Tag: ADHD

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ADHD Among College Students, Let’s Be Aware

ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental and psychiatric disorder found 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 the 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 high 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 stress-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 the two, 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 educational 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 receive 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. This study has helped bridge the gap between comorbidities in ADHD patients of various age groups. For the development of 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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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.

 

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The rising cost of poor diet: ADHD symptoms in children

A handful of Halloween candy later, and you are skipping around the room, your hands are fidgety, speech is jittery, and it’s hard to contain your burst of energy. You are probably quite familiar with the sugar rush that affects you this one day a year… two days a year? Three days? Almost every day?

Time and again, nutritional studies and long-term research has shown that poor dietary patterns of children influence neural development and behavior, especially hyperactivity and attention capacities, leading to diagnoses like ADHD.

A study from 2009 followed a group of children over several years and found that for significant increases in “junk food” consumption at ages 4-5, the risk for hyperactivity at age 7 was elevated. Another study, from 2004, demonstrated a prolonged association between artificial food coloring and hyperactivity. While the cause of ADHD is still undetermined, dietary patterns certainly play a role. Not only do high-fat, high-sugar diets cause issues in the developing nervous system, but these diets tend to also be low in valuable vitamins and micronutrients.

A more recent study, published online in March 2018 in European Journal of Clinical Nutrition, showed a positive correlation between a “processed” food pattern, a “snack” food pattern, and ADHD symptoms in children age 3-6. On the other hand, there was a negative correlation between a “vegetarian” food pattern and ADHD symptoms. This study used data collected from over 14,000 preschoolers in Ma’anshan City, China, and was the first large scale study in mainland China to investigate connections between diet and ADHD in children. The prevalence of ADHD symptoms in the group studied was 8.6%.

Researchers asked caregivers and parents to answer questionnaires about the recent food consumption and food choices of their children, and gave the children a Conners Abbreviated Symptom Questionnaire to assess for ADHD symptoms. Then, the researchers allocated five dietary patterns to represent the common answers expressed by the caregivers and parents: (1) “processed,” for fast food, fried foods, preserved fruit, and other high-fat food items, (2) “snack,” for high-sugar foods like sweets, biscuits, cakes, and chocolates, (3) “protein,” for red meat, poultry, eggs, fish, fruit, and rice, (4) “beverage,” for flavored milk, soda, and yogurt, and (5) “vegetarian,” for grains, beans, and fruit or vegetable juice.

Children who had a “processed” or “snack” dietary pattern had a significantly higher likelihood of demonstrating ADHD symptoms, hyperactivity, and attention problems. There was no correlation between ADHD symptoms and the “protein” or “beverage” categories, but the “vegetarian” dietary pattern seems to act as a protector against ADHD symptoms.

This study can not show causation, or that a poor diet causes ADHD. However, it can not be refuted that diet is an influencing factor in development and behavior in children. High-fat, high-sugar foods tend to be cheaper, more accessible, and more conveniently packaged in bags and wrappers for on-the-go, and they don’t need to be refrigerated. They taste good. But, the cost is a rising prevalence of ADHD and similar disorders. The relationship between food and hyperactivity is further evident through studies that have shown that elimination diets and fish oil supplements can reverse the ADHD symptoms. Fatty foods and sugary foods should be eaten in moderation; Halloween should not be occurring every day.

Source:

Yan, S., Cao, H., Gu, C., Ni, L., Tao, H., Shao, T., Xu, Y., & Tao, F. (2018). Dietary patterns are associated with attention-deficit/hyperactivity disorder (ADHD) symptoms among preschoolers in mainland China. European Journal of Clinical Nutrition [Published online March 13, 2018]. doi:10.1038/s41430-018-0131-0.