Tillsammans med företaget Usify genomfördes en intervjustudie som en del av deras projekt där de utvecklar ett behandlingsprogram riktat till vuxna personer med ADHD. Studien hade sex deltagare vilka var diagnostiserade med antingen ADHD eller ADD. Syftet med studien var att ta reda på vilka upplevelser deltagarna hade gällande video-, text- och ljudmaterial som utformats för behandlingsprogrammet. I materialet gavs förklaringar till de problem ADHD kan ge upphov till samt så presenterade konkreta sätt att hantera dessa på. Intervjuerna analyserades med tematisk analys och resulterade i åtta teman som återspeglade deltagarnas upplevelser, åsikter och reflektioner kring materialet. Deltagarna hade i vissa fall en gemensam uppfattning medan de i andra fall tänkte olika. De var positivt inställda till vissa aspekter av materialet och negativt inställda till andra. Utifrån resultatet diskuteras det hur Usify kan utforma materialet för att ta fram en tjänst som på bästa sätt möter användares behov och önskemål. Ett av de viktiga fynden var att ifall användare ska uppleva sig motiverade att använda tjänsten så behöver videor och texter hållas korta samtidigt som det ges fördjupad information som ger nya insikter och ny förståelse till användaren. Denna information bör ges både i text- och videoformat då båda formaten har olika styrkor jämfört med varandra. / An interview study was carried out together with the company Usify who are developing a treatment program for adults diagnosed with ADHD. The study had six participants who were diagnosed with either ADHD or ADD. The aim of the study was to hear what experiences the participants had after using the material consisting of videos, texts and audio files that had been made for the treatment program. In this material there were explanations of the different difficulties that ADHD give rise to and practical ways to cope with these. The interviews were analyzed using thematic analysis which resulted in eight themes that reflected the participants experiences, opinions and reflections regarding the material. In som cases the participants agreed with each other whereas they disagreed in others. They were positive regarding some aspects of the material and negative regarding others. Based on the results the discussion elaborates on how Usify can go about to design a service that meets user needs and requests. One of the important findings was that in order to have the user motivated to use the service the videos and texts must be kept short, but at the same time there must be depth to the information that gives new insights and understanding to the user. This information should be given in both text- and video format since the two formats have different strengths compared to each other.

Thesis advisor: Elizabeth Kensinger / Thesis advisor: Katherine Mickley Steinmetz / Distractibility and impulsivity have long been thought of as two separate psychological processes; however, there is currently evidence that suggests otherwise. The aim of this study was to gain a better understanding on the behavioral level of the interaction between these two traits. I proposed a model in which some individuals have a higher than average threshold for activation of the top-down cognitive control resources that are important for directing and maintaining attention as well as for regulating impulsive behaviors. To test the strength of this model I used an experimental paradigm that combined two different types of tasks—a spatial working memory task and a delay discounting of a primary reward (juice) task. Participants were administered the Conners’ Adult ADHD Rating Scale in order to be classified in terms of their trait distractibility and trait impulsivity subscale scores. The results suggest that there is indeed an association between the traits of distractibility and impulsivity, and that they may be linked by a common mechanism involving a variable threshold of activation of top-down control resources to regulate these behaviors. / Thesis (BS) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program. / Discipline: Psychology.

Bakgrund: Tidigare studier visar att mellan 5-10% av alla barn och 3-10% av dagens vuxna har ADHD ( Attention-Deficit/Hyperactivity Disorder). Bakomliggande orsaker till ADHD är idag inte helt klarlagt. Individer med ADHD har symtom som koncentrationsproblem, hyperaktivitet och impulsivitet vilket påverkar deras dagliga liv.  Syfte: Syftet med studien var att belysa vuxnas upplevelser av att leva med ADHD. Metod: En litteraturstudie utfördes på fem självbiografier som kvalitetsgranskades och analyserades med hjälp av Lundmans & Hällgren Granheims (2012) kvalitativa manifesta innehållsanalys. Resultat: Att leva med ADHD innebär många svårigheter. Det framkom samstämmiga uppgifter som beskrev känslan av att vara annorlunda, utanförskap, dålig självkänsla. För att klara vardagen krävdes ett ökat behov av strategier och rutiner samt stöd från familjen.  Slutsats: Individer med ADHD, upplever svårigheter i vardagen som medför både mentalt och socialt lidande. Det kan finnas ett behov av att sjuksköterskan får en fördjupad förståelse för hur det är att leva med ADHD, likaså på vilket sätt sjuksköterskan kan hjälpa och vägleda dessa individer vid kontakt med sjukvården.

This thesis investigates the nature of atypical attention in relation to autism spectrum disorders (ASD) symptoms, as well as the mechanisms by which it may relate to social impairment. First, does atypical non-social attention predict social impairment over time in the context of ASD, suggestive of a causal relationship? Second, if atypical attention plays a role in social impairments in ASD, what is the mechanism? With regards to the first question, longitudinal data with children at familial risk for ASD demonstrated a unidirectional relationship between non-social attention and social functioning at the cognitive level: 2-year-old non-social attention predicted 3- year-old face recognition, but there was no relationship between 2-year-old face popout and 3-year-old visual search. Additionally, we examined the relationships between ASD and ADHD symptoms over three years in children at high risk for both—children with fragile X syndrome. This allowed for investigating atypical non-social attention and social impairment at the symptoms level, again revealing a unidirectional relationship with ADHD symptoms predicting ASD symptoms over time but not the reverse. These findings suggest that atypical non-social attention may contribute to social impairment. With regards to the second question, a novel eye-tracking and visual search paradigm revealed how task irrelevant social stimuli in natural scenes can lead to poorer subsequent explicit spatial contextual memory and altered memory-guided attention orienting - effects that were moderated by autistic traits and social anxiety within a neurotypical population. Further, this research found cross-sectional development, comparing 6-10-year-old children to young adults, and investigated the neural markers of social stimuli's effect on memory. These studies suggest a possible mechanism whereby a reduced social attention bias could lead autistic individuals to learn and remember less about people and the social world and result in social impairment.

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with functional impairments across the lifespan, including in the social domain. The cognitive processes underlying the disorder, as well these associated social impairments, are still being debated. This points to the need for introducing new approaches. Event perception, the process of perceiving ongoing streams of activity into whole events, provides a unique perspective on the cognitive and social deficits in ADHD and how they might be related. Event perception is a compelling approach due to its methodological advantages, theory, and originality. Therefore, the overarching goal of this dissertation is the use of event perception to elucidate cognitive underpinnings of ADHD and associated social impairments. In the background section of this dissertation, I review the evolution of scientific conceptualizations of ADHD as a disorder and its core features, including cognitive underpinnings. In addition, I highlight the cognitive components of the disorder, revealing a need for continued exploration of possible cognitive contributors. Next, I deliver an overview of the functional impairments associated with ADHD, with a special focus on social difficulties. Current theories regarding the factors that contribute to social impairment among those with ADHD are presented along with their methodological, conceptual and practical shortcomings. To address these flaws, I propose turning to event perception as a mechanism of social cognition. This section ends with a description of the guiding Event Segmentation Theory, links between event perception and ADHD, and potential event perception related contributions to the ADHD literature. The first study addresses event perception as a cognitive deficit among those with ADHD, while the second addresses the relationship between event perception, symptoms of ADHD, and social functioning. Results of the two studies point to event perception differences associated with ADHD, as well as symptoms of ADHD acting as mediators in the relationship between event perception and social impairment. As a first initiative to apply event perception to ADHD and its related impairments, these results contribute to current conceptualization of ADHD, as well as support the use of event perception to further inquiries into ADHD and development of future interventions. The dissertation is concluded with a broad discussion of the meaning of the results, as well as limitations, implications and future research directions.

Objective. To examine associations among attention-deficit/hyperactivity disorder (ADHD) symptom dimensions (hyperactivity, impulsivity, inattention, and sluggish cognitive tempo [SCT]) and functional impairment among adults. The potential influence of co-occurring internalizing and externalizing difficulties, as well as self-reported executive functioning deficits, on these associations was also evaluated. Methods. One thousand eight hundred and ninety-four adults (58.8% female; 75.9% Caucasian; age: M = 36.24 [SD = 11.65] years) recruited from Amazon’s Mechanical Turk (MTurk) completed extensive questionnaire batteries assessing ADHD symptoms, co-occurring internalizing and externalizing difficulties, executive functioning deficits, and functional impairment across a range of domains. First, factor analyses were completed to identify empirically-derived functional impairment factors for use in subsequent analyses. Second, associations between ADHD symptom dimensions and functional impairment factors were examined via a path model. Third, multiple mediation analyses were conducted to evaluate the impact of ADHD symptom dimensions on functional impairment domains via internalizing and externalizing difficulties. Finally, additional multiple mediation analyses were completed to examine to influence of ADHD symptom dimensions on functional impairment via self-reported executive functioning deficits. Results. Factor analyses identified four overlapping but distinct functional impairment factors indexing general impairment, quality of life, romantic relationship functioning, and social support. Path analyses revealed significant associations between increased ADHD symptoms and higher general impairment, lower quality of life, reduced romantic relationship functioning, and decrements in perceived social support. Multiple mediation analyses indicated that ADHD symptom dimensions influence functional impairment domains via specific internalizing, externalizing, and executive functioning difficulties. Conclusions. The pattern of findings provides further support for associations between ADHD symptom dimensions and a range of functional impairments, as well as highlighting potential exacerbation of these effects in the presence of co-occurring mental health and executive functioning difficulties. Current findings may help to clarify the complex phenomenology of ADHD in adults, and carry implications for improving extant treatment approaches.

The purpose of this research was to identify risk factors for future substance abuse (SA) and/or substance dependence (SD) among young boys with attention deficit/hyperactivity disorder (ADHD). The prevalence of childhood ADHD among adult substance abusers has been well documented and stimulant medication therapy is considered to be a protective factor. However, this population remains at high risk for developing SA disorder in adulthood. Thus, since stimulant therapy alone does not eliminate the risk of future SA, it is important to determine other factors that contribute to this problem in this population. The specific questions addressed in this research were 1) What risk factors predict SA problems in later life for adolescent boys who were diagnosed with ADHD? ; 2) Do boys diagnosed with ADHD and receiving stimulant medication have the same risk factors for SA as undiagnosed/unmedicated (normal) boys? and 3) Is the medication effect at reducing SA in later years dependent or independent of the response to the pharmacological treatment for behavioral symptoms of ADHD? This study evaluated data collected in a longitudinal study (1968 to present) of boys diagnosed with ADHD at the University of Iowa Hospital outpatient psychiatric clinic. Longitudinal regression and odds-ratios were used to measure the strength of correlation of risk factors to adult SD outcomes in three groups: diagnosed medicated boys, diagnosed unmedicated boys and a comparison group of undiagnosed, unmedicated (normal) boys. It was hypothesized that specific risk factors could be identified in the two groups of diagnosed boys (medicated and unmedicated). It was further hypothesized that poor response to medication would predict higher rates of adult substance abuse. and thus be an indicator for early prevention/intervention need for the poor responders. Results indicated that few of the evidence-based risk factors identified for the general adolescent population were significant predictors of adult SD for these adolescents diagnosed with ADHD. Other identified risk factors did not appear to be influenced by the effects of the medication. Response to stimulant medication was not related to the outcome of adult substance dependence, indicating that the protective factor exists regardless of medication response.

ADHD is a common behavioral problem among children and adolescents and has been studied extensively. However, this disorder is still understudied in ethnic, immigrant minorities in the U.S. such as Arab families. Thus, this descriptive, qualitative study was important and needed because a gap exists in the literature concerning Arab immigrant mothers' perceptions of the children's behavioral problems such as ADHD and the implications of such child behavioral problems within the Arab immigrant family. The available literature has focused on other minorities in the United States and not Arab minorities. Accordingly, this study focused on and took a qualitative approach in order to gain an in-depth understanding of how Arab immigrant mothers perceive, describe and respond to children behavioral problems. The main purpose of this study was to elicit mothers' perceptions of and responses to behavioral problems in children, especially those behaviors associated with ADHD, in a purposeful sample comprised of Arab immigrant Muslim mothers. The findings of this study indicate that generally, mothers used several terms to describe problematic behaviors in children, words like "active", "overactive", "spoiled", "concentration problems,"...etc. Also, mothers reported several strategies for how they would respond to a child's behaviors if the child exhibited behavioral problems as well as the use of many resources available for handling a child with behavioral problems. Mothers reported various issues they considered to be triggers that would cause them to seek help for a child's behaviors. Moreover, mothers emphasized the issues of social stigma, lack of knowledge, and lack of resources as problems that would hinder them from seeking professional mental health assistance for treating behavioral problems for children in the mothers' country of birth. The results indicated that the mothers' unfavorable attitudes toward seeking formal mental health services are most likely to be affected by cultural and traditional beliefs about mental health problem. Interestingly, mothers reported that their attitudes toward children's behavioral problems differ when in the U.S. than the generally accepted attitudes held in their home countries. This study added new knowledge and also provided information to social scientists, health care providers, mental health professionals, educators, and policy makers to better understand the needs of Arab immigrant families with children who may suffer from behavioral problems/ADHD. Finally, this study provided information for future researchers who wish to study child behavioral problems/ADHD with immigrant families other than Arabs.

This study investigated whether psychologists are attempting to distinguish between attention deficit hyperactivity disorder (ADHD) and depression in youth. Findings indicate that, overall, clinicians are conducting comprehensive evaluations and considering ADHD and depression as likely diagnoses. Clinicians were more likely to use self-report depression measures if the client was female or adolescent than if the child was male or school age; however, they were equally likely to incorporate ADHD-related measures with males and females , and 8 year olds and 15 year olds . Clinicians were more likely to consider adolescents than school-age children and females than males to have a mood disorder. Doctoral-level clinicians were more likely to consider a mood disorder and ADHD than master's- level clinicians. Clinicians who had completed a child psychopathology course were more likely to consider ADHD than those who had not completed such a course. The implications of these findings for child-oriented clinicians are discussed.

Das serotonerge System bildet schon seit Jahrzehnten einen Schwerpunkt in der psychiatrischen Grundlagenforschung. Seinen weit verzweigten Leitungsbahnen wird eine global-modulatorische Eigenschaft für die Aufrechterhaltung des Gleichgewichts zwischen unterschiedlichen Hirnregionen und unterschiedlichen Neurotransmitter-systemen zugeschrieben (Hüther und Rüther, 2000). Darüber hinaus ist die serotonerge Neurotransmission ein Hauptmodulator emotionalen Verhaltens, das Angst und Ängstlichkeit ebenso umfasst wie Aggression und Impulsivität (Lesch et al., 2003). In der vorliegenden Arbeit wurden im Sinne eines Kandidatengenansatzes zwei Assoziationsstudien durchgeführt. Im ersten Teil wurde versucht, eine mögliche Assoziation zwischen der Erkrankung an affektiven Störungen und drei vorbeschriebenen SNPs des FEV-Gens aufzudecken. FEV ist das humane Homolog des in mehreren Tierversuchen untersuchten Pet-1-Gens, dem vor allem eine zentrale Bedeutung in der embryonalen Entwicklung des serotonergen Systems zugeschrieben wird. Zusätzlich wurde ein 286 bp langer Abschnitt des Exon 3 sequenziert, um die Häufigkeit der sieben in diesem Abschnitt beschriebenen SNPs bei unipolar depressiven Patienten abzuschätzen und ggf. neue Varianten zu detektieren. Der zweite Teil untersuchte das Auftreten zweier bereits von anderen Autoren beschriebener SNPs des TPH2-Gen bei an der adulten Form des ADHS leidenden Patienten im Vergleich zu einer Kontrollgruppe. Die im zentralen serotonergen System dominierende Tryptophanhydroxylase 2 (TPH2) ist das erste, geschwindigkeitsbegrenzende Enzym der Serotonin-Biosynthese. Die Genotypisierung der einzelnen SNPs erfolgte mit unterschiedlichen Methoden. So kam sowohl die PCR, der Restriktionsenzymverdau, die Minisequenzierung (SNaPshot®) als auch die MALDI-ToF Massenspektrometrie und die Sequenzierung zum Einsatz, die Auftrennung einzelner Schnittprodukte erfolgte durch die Gelelektrophorese. Die erste Stichprobe umfasste 270 Patienten (davon 179 weiblich) mittleren Alters mit einer Diagnose aus dem affektiven Formenkreis (180 mit bipolar-affektiver Störung gemäß den DSM-IV Kriterien, weitere 90 Patienten mit einer rezidivierenden unipolaren depressiven Störung) sowie 362 (davon 174 weibliche) Kontrollpersonen. Die Stichproben der zweiten Studie umfassten 284 am adulten ADHS (Diagnose nach DSM IV) leidende Patienten (140 davon weiblich) und 120 Kontrollpersonen (61 davon weiblich). Statistisch wurden die Daten sowohl auf Einzelmarker- als auch auf Haplotypniveau ausgewertet. In beiden Studien konnte keine Assoziation der untersuchten Polymorphismen des FEV- bzw. TPH2-Gens mit der jeweiligen Erkrankung (affektive Störung / adultes ADHS), weder auf Einzelmarker- noch auf Haplotypniveau, nachgewiesen werden. Die Sequenzierung des 286 bp langen Abschnitts von Exon 3 des FEV-Gens zeigt eine ausgeprägte Konservierung der Sequenz dieses Gens, wie sie auch von anderen Autoren beschrieben wurde. Die hier untersuchten Kandidatengene FEV und TPH2 sind auch weiterhin interessante Ansatzpunkte für die psychiatrische Grundlagenforschung. Die Aufklärung der genauen Wirkungsweise von FEV und seine Rolle in der Entwicklung des menschlichen serotonergen Systems erscheint jedoch vordergründig, um zunächst Funktion, Interaktionen und mögliche pathogenetische Mechanismen aufzudecken und dann gezielter die Einflüsse bestimmter Polymorphismen zu untersuchen. / Since decades, the serotonergic system is one major focus of basic research in psychiatry. The widely branched serotonergic network is thought to have global-modulatory impact on diverse brain regions and transmitter systems (Hüther & Rüther, 2000). Moreover, serotonergic neurotransmission plays a key modulatory role in emotional behavior, including for example fear, anxiety, aggression and impulsivity (Lesch et al., 2003). Within the present manuscript, two association studies focussing on two candidate genes of the serotonergic system are presented. The first study aimed at investigating the association between affective disorders and three previously described SNPs of the FEV gene. FEV is considered the human homolog of the murine Pet-1-gene and has been suggested to be of key importance for the embryonic development of the serotonergic system. In addition, the study aimed at detecting new variants, and therefore assessed the frequency of seven new SNPs located on a 286 bp long part of the Exon 3, and tested for their association with unipolar depressive disorder. The second study aimed to compare the frequency of two previously described SNPs of the TPH2- gene between a sample of adult ADHD patients and a sample of healthy controls. TPH2 is thought to be the dominating speed reducing enzyme to central serotonergic biosynthesis. While genotyping of the respective SNPs was done using different methods, i.e. PCR, restriction enzyme digest, SNaPshot®, MALDI-ToF mass spectrometry as well as sequencing, all cleavage products were separated using gel-electrophoresis. The first studies‘ sample consisted of N=270 middle-aged patients (179 female) diagnosed for affective disorders according to DSM-IV criteria (i.e. n=180 bipolar disorder, n=90 unipolar depression), and N=362 (174 female) healthy controls. Within the second study, N=284 patients suffering from adult ADHD (140 female) and 120 healthy controls (61 female) were investigated. Data within both studies have been analyzed for single-marker as well as for haplotype associations. In both studies, no associations between the polymorphisms under investigation and the respective disorders were found (neither on the single-marker nor on the haplotype level). In accordance with previous reports, a marked conservation of a section of the Exon 3 sequence (286 bp) of the FEV gene was found. Although both candidate genes (FEV, TPH2) are of further interest for basic research into Psychiatry, unraveling the role of FEV in the development of the human serotonergic system seems to be of primary importance. Once the functional associations, interactions and pathogenic mechanisms have been discovered, future research might be able to more specifically target the role of single polymorphisms within the serotonergic network.