The prognosis of attention deficit hyperactivity disorder (ADHD) continues to “show heightened risk of multiple mental health and social difficulties as well as premature mortality in adult life” after nearly 50 years of primary pharmacological treatment.1 If the prognosis of ADHD is not changed by stimulants, then 2016 research that stimulants may cause cardiac arrhythmia and myocardial infarction associated with subsequent death in children younger than 17 years prescribed methylphenidate (MPH)2 raises the question of whether stimulants should be used. Furthermore, a 2015 Cochran Review found 98·6% of ADHD randomized clinical trials were considered high risk for bias and the remaining trials could also have been considered high risk by using a stricter definition.3 Has medicalization and marketing of the diagnosis and treatment of ADHD become the basis of putting children at risk by using stimulants, especially in the United States?4,5

Despite evidence of an association between prenatal acetaminophen exposure and attention deficit hyperactivity disorder (ADHD) in offspring, the causal role of prenatal acetaminophen exposure in child ADHD remains unclear owing to limitations of prior studies. Prior studies have relied on maternal self-report, failed to quantify acetaminophen dose, and lacked mechanistic insight. Chapter 1 formally introduces this topic and provides background information summarizing the high prevalence of ADHD, widespread use of acetaminophen during pregnancy, and potential molecular mechanisms through which the drug may harm fetal development. In Chapter 2, we examined the association between prenatal acetaminophen exposure measured in meconium and ADHD in children aged 6 to 7 years, along with the potential for mediation by functional brain connectivity. Data came from a prospective birth cohort study from the Centre Hospitalier Université de Sherbrooke in Sherbrooke, Québec, Canada. We included 393 eligible children, of whom 345 had meconium samples collected at delivery and information on ADHD diagnosis. Mothers were enrolled from September 25, 2007, to September 10, 2009, at their first prenatal care visit or delivery. Acetaminophen levels were measured in meconium, and physician diagnosis of ADHD was determined at follow-up when children were aged 6 to 7 years or from medical records. Additionally, when children were aged 9 to 11 years, resting-state brain connectivity was assessed with magnetic resonance imaging, and attention problems and hyperactivity were assessed with the Behavioral Assessment System for Children Parent Report Scale. Associations between meconium acetaminophen levels and outcomes were estimated with linear and logistic regressions weighted on the inverse probability of treatment to account for potential confounders. Causal mediation analysis was used to test for mediation of the association between prenatal acetaminophen exposure and hyperactivity by resting-state brain connectivity. Among the 345 children included in the analysis (177 boys [51.3%]; mean [SD] age, 6.58 [0.54] years), acetaminophen was detected in 199 meconium samples (57.7%), and ADHD was diagnosed in 33 children (9.6%). Compared with no acetaminophen, detection of acetaminophen in meconium was associated with increased odds of ADHD (odds ratio [OR], 2.43; 95%CI, 1.41-4.21). A dose-response association was detected; each doubling of exposure increased the odds of ADHD by 10% (OR, 1.10; 95%CI, 1.02-1.19). Children with acetaminophen detected in meconium showed increased negative connectivity between frontoparietal and default mode network nodes to clusters in the sensorimotor cortices, which mediated an indirect effect on increased child hyperactivity (14%; 95%CI, 1%-26%). In Chapter 3, we used data from the same Canadian birth cohort to examine whether prenatal acetaminophen exposure is associated with adverse birth outcomes and/or pregnancy complications, and if birth outcomes may mediate the association of prenatal acetaminophen with child ADHD. This study included 393 children for whom acetaminophen was measured in meconium at delivery. We tested associations of prenatal acetaminophen with birthweight, preterm birth, gestational age, small and large for gestational age, gestational diabetes, preeclampsia, and high blood pressure. Using causal mediation analyses, we assessed whether birth outcomes mediated the association of prenatal acetaminophen with ADHD. We imputed missing data via multiple imputation and used inverse probability weighting to account for confounding and selection bias. Prenatal acetaminophen exposure was associated with decreased birthweight by 136 g (β = −136; 95% CI [−229, −43]), 20% increased weekly hazard of delivery (hazard ratio = 1.20; 95% CI [1.00, 1.43]), and over 60% decreased odds of being born large for gestational age (odds ratio = 0.38; 95% CI [0.20, 0.75]). Prenatal acetaminophen was not associated with small for gestational age, preterm birth, or any pregnancy complications. Causal mediation effects were non-significant for all birth outcomes in both unadjusted and adjusted models, indicating no evidence that birth outcomes linked prenatal acetaminophen exposure with child ADHD. In Chapter 4, we examined the effects of developmental acetaminophen exposure on mouse behavior and frontal cortex gene expression. Although prior studies have investigated neurodevelopmental effects of prenatal acetaminophen exposure in rodents, the results of these studies are not always in agreement. Additionally, no mouse studies of prenatal acetaminophen exposure have investigated offspring attention deficits in behavior tasks specifically designed to measure attention, and no prior rodent studies have utilized ‘omics’ technologies for an untargeted exploration of potential mechanisms. We randomly assigned pregnant mice (starting embryonic day 4-10) to receive acetaminophen (150 mg/kg/day) or vehicle control through postnatal day 14. We employed a battery of behavior tests for 111 mouse offspring, including pup ultrasonic vocalizations, elevated plus maze, open field test, CatWalk, pre-pulse inhibition, and 5-choice serial reaction time task. Frontal cortex was collected at birth from 24 pups for RNA-sequencing. Developmental acetaminophen treatment resulted in increased pup vocalizations after separation from the litter, as well as decreased ambulation and vertical rearings in the open field task among male but not female offspring. Acetaminophen treatment was also associated with altered frontal cortex gene expression relating to glutathione and cytochrome p450 metabolism, DNA damage, and the endocrine and immune systems. Together with the multitude of other cohort studies showing adverse neurodevelopment associated with prenatal acetaminophen exposure, this work suggests caution should be used in administering acetaminophen during pregnancy. In humans, we found that prenatal acetaminophen exposure was associated with child ADHD, altered resting-state brain connectivity, and adverse birth outcomes. Furthermore, our results suggest altered brain connectivity as a potential underlying mechanism linking prenatal acetaminophen use with child hyperactivity. While adverse birth outcomes such as preterm birth and reduced birthweight are known to be associated with ADHD, we found no evidence for mediation by birth outcomes of the association between prenatal acetaminophen exposure and ADHD. In mice, we found that developmental acetaminophen treatment resulted in elevated anxiety-like behaviors in male offspring, as well as gene expression changes in the frontal cortex. Future studies are needed to explore whether the altered molecular pathways revealed by RNA-sequencing directly link acetaminophen exposure with offspring behavior changes.

During the past 80 years, similar descriptions of a hyperactive behavior pattern in children have appeared in medical, educational, and psychological literature. Hyperactivity has been conceptualized as a character disorder, an organic disorder, and, most recently, as a behavior disorder. In this study, hyperactivity was explained in interactional terms, using Rotter's social learning theory of personality. Little consideration has been given in research to the influence of an abnormally high activity level upon personality development during childhood. The purpose of this study was to investigate the general influence of negative interactions associated with hyperactivity upon the organization of four personality constructs: locus of control, self-esteem, trait anxiety, and state anxiety.

Personer med ADHD riskerar ohälsa i högre grad än befolkningen i stort. Såväl matvanor, som hälsolitteracitet kan ha signifikant inverkan på individers hälsa. Syfte med studien var att undersöka sambandet mellan matvanor och nivån av hälsolitteracitet hos personer med självrapporterad diagnostiserad ADHD, samt kontrollera för demografiska och socioekonomiska faktorer. Metod: En tvärsnittsstudie genomfördes på sociala medier med hjälp av en digital enkät under vecka 9–13, 2023. Svar från 191 personer, (156 kvinnor, 35 män) samlades in och analyserades med logistisk regressionsanalys. Den beroende variabeln matvanor erhölls genom sammanställning från åtta enskilda matvanor: intag av grönsaker, frukt, fullkorn, socker, salt, kött/chark, kvalitet av matfett och fetthalt av mejeriprodukter. Variabeln kunde anta värden bra och mindre bra matvanor. Den oberoende variabeln hälsolitteracitet kunde anta tre nivåer. Ålder, kön, utbildning och socioekonomiska faktorer var dikotomiserade confounders. Resultat: Högre nivå av hälsolitteracitet och ålder&gt; 35 år var associerade med hälsosammare matvanor. Personer med problematisk och tillräcklig nivå av hälsolitteracitet hade 8,3 (p &lt;0,008), respektive 14,8 (p &lt;0,001) gånger högre sannolikhet att ha bättre matvanor, jämfört med personer med otillräcklig nivå av hälsolitteracitet. När de olika matvanorna analyserades enskilt var högre intag av grönsaker (OR=2,93 [1,29–6,63]), frukt (OR=3,68/3,20 [1,32–10,26/1,18–8,53]) och bättre kvalitet på matfett (OR=2,94 [1,35–6,39]) associerade med högre nivå av hälsolitteracitet. Slutsats: Högre nivå av hälsolitteracitet och högre ålder (&lt;35 år) var associerade till sämre matvanor bland personer med ADHD. Det krävs vidare forskning kring hälsolitteracitet, matvanor och ADHD, samt vilka interventioner behövs. / <p>Betyg i Ladok 230606.</p>

Recent advances in artificial intelligence and natural language processing have led to the development of new assistive technologies for people with disabilities. This study builds on these advancements to investigate whether the AI-driven chatbot ChatGPT can assist individuals with Attention Deficit Hyperactivity Disorder (ADHD) in better comprehending and recalling written text. The study involved two groups of participants, one with ADHD and one without, who completed two reading comprehension tests, one with ChatGPT as a learning aid and the other without. Additionally, interviews were conducted with all participants to supplement the findings. Though our results showed a decrease in comprehension abilities across both groups when having access to ChatGPT, the participants who had used ChatGPT previously, in any form, had an increase in comprehension. The majority of participants were positive towards using ChatGPT in a similar way in the future. However, we believe that providing participants with a proper education on ChatGPT prior to testing, as well as conducting further testing with a larger sample size over a longer period of time, is necessary to provide a more accurate conclusion. / Senaste framstegen inom artificiell intelligens och språkteknologi har lett till utveckling av nya hjälpmedel för personer med funktionshinder. Den här studien bygger på dessa framsteg för att undersöka om den AI-drivna chatbotten ChatGPT kan hjälpa personer med Attention Deficit Hyperactivity Disorder (ADHD) att bättre förstå och minnas skriven text. Studien omfattade två grupper av deltagare, en med ADHD och en utan, som genomförde två läsförståelseprov, ett med ChatGPT som inlärningshjälpmedel och ett utan. Dessutom genomfördes intervjuer med alla deltagare för att komplettera resultaten. Trots att vårt resultat visade en minskning av läsförståelse kunskaper över båda grupperna när de hade tillgång till ChatGPT, de deltagare som hade använt ChatGPT tidigare, i någon form, hade en ökning i läsförståelse. Majoriteten av deltagarna var positiva till att använda ChatGPT på liknande sätt i framtiden. Vi anser dock att ge deltagarna en ordentlig introduktion till ChatGPT före testningen, samt att genomföra ytterligare tester med ett större urval under en längre tidsperiod, är nödvändigt för att ge en mer korrekt för att ge en mer precis slutsats.

For those with attention deficit hyperactivity disorder (ADHD), social interactions involving high levels of face-to-face interaction can raise stress levels and emotional dysregulation. Using animated avatar video models may mitigate potential emotional dysregulation while learning social skills in these populations. This study examined autonomic data of adolescents aged 7-13 diagnosed with attention deficit hyperactivity disorder (ADHD), n=5 during avatar animated video modeling (AAVM) of social and emotional skills. This was a replication study with the addition of biofeedback data collection and a change of population. Participants were given three Nearpod training modules with AAVM and multiple-choice quizzes on self-awareness, social awareness, and relationship skills. Using a multiple baseline design, we collected Social Emotional Learning (SEL) scores at baseline, and during each phase of intervention. During all phases, we collected heart rate and analyzed heart rate variability (HRV) metrics: standard deviation of N-N intervals (SDNN), high frequency (HF), low frequency (LF), and HF/LF ratio). We also collected real-time somatic data: muscle tension (EMG), skin conductance (SC), and skin temperature (temp). The somatic autonomic data were not analyzed as part of this thesis. Results suggest that persons with ADHD may benefit from avatar animated video modeling delivered instruction based on patterns in autonomic data, increases in scores on the targeted skills taught during instruction, and participant's expressions about this method of learning. In future research and practice the population for this content could be narrowed to age 8-12. Reliable but smaller and less obtrusive biofeedback devices are currently available, and having several accessible options is recommended.

Accessibility for people with ADHD is rarely covered by the research of Library and Information Science. University libraries, whose main task is to guide and provide services for students and researchers, have the means to support students with ADHD in several ways. Aside from educational support, these libraries offer a physical environment for studying. However, the existence of accessibility adaptation does not necessarily guarantee satisfaction among the group. The purpose of this paper was to examine the experiences of students with ADHD of the physical environment of their university libraries, of their sense of place. Additionally, this paper investigates how libraries can improve the design of their physical environment to meet the needs of these students. The data was collected through semi-structured interviews and analysed through thematic analysis. The findings resulted in two main themes: varying impact of social interaction and strategies and adaptation to the environment. Results showed that the library in some ways is well adjusted to their needs, but the students have to adjust to the environment in several ways because of some constraints. Additionally, the social aspects of the environment have a very big influence on the experience of the library. The prescence of other students can cause both stress and inspiration among the respondents, whose reactions would vary. Finally, a solution for a library design that would meet the needs of students with ADHD is universal design.

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