Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2008. / Directed by Arthur Anastopoulos; submitted to the Dept. of Psychology. Title from PDF t.p. (viewed Apr. 13, 2010). Includes bibliographical references (p. 102-125).

Thesis (Ph. D.)--Ohio State University, 2005. / Title from first page of PDF file. Document formatted into pages; contains xviii, 251 p.; also includes graphics (some col.). Includes bibliographical references (p. 150-157). Available online via OhioLINK's ETD Center

Dissertation (Ph.D) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 192-222.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 71-78). Also available on the Internet.

M.A. / Literature indicates that childhood ADHD has received considerable attention and recognition in today’s society and is effectively represented in the DSM. In comparison, there is still much controversy surrounding ADHD in adults (aADHD), despite the fact that almost 50 to 70% of people diagnosed with childhood ADHD continue to manifest symptoms in adulthood. Research indicates that aADHD manifests differently to childhood ADHD, in that the core symptom is inattention and not hyperactivity. Research also indicates that there is a high comorbidity between aADHD and substance dependence, including nicotine dependence. It is hypothesized that these individuals present with hypodopamine, and nicotine acts on a number of neurotransmitter pathways, including the dopaminergic and acetylcholinergic pathways, effectively stimulating the release of dopamine. Whilst there is considerable literature on nicotine and ADHD, there is a complete lack of literature on the relationship between aADHD and Hookah Pipe smoking. This study aimed to rectify this situation. The present study was conducted with two major purposes in mind: (1) to investigate the relationship between Hookah Pipe smoking and its effects on attention and concentration in young adults with Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology, and (2) to demonstrate whether Hookah has a greater effect than cigarettes (as Hookah reportedly has higher concentrations of nicotine than cigarettes). A total sample of 39 participants (14 males, 35 females) aged 18 to 26 years was recruited and divided into the following six groups using the ASRS, the Burke-Austin Self-Report ADHD Questionnaire and a substance abuse questionnaire as screening tools: ADHD (Hookah), ADHD (Nicotine), ADHD (Non-Smoking), Non-ADHD (Hookah), Non-ADHD (Nicotine) and Non-ADHD (Non-Smoking). Furthermore, a quasi-experimental research design was used, whereby the Cambridge Neuropsychological Test Automated Battery (CANTAB) ADHD Battery was administered across three test conditions, with a seven minute intervention between the pre- and post-intervention, and a 90 minute waiting period between the immediate and intermediate post-intervention, so as to test the effects of the nicotine as it neared its elimination half-life of two hours.

Background: In recent years the incidence of Attention Deficit/Hyperactivity Disorder (ADHD) has increased. Objectives: The primary aim of the study was to determine the treatment of children and adolescents diagnosed with ADHD in South Africa and more specifically the Eastern Cape. Methods: The study consisted of two parts, a retrospective drug utilisation study and a questionnaire survey. The drug utilisation study was conducted on chronic medication records of a private sector medical scheme administrator and contained records from 1994 to 2006. A total of 42 250 records representing 8 274 patients and 4 001 families, were analysed. The questionnaire survey was conducted in the Eastern Cape. The questionnaires were distributed by responsible pharmacists to parents of children receiving medication for the treatment of ADHD from his/her pharmacy. Fifty one completed questionnaires were analysed. Results: The average age of patients in the drug utilisation study were 14.28 (SD = 5.50) years. Males represented 77.37 percent of patients. Ritalin® 10 mg was the most frequently prescribed methylphenidate-containing product, followed by Ritalin® LA 20 mg. The two most frequently prescribed active ingredients apart from methylphenidate were fluticasone and budesonide. The two most common comorbid conditions were allergic rhinitis and asthma. The average age of patients in the questionnaire survey was 10.26 (SD = 2.51) years. Males represented 73.58 percent of patients. A third of patients had relatives previously diagnosed with ADHD. Ritalin® 10 mg was the most frequently prescribed methylphenidate-containing product. Conclusion: ADHD is a complex life-long disorder. It does not only affect the child diagnosed with the disorder, but also has effects on the family, schooling system and peer relationship. Therefore, more studies regarding the incidence and treatment of ADHD need to be conducted in South Africa.

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects 11% of children in the US alo­ne. Methylphenidate (MPH) is the most commonly prescribed drug for the treatment of ADHD. Given the fact that ADHD symptoms persist in up to 50% of patients, many children receive MPH from childhood to early adulthood. Unfortunately, most of the scientific literature focuses on the short-term consequences of MPH, even though individuals are taking MPH for many years. Previous research has shown that long-term exposure to MPH causes dopamine-releasing neurons within the nigrostriatal pathway to die when exposed to the Parkinsonian toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPH acts by blocking dopamine transporters and norepinephrine transporters, preventing the reuptake and removal of these neurotransmitters following release and increasing the time outside of the protective environment of the neuron’s vesicles. We hypothesize that spontaneous oxidation of excess dopamine to a quinone metabolite is rendering these neurons within this particular pathway to be more sensitive to MPTP. The dopamine quinone may be bound by the antioxidant glutathione (GSH) in an effort to protect the cell against oxidative stress. However, as the finite amount of GSH is depleted, the quinone may lead to the production of highly reactive molecules, leading to mitochondrial damage and cell death which may be accelerated by MPTP. In order to examine this hypothesis, we chose to study adolescent male Swiss-Webster mice, which have been shown to be resistant to MPTP’s toxic effects. They were divided into 3 cohorts and administered either saline (control), 1 mg/kg MPH (therapeutic dose) or 10 mg/kg (abusive dose) via intraperitoneal (IP) injections for 12 weeks. Mice were injected twice daily, Monday through Friday, mimicking a school-week dosing schedule. After 12 weeks, all animals received a drug washout period of 7 days. Then, half of each cohort was treated with MPTP (4 x 20 mg/kg, every 2 hours), while the other half was administered 4 injections of sterile saline. Either 3 or 7 days after MPTP or saline treatment, the mice were sacrificed, brains were removed, and the substantia nigra (SN) and striatum (STR) were collected. These areas of the brain make up the nigrostriatal pathway and are affected by Parkinson’s disease. Oxidative stress related to increased dopamine levels was determined using the glutathione assay to measure GSH content, near-infrared fluorescence dot blots to measure free and protein-bound ortho-quinones, and an ATP luciferase assay to measure mitochondrial function. Interestingly, there was a significant decrease in GSH as the dose of MPH was increased with both saline and MPTP samples. Furthermore, a significant increase in quinones was observed as the dose of MPH increased. We also expect to see a decrease in ATP inversely proportional to the dose of MPH indicating increased oxidative stress. In conclusion, it appears that long-term exposure to MPH sensitizes dopaminergic neurons within the nigrostriatal pathway to oxidative stress, rendering them vulnerable to further insults, such as MPTP exposure. As such, these studies provide insight into the risks of long-term psychostimulant exposure.

A literature review was performed to examine the existing research on COVID-19 lockdown as it relates to ADHD child/adolescent individuals, media use, and impact on their educational performance and learning. It was surmised that with the COVID-19 epidemic prompting a transition to remote learning, a less structured and isolated learning environment, combined with increased screen time, would impair ADHD individuals’ performance and learning. A literature search for articles published between 2020 and 2021 from Pubmed, Google Scholar, PsychInfo, was performed. Search phrases and keywords included “covid, ADHD, child, impact, remote learning, media, screen”. Studies primarily utilized parental reports, with very few from the perspective of the ADHD individuals’ themselves. It was found that with the COVID-19 quarantine and transition to online learning, ADHD individuals’ experienced decreased ability to keep focused or adhere to daily routine, as well as increased inattention-related problems, such as careless mistakes or lack of completion in homework, which in turn translated into overall subjective reports of “more difficulty with remote learning.” Increased screen time, television, social media and gaming were noted amongst ADHD individuals. The suggested impact of increased screen time and media use was that ADHD children with problematic digital media use suffer from more severe core symptoms of ADHD, negative emotions, executive function deficits, damage on family environment, pressure from life events, and a lower motivation to learn. With these findings, it would be expected that the number of new ADHD cases, prescriptions for and usage of stimulants for treatment would rise amidst the COVID epidemic. However, data has not been studied or well documented thus far. Further research could extend to studying the impact of remote learning on neurotypical children and the risk for misdiagnosis of ADHD in children and adolescents or over-prescribing medications to youths with and without ADHD.

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