whereas hyperactivity and impulsivity tend to decline more over age (Biederman et al. 2000). Despite these age-related symptomatic improvements, ADHD is a highly persistent disorder with between one third and half of ADHD children still meeting clinical threshold criteria and the majority of children with ADHD being functional impaired at adult age (Faraone et al. 2015).Despite claims of overdiagnosis and overtreatment of ADHD, survey data about treatments received for ADHD among children with special needs tell a different story (Visser et al. 2015). Of all adolescents of a national representative USA sample of 12-17 year old with ADHD, 27.9% were reported to have received both medication and behavioural interventions in the last year, 48.3% received medication only, 12.5% received behavioural interventions only and 14.3% did receive neither medication nor behavioural interventions (Visser et al. 2015). Furthermore, the persistence of the disorder over adolescence into adulthood is not matched by continuity of care in this important phase of life. For example, prescription data of ADHD medication by UK general practitioners show a significant drop from age 15 to 21 years. This discontinuation of medication treatment is much greater than the agerelated decline in symptoms, suggesting that young adults with ADHD receive insufficient treatment (McCarthy et al. 2009). This is more alarming, since adolescen...

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“…Contextual differences in children’s clinical symptoms are increasingly recognized as reliable differences rather than measurement error (De Los Reyes et al, 2015; Rommelse et al, 2015). Some have suggested that ODD may be best conceptualized as informant-specific, because ODD identified by mothers only versus teachers only have different correlates (Drabick et al, 2007; Offord et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Contextual variation in young children's observed disruptive behavior on the DB‐DOS: implications for early identification

Petitclerc

Briggs‐Gowan

Estabrook

et al. 2015

Child Psychology Psychiatry

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Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment (PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale (FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB-DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB-DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research.

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Contextual variability of ADHD symptoms: embracement not erasement of a key moderating factor

Cited by 20 publications

References 26 publications

Developmental Relations Between ADHD Symptoms and Reactive Versus Proactive Aggression Across Childhood and Adolescence

Developmental Relations Between ADHD Symptoms and Reactive Versus Proactive Aggression Across Childhood and Adolescence

Optimising treatment strategies for ADHD in adolescence to minimise ‘lost in transition’ to adulthood

Contextual variation in young children's observed disruptive behavior on the DB‐DOS: implications for early identification

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