ADHD Among College Students, Let’s Be Aware

ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental and psychiatric disorder observed in all age groups. Past studies have observed simultaneous occurrence of ADHD and other psychiatric disorders in children and adults. To bridge the gap between the two age groups, researchers at the University of North Carolina in Greensboro published a study in 2018 that examining and patterns of non-ADHD psychiatric disorders among 443 emerging adults (1st-year college students aged 18-22 yrs) with and without ADHD. Clinical assessment using multiple methods like interviews, observations, tests and expert reviews showed a significantly higher rate of such disorders among students with ADHD.

Comorbidity is the term used to describe the simultaneous occurrence of two chronic diseases or disorders among individuals. The effects of comorbidity of psychiatric disorders and ADHD on the educational and social functioning of college students is still unclear to the scientific community due to the limited number of studies and their varying results.This 5-year investigation was conducted to assess comorbidity in 1st-year college students with ADHD compared to a non-ADHD group. The rate of one current non-ADHD diagnosis was significantly higher for the ADHD group (55%) compared to the non-ADHD group (11%). Amongst the diagnoses were depressive disorders, anxiety disorders, trauma- and stressor-related disorders, and learning disorders. Interestingly enough, this rate was higher than those observed among children, but lower than in adults. This raises the possibility of continuity in the development of comorbidity with age among individuals with ADHD.

The study also analyzed the potential influence of ADHD type, gender, and ethnic/racial diversity status on comorbidity in ADHD patients. ADHD can be divided into predominantly hyperactive-impulsive, predominantly inattentive, or combined. Due to the lack of significant sample numbers for the first group, only the latter two groups were compared. Among these, the combined group showed a much higher rate of having one current comorbid condition. Based on gender, women with ADHD were more likely to have a comorbid disorder compared to men. However, there was no difference found amongst the various ethnic and racial groups. This can be accounted to the disparity in the number of individuals with different diversity status.

 

women with ADHD
Within the ADHD group, women showed a higher rate (68.4%) of having a comorbid disorder compared to men (40.6%)

Further research is necessary since the study did not specify the possible reasons for the comorbidities associated with ADHD, for example, whether it was increased risk or simply overlapping symptoms. In addition, the samples were all from college campuses in the US, so it cannot be generalized to students in other parts of the world. The effects of comorbidity on educationals and social functioning were also not established. However, based on the results, we can agree that there is a distinctly high rate of comorbidity among students with well-defined ADHD in the US. This greatly increases the risk of college students with ADHD experiencing psychosocial difficulties.

In light of these facts, there is a huge necessity for parents and high school educators to be aware of such comorbidities and work together with the students to continue proper care during the transition into college. Furthermore, colleges and universities that provide clinical and academic support services must be aware of the possibility of comorbidities among students with ADHD and  provide proper evaluations and treatment services accordingly. This study has helped bridge the gap between comorbidities in ADHD patients of various age groups. For the development of proper clinical assessment and treatment, future studies need to find proper reasoning for the association between ADHD and co-occurring psychiatric disorders.

Reference:

Anastopoulos, A.D., DePaul, G.J., Weyandt, L.L., Morrissey-Kane, E., Sommer, J.L., Rhoads, L.H., Murphy, K.R., Gormley, M.J., Gudmundsdottir, B.G. 2018 Rates and Patterns of Comorbidity Among First-Year College Students With ADHD. Journal of Clinical Child & Adolescent Psychology 47(2):236-247

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Link to image 1, Image 2

New skin sensors collect health data, study reports

Body temperature map
Body temperature map. All temperatures were collected by skin sensors, and transmitted to a computer to generate an image. Credit: Han et al.

The era of health tracking is upon us. The ability to track details about our moment-to-moment health has grown exponentially in recent years, from Fitbits logging our sleep patterns and heart rates, to ‘Smart Pills,’ which transmit a signal from a microchip imbedded in a swallowable tablet to an iPhone in order to track compliance with a pill regimen. Recently, a research group working at Carle Hospital at the University of Illinois took the concept of health data to the next level by tracking body temperature and pressure in bedridden patients and sleep study patients. Instead of tracking data from one point, like the wrist, they collected data from the entire body, which is a progressive approach in health tracking technology.

The newly developed skin sensors are thin, soft, wireless, and made of silicon. They have been shown to adhere to the skin without causing irritation, and they are waterproof, so they can collect data even in the shower. In testing, the skin sensors were placed at various points over the whole body, creating a temperature-map and pressure-map of the wearer.

Skin sensors
Sensors placed on the back, and the back of the arms and legs to collect temperature and pressure data. Credit: Han et al.
Pressure map
Pressure map. Credit: Han et al.

Because they are wireless and battery-free, they can stay on a patient for long periods of time, and can easily travel with a patient between wards in a hospital, or from an intensive care facility to a nursing home. They can stay on during medical treatments and during physical therapy. They collect and transmit data to a computer every 3 seconds, so a continuous digital picture of temperature and pressure can be recreated online.

I personally don’t the idea of swallowing a microchip along with my medication, but this new study utilizing skin sensors has incredible implications for medicine. The study, published online in Science Translational Medicine in April 2018, explained that since body temperature naturally fluctuates between day and night, the sensors can be used to measure circadian rhythms. In this case, researchers tested the sensors in a sleep clinic.

The researchers also used the sensors to measure prolonged pressure on the body in bedridden patients. Pressure ulcers, also known as bed sores, are a concern for patients in long-term recovery who spend the majority of their time lying down. Bony areas of the body, like shoulder blades and the buttocks, can develop these bed sores, or irritations, from staying in one position too long. The skin sensors, strategically placed in high-risk areas for bed sores, can detect when the pressure reaches a harmful level.

Source:

Han, S., Kim, J., Won, S.M., Ma, Y., Kang, D., Xie, Z., … Rogers, J.A. (2018). Battery-free, wireless sensors for full-body pressure and temperature mapping. Science Translational Medicine, 20(435). [Published online 04 Apr 2018]. DOI: 10.1126/scitranslmed.aan4950.

Can Frogs Tell us how to Avoid Extinction?

The Centrolene prosoblepon, a frog native to Countries in Central America, is one of the many amphibians affected by the chytrid fungus disease. Source: Flickr

Think the black plague, but worse. It’s called the chytrid fungus disease, and you don’t have to worry about it unless you’re a frog or salamander. While the black plague killed about 30 to 50 percent of the worldwide human population, the chytrid fungus has been able to wipe off whole amphibian populations off the map. Researchers at the Smithsonian Tropical Research Institute (STRI) in Panama have published their study, Shifts in Disease Dynamics in a Tropical Amphibian Assemblage are not due to Pathogen Attenuation, in the March 30 edition of Science detailing the results of this epidemic and its implications for disease-related extinction.

The researchers were lucky as they saw the epidemic coming from Costa Rica to Panama, and were able to study the amphibians and the disease during and after its peak. Researchers were able to examine the various interactions hosts had with the pathogen because they collected host samples and pathogen from before, during, and after the epidemic occurred. They specifically tracked infection patterns and virulence, species numbers and communities, and their resistance to the pathogen.

Recovery of nine amphibian species between five and 13 years was observed even though the fungus, Batrachochytrium dendrobatidis, was still present. After noticing that the skin secretion of wild frogs inhibited fungus growth remarkably more than the secretion from frogs moved into captivity before the disease arrived, researchers hypothesized that the wild frogs became more resistant to the disease. Think of the notion that kids should eat dirt to build up their immune system. If an organism is never exposed to various environmental elements, their body will never learn how to resist them, making it extremely difficult to combat disease.

Roberto Ibáñez, a STRI staff scientist and in-country director of the Panama Amphibian Rescue and Conservation Project said, It is vital to understand how disease transitions work — from outbreak, to epidemic, to coexistence — and our results have implications for a skyrocketing human population facing emerging diseases with the potential to cause global pandemics.” The results of this study and others relating to highly virulent disease systems suggest that some disease dynamics may be primarily driven by host factors – such as the ability of the organism to develop pathogen resistance or genetic variation – specifically when infectious agents remain highly pathogenic (disease causing). These findings have expanded our understanding of the spatiotemporal changes in host-pathogen interactions.

Jamie Voyles, Douglas C. Woodhams, Veronica Saenz, Allison Q. Byrne, Rachel Perez, Gabriela Rios-Sotelo, Mason J. Ryan, Molly C. Bletz, Florence Ann Sobell, Shawna McLetchie, Laura Reinert, Erica Bree Rosenblum, Louise A. Rollins-Smith, Roberto Ibáñez, Julie M. Ray, Edgardo J. Griffith, Heidi Ross, Corinne L. Richards-Zawacki. Shifts in disease dynamics in a tropical amphibian assemblage are not due to pathogen attenuationScience, 2018; DOI: 10.1126/science.aao4806v

Birds: The Signal of Climate Change in National Parks

Researchers at the National Audubon Society analyzed how climate change will effect birds in the United States National Park System. Birds are sensitive to their environment. They are mobile, responsive, and conspicuous. Birds are also an economic attraction to National Parks, contributing $107 billion to the industry for bird watching.  To determine how birds would be impacted, Wu and their colleagues analyzed 513 species across 274 national parks based on high and low greenhouse gas scenarios. They used their analysis to determine the climate suitability of the birds. Afterwards, they classified the species under five categories: improving, worsening, stable, potential colonization, and potential extirpation (local extinction).

fying birds above ice
Image from New Scientist

From their results, 24-50% of these birds are highly vulnerable to climate change. Also, highly sensitive birds are 21% more likely to lose half of their climatic suitability by mid-century. Birds from the Great Lakes region, most migratory species, were more likely to be vulnerable species. Despite most of these species categorized as vulnerable species, their model predicted that potential colonization are more likely to occur than extirpation during a high greenhouse scenario. More potential colonies transpire in the winter, 42.1 species, rather than the summer, 22.5 species. This would increase the species richness within the parks, which measures the count of species within an ecological community. Wu and their coauthors explain that birds are responding to warmer winters by making more colonies in the North, such as the Midwest and Northeast. During the stage of potential colonization, the present conditions for the birds are dismal, but they are projected to improve overtime to be suitable in that location.

Researchers at the National Audubon Society analyzed how climate change will effect birds in the United States National Park System. Birds are sensitive to their environment. They are mobile, responsive, and conspicuous. Birds are also an economic attraction to National Parks, contributing $107 billion to the industry for bird watching.  To determine how birds would be impacted, Wu and their colleagues analyzed 513 species across 274 national parks based on high and low greenhouse gas scenarios. They used their analysis to determine the climate suitability of the birds. Afterwards, they classified the species under five categories: improving, worsening, stable, potential colonization, and potential extirpation (local extinction).

From their results, 24-50% of these birds are highly vulnerable to climate change. Also, highly sensitive birds are 21% more likely to lose half of their climatic suitability by mid-century. Birds from the Great Lakes region, most migratory species, were more likely to be vulnerable species. Despite most of these species categorized as vulnerable species, their model predicted that potential colonization are more likely to occur than extirpation during a high greenhouse scenario. More potential colonies transpire in the winter, 42.1 species, rather than the summer, 22.5 species. This would increase the species richness within the parks, which measures the count of species within an ecological community. Wu and their coauthors explain that birds are responding to warmer winters by making more colonies. During the stage of potential colonization, the present conditions for the birds are dismal, but they are projected to improve overtime to be suitable in that location.

These projections are important to park management and policy.  The current management style focuses on landscape-scale conservation. However, the authors suggest the National Park Service adopt a climate-informed conservation strategy that increasing habitat mobility and restoration. From this strategy, the authors hope to instill resistance (protecting highly valued resources) and resilience (improving species capacity).

To learn more about the effects of climate change on birds, follow the links below:

http://climate.audubon.org/

https://climatekids.nasa.gov/extreme-weather-birds/

Source:

Wu, J., Wilsey, C.B., Taylor, L. Schuurman, G.W. 2018. Projected avifaunal responses to climate change across the U.S. National Park System.  PLOS ONE: https://doi.org/10.1371/journal.pone.0190557

Scared of Asteroids? You Shouldn’t Be

Image of Chariklo, the first Asteroid known to have a ring system.

Everyone has a secret fear that the Earth will be destroyed by an Asteroid impact, right? On February 28th, Bill Cooke, a member of NASA’s Meteoroid Environment Office, delivered a presentation on the threat of asteroids to Earth.  Cooke began his talk with a description of the Asteroid Belt.  Unlike the jam packed area seen in standard science fiction movies, the actual asteroid belt is 500 million miles wide and contains thousands of asteroids spaced about a million miles apart. These asteroids can be classified by their contents into six different types (C – Carbonaceous, S – pyroxene and olivine, D/P – primitive, M – Iron, and E – Enstatite). The terminology of the asteroid also changes based on its size and location. Meteoroids are chunks of rock and ice out in space which are about the size of a boulder. Meteors are meteoroids that disintegrate in Earth’s atmosphere, while meteorites are what is left of a meteoroid if it makes it to the surface of the Earth. Cooke even explains how to classify meteors based on their brightness.  Fireballs are meteors that are brighter than Venus, and Superbolides are meteors that are brighter than a full Moon.

All of this information becomes important once Cooke gets into the nitty gritty of his discussion on history’s famous meteorite falls. There have been several recent events including the meteorite falls in Peekskill, NY in 1992, in Park Forest, IL in 2003, as well as the February, 2013, Chelyabinsk meteorite. The Chelyabinsk meteorite didn’t strike anyone, but over 1600 people were injured from associated glass and debris.  However, there HAVE BEEN examples of people being directly struck by meteorites. A record exists of a friar being killed by a “stone from the clouds,” and in 1992 a small boy in Uganda was hit by a small fragment and was not injured.

Cooke then talked about how there have only been four major meteorites throughout history (Chelyabinsk included) that have actually caused significant damage. The danger from meteorite impacts is quite small, and there are people protecting us from these rocks. Yes, we would all love it to be Superman, but alas it is just a group of scientists! Scientists at NASA have conducted many different surveys on the rocks floating around in space. The International Asteroid Warning Network (IAWN) and the Space Missions Planning Advisory Group (SMPAG) work together to determine the impact time, location and severity of asteroids, as well as potential deflection mission plans. The U.S.’s policy current policy is to attempt to deflect any meteoroid larger than 50 meters.  For smaller impacts, our plan is just to evacuate the impact zone. So all of this being said, your irrational fear of being hit by a meteor should be calmed! The scientists are protecting you.

 

LINK: https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20180002057.pdf

 

Cooke, B. 2018. The Asteroid Threat to Earth. NASA Technical Reports Server: M18-6549.

There’s a Reason They’re Called Floodplains

Since the start of mankind, rivers have played a vital piece in fostering colonies and settlements. The Mississippi is no different. The 3,800 kilometer long river and its floodplains host many farms and population centers. To help protect this infrastructure, river controlling devices such as levees, dams, and walls line the exterior of the river to help prevent flooding events. However, new studies show that these barriers might be causing higher frequencies and magnitudes of massive flooding events.

Research done across a number of different colleges, including Northeastern University, found that residents within the Mississippi floodplains could be in major trouble. By using a number of different methods including studying past stream flow data, past sedimentary samples, historical climate data, and current tree-ring lines, the researchers found that the river’s massive flooding events (100 year events) have increased by over 20%  and have seen an amplification of flood magnitudes over the last 500 years. They also found that 75% of this increase is due to human modifications of the river and its basin. The other 25% was found to be climate related.

Flodding
Aerial view of flooding of the Mississippi in Arkansas 2011 (photo by Lance Cheung)

The confinement of the rivers channel which occurs in part to the levees, is good at alleviating small flood risks but hugely magnifies ones that are able to over top them. Anthropogenic modifications to the river’s channel which began to appear in the early 20th century was seen to have a direct correlation with these more powerful flooding events. The rivers manipulated channel allows for little room to expand during flooding events, in order to protect the many farmlands and cities which line the exterior of it. This less natural flow channel means that when floods actually do surpass the protections in place to stop them, they do far more damage then they would have had the walls not been there in the first place.

Further problems arise when economic costs come into play. Because the rivers banks are so highly populated its almost impossible to relocate infrastructure already in place which would allow the river to take a more natural course. The lower half of the Mississippi river in particular is most in danger to flooding and thus has higher economic problems which occur when events top the levees. The researchers who conducted the study also predict the magnitude and frequency of mass flooding events of the Mississippi river are only going to continue to grow. This leaves the government in a tricky spot, should we start funding huge, extremely difficult and costly relocation projects or further risk devastating flood hazards by continuing artificial channelization.

For more information visit https://www.nature.com/articles/d41586-018-04061-z.

Source

Munoz, S.E., et al., 2018. Climate control of Mississippi River flood hazard amplified by river engineering. Nature. 556, 95-98.

Restoration of the Gulf Takes More Than Money

Sediment-laden water pours into the northern Gulf of Mexico from the Atchafalaya River in an image taken by the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Aqua satellite on April 7, 2009.
Source: Nasa

Researchers at University of Waterloo published a study in Science in late March of 2018 giving new insight into the fact that restoring the water quality in the Gulf of Mexico is harder than originally thought. The Gulf of Mexico contains a hypoxic or dead zone, an area found in bodies of water that have extremely low levels of oxygen due to excessive nutrient pollution from human activities. Recently, attempts have been made to reduce the size of the Gulf’s dead zone, but despite these investments of large amounts of money, researchers have concluded that the legacy of nitrogen is so intense that these goals are unrealistic.

This dead zone is due to large quantities of nitrogen being carried through rivers and streams across the North American corn belt to the Gulf. Massive algal blooms sparked by the concentration of nitrogen leads to oxygen depletion, making it more difficult for marine life to survive. Due to its continual expansion, this area is approximately the size of New Jersey, and will continue to grow unless drastic measures are taken. Major changes in agricultural and river management practices must be made in order to see any type of improvement of water quality.

Researchers compiled and analyzed more than two centuries of agricultural data, showing that nitrogen has been accumulating in soil and groundwater due to intensive agricultural production. The water quality of the Gulf of Mexico has been declining since the 1950’s. It’s hypoxic zone is mainly caused by use of fertilizer and intensive livestock production. Manure and fertilizer are both rich in nitrogen, and can easily enter watersheds through runoff.

After this analysis, researchers modeled the results and concluded that even under best-case scenarios where effective conservation measures are implemented instantly, it would take over 30 years to restore the Gulf of Mexico through depletion of excess nitrogen. They continue their analysis to phosphorus, which is a major instigator of algal blooms in inland waters

The need for intensive agricultural production is only increasing, nitrogen quantities will continue to rise do to this, creating a massive problem for marine life around the globe. Effective policy must be implemented to curb the growth of this massive dead zone in the Gulf of Mexico, which imposes a great risk on marine ecosystems all over the region.

K. J. Van Meter, P. Van Cappellen, N. B. Basu. Legacy nitrogen may prevent achievement of water quality goals in the Gulf of MexicoScience, 2018; eaar4462 DOI: 10.1126/science.aar4462

Irrigating for the Future

New research from the University of California may have uncovered a way to simultaneously  irrigate crops and refill the groundwater table below. The groundwater in California provides its residence with water in times of need. During dry years, groundwater provides 46% of the water supply for Californians. In the last two dry spells, groundwater well levels have dropped some 10 to 50 feet. The state has enacted plans to sustainably manage the groundwater, but at the rate groundwater is being used, who knows how long it will be until there isn’t any left to rely on.

That is why researchers are trying to refill these groundwater reserves. By intentionally flooding fields in the winter months, they hoped to see water percolate deep into the soil and replenish the reserves below. While attempting to do so, they also needed to be aware of the health of the crops in those fields. Researchers noted that over watering the soil could cause disease, damage the roots, and therefore, have a negative economic impact. That is why they decided to perform this experiment with alfalfa. Alfalfa is widely used, nitrogen fixing, and a low economic risk. Since it is nitrogen fixing, it does not require the use of fertilizers and also eliminates the problem of runoff and leaching. Using two well established fields for the experiment, researchers began applying water in 2015 and continued at the second field until 2016.

Once both studies were complete, the data was analyzed and the researchers found that much of the water applied made it deep into the ground. At the first site, 95-98% of the water left the upper root zone of the top 2 feet of soil as deep percolation, traveling 5 feet below into the ground. The second site showed 93-99% of the water entering the ground as deep percolation. There was only one instance where there was a negative relationship between yield and amount of water. This shows that flood irrigating alfalfa fields may be a sustainable possibility to achieve crop yield and manage underground reserves. Although, certain factors may enhance the success of this method. It is recommended that before farmers take up this method, they ensure that their soil is suitable. Soils in this study were very fine, with high porosity. Researchers estimated that 300,000 acres of alfalfa fields in California have soils that would take well to this method.

It would be interesting to see how these results vary from the norm. Groundwater is very important for agriculture and human households, although there isn’t much being done throughout the country to help maintain these reserves. That is why it is so essential that we conserve water when possible, especially if you source your water from a well.

Source: Dahlke, H., Brown, A., Orloff, S., Putnam, D., O’Geen T. (2018) Managed winter flooding of alfalfa recharges groundwater with minimal crop damage. California Agriculture 72(1):65-75.

Photo: Flickr

Dietary Fiber Decreases Diabetic Difficulties

Every human digestive system is home to trillions of bacterial cells, known as a microbiota. In fact, there are more bacteria in a person’s digestive tract than there are human cells in their entire body. These bacteria play an essential role in digestion, breaking down otherwise indigestible nutrients, into compounds that humans can use. This study finds that increased consumption of fiber can lead to a dramatic reduction in symptoms for patients with Type 2 Diabetes.

 

Although dietary fiber is indigestible to humans, it is fermentable by the gut microbiota. The gut bacteria ferment the dietary fiber and break it down into short fatty acids, which are essential for moderating glucose, or sugar, concentration, and maintaining proper human health. It is when these fatty acid molecules are lacking that the effects of Type 2 Diabetes are most severe.

 

Type 2 Diabetes is characterized by an imbalance in glucose concentration in the blood. By increasing short chain fatty acids, excess glucose can be metabolized (broken down and utilized) and the effects of Type 2 Diabetes are greatly diminished. It should come as no surprise that a dietary solution can be offered for a disorder that is largely the result of dietary imbalances, but this study restates the critical importance of the gut microbiota in digestion, and diabetes research. Because though many essential nutrients are indigestible to by humans, there is a lot more at play in digestion than the human physiology.

 

This study was published in Science Magazine, and serves as a reminder that the gut microbiota is a complex ecosystem that differs greatly from person to person depending on a variety of factors. The relationship between gut bacteria and humans is a mutually beneficial one, as the human consumes fiber, which the bacteria breaks down into usable compounds, which both bacteria and human can utilize. This research may serve to shift the focus in diabetes treatment from dietary glucose, to a more comprehensive understanding of digestive processes.

 

 

Zhao L, Zhang F, Ding X, Wu G, Lam YY, et al., (2018) Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes. Science 359 (6380), 1151-1156

What does ADHD look like in the brain of a preschooler?

According to the National Survey of Children’s Health from 2016, 9.4% of children in the United States have been diagnosed with ADHD, almost 1 in 10 children. ADHD, or attention-deficit/hyperactivity disorder, is a neurological disorder characterized by impulsive behavior, different attention patterns, restlessness, and disorganization. You might hear a coworker casually claim, “I can’t focus on these emails.. my ADHD is acting up!” However, ADHD is not something that comes and goes. It is a different way of thinking, which stems from abnormal brain developmental patterns.

Although ADHD can manifest as early as 4 years old, most studies have only analyzed older school-age children. A new study published online in March 2018 in the Journal of the International Neuropsychological Society recruited a group of 4-5 year olds, including 52 children exhibiting ADHD symptoms and 38 children without ADHD symptoms to use as a comparison group. With consent from both the parents and children of course, they performed MRI scans to get a look at their brain structure.

Brain scan
A brain scan showing gray matter borders (cell bodies) with white matter in the inner regions of the brain (cell axons); Credit: Wikipedia Commons.

Overall, the researchers found that some regions of the brain had a smaller volume in children with ADHD, compared to the group of children with no ADHD symptoms. In particular, gray matter volumes were decreased. Gray matter, named for its natural brownish-gray color, is tissue comprised of the cell bodies of neurons in the brain and spinal cord. A neuron cell has a central body, and a long axon “branch” which sends messages to other neurons. The neuron cell bodies tend to congregate together in the brain and arrange themselves as “gray matter.” The axons also form groupings and are visualized as white matter.

In the brains of children with ADHD, the researchers noticed that the gray matter volume was reduced most significantly in subregions of the right frontal lobe and the left temporal lobe of the brain, and greater losses in volume corresponded with greater severity of ADHD symptoms. These brain areas with smaller gray matter volume are involved in inhibitory control (for example, preventing one’s self from blurting out an answer instead of raising a hand in class), working memory (for example, remembering the question on a worksheet while in the middle of writing an answer), planning (for example, deciding to clean up the desk, then turn in homework, then put books in backpack in that order), and response control (for example, correctly following a teacher’s directions).

Brain schematic
A schematic of the brain showcasing the frontal lobe and temporal lobe, each of which play a role in ADHD symptoms; Credit: w:User:Washington irving, Wikipedia Commons.

Previously, gray matter volume differences have been assessed in older children, but this study demonstrates that brain structure developments are discernible in children as young as four. The gray matter volume of another brain area, the anterior cingulate cortex, which plays a role in attention, decision-making, and impulsivity, has been evaluated in other studies. In older children with ADHD, there is a reduction in volume of the anterior cingulate cortex, but there was no difference between groups in the 4-5 year olds, suggesting that neural development is transpiring during the course of several years.

Scientists are gaining a better understanding of developmental trajectories of  ADHD with this kind of research. The hope is that these research studies will one day shed light on what triggers the differences in gray matter volume. These neurological differences are believed to be shared by Albert Einstein, Walt Disney, and John F. Kennedy, who also had ADHD symptoms. With this knowledge, we can gain a greater appreciation of what makes us who we are.

Sources:

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). (2018). General Prevalence. CHADD: The National Resource on ADHD. Retrieved Apr 3, 2018 from http://www.chadd.org/Understanding-ADHD/About-ADHD/Data-and-Statistics/General-Prevalence.aspx.

Growl, J.M. (2018). Famous people with ADHD. PsychCentral. Retrieved Apr 3, 2018 from https://psychcentral.com/lib/famous-people-with-adhd/.

Jacobson, L.A., Crocetti, D., Dirlikov, B., Slifer, K., Denckla, M.B., Mostofsky, S.H., & Mahone, E.M. (2018). Anomalous brain development is evident in preschoolers with attention-deficit/hyperactivity disorder. Journal of the International Neuropsychological Society, First View [Published online]. https://doi.org/10.1017/S1355617718000103.

Mayo Clinic Staff. (2018). Adult attention-deficit/hyperactivity disorder (ADHD). Mayo Clinic. Mayo Foundation for Medical Education and Research. Retrieved Apr 3, 2018 from https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878.

 

Health Screening for Military Veterans: Do It Right Now!

Marine Corps

Alcohol use disorder (AUD) and post traumatic stress disorder (PTSD) are two of the most common disorders among U.S. military veterans that often occur concurrently. Although both disorders are individually associated with poor health and wellbeing, past studies have shown that the rates of physical and mental health problems are higher in patients with co-occurring AUD and PTSD. Researchers from the National Center for PTSD and the VA San Diego Healthcare System published a study in 2018 that examined the burden associated with the co-occurrence of AUD/PTSD relative to either disorder occurring alone among US military veterans.

The study was conducted using data from the the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3,157 US veterans aged 21 and older. Overall, the sample group consisted of 14.8% probable current AUD, and 16.4% current PTSD, but only 2.8% comorbid AUD/PTSD. Comorbid is a term used to describe two or more disorders or diseases occurring at the same time. As part of the study, veterans were asked about their primary source of healthcare and their current mental health care situation.

The study assessed AUD and PTSD along with probable depressive and anxiety disorder, physical and mental functioning, quality of life, and cognitive functioning.

Results showed that, compared to veterans with AUD only, patients with comorbid AUD/PTSD or PTSD only were more likely to have co-occurring depression and anxiety, and current suicidal ideation. Additionally, they also scored lower on mental, physical and cognitive functioning, and quality of life measures. Compared to PTSD only, the comorbid group was, again, much more likely to have attempted suicide in their lifetime. The difference in the rates of depression and anxiety between the two groups was also very high. However, the fact that veterans with AUD/PTSD has similar functioning, quality of life, and psychiatric comorbidity as compared to veterans with PTSD only suggests that the increase burden associated with PTSD/AUD was largely driven by problems associated with PTSD. This may have been because the AUD/PTSD group was very small and there was unevenness in the size of the different diagnostic groups amongst the veterans.

There were also some other limitation associated with the study, which could have brought about discrepancies in the final results. The prevalence of AUD could have been underestimated because although AUD is primarily associated with young adults, the study mostly consisted of older white men. Moreover, suicide attempts were asked in terms of entire lifetime, so it is not certain if they had occurred before or after military service or the onset of AUD or PTSD. Nevertheless, the findings, overall, reflect the mental and physical health burden associated with co-occurring AUD and PTSD.

The study stresses the importance of screening veterans for AUD and PTSD given that less than half of the veterans with these disorders were receiving mental health treatment. Moreover, it also highlights the need for further research to understand how to reach out to and engage these veterans in screening, assessment, and treatment for such disorders.

Reference: Norman, S.B., Haller, M., Hamblen, J.L., Southwick,S.M., Pietrzak, R.H. 2018 The Burden of Co-Occurring Alcohol Use Disorder and PTSD in U.S. Military Veterans: Comorbidities, Functioning, and Suicidality. Psychology of Addictive Behaviors 32(2): 224-229

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