Atualização de novembro de 2006 - Parte 1

A computerized test of self-control predicts classroom behavior.

Hoerger ML, Mace FC.

Wales Centre for Behaviour Analysis, University of Wales, Gwynedd, Bangor LL57 2AS, United Kingdom. m.hoerger@bangor.ac.uk

J Appl Behav Anal. 2006 Summer;39(2):147-59.
We assessed choices on a computerized test of self-control (CTSC) for a group of children with features of attention deficit hyperactivity disorder (ADHD) and a group of controls. Thirty boys participated in the study. Fifteen of the children had been rated by their parents as hyperactive and inattentive, and 15 were age- and gender-matched controls in the same classroom. The children were observed in the classroom for three consecutive mornings, and data were collected on their activity levels and attention. The CTSC consisted of two tasks. In the delay condition, children chose to receive three rewards after a delay of 60 s or one reward immediately. In the task-difficulty condition, the children chose to complete a difficult math problem and receive three rewards or complete an easier problem for one reward. The children with ADHD features made more impulsive choices than their peers during both conditions, and these choices correlated with measures of their activity and attention in the classroom

Adolescents with attention deficit and hyperactivity disorder/learning disability and their proneness to accidents.

Brook U, Boaz M.

Department of Pediatrics, Edith Wolfson Medical Center, Holon and Sackler Faculty of Medicine, Tel Aviv University, Israel. brookuzi@post.tau.ac.in

Indian J Pediatr. 2006 Apr;73(4):299-303.

OBJECTIVE: The aim of the study was to determine if attention deficit and hyperactivity disorder (ADHD)/ learning disability (LD) adolescents are more prone to accidents and to investigate the parental mode of coping with that risk.

METHODS: One hundred and eight high school pupils diagnosed with ADHD/LD and studying in an institute of "special education" were examined and interviewed on the subject of accidents. Eighty-seven pupils, studying in a nearby academic high school, served as a control group.

RESULTS: The results showed that pupils in the study group had been involved in 0.57 +/- 1.6 accidents (until the present study) in comparison to 0.23 +/- 0.4 accidents in the control group (p=0.001). The accidents in the ADHD/LD study group had occurred at the mean age of 11.1 +/- 3.4 yr. Eight decimal three percent of these pupils had been involved in recurrent accidents. Circumstances and locations where the accidents occurred were: falls while running or participating in sports activities (38.5%), home environment (23%), school environment (19.2%) and road accidents (11.5%).
CONCLUSION: The study shows that there is a real risk for ADHD/LD adolescents to be involved in all kinds of accidents. Parents should be counting on the help of professional advisors to decrease that risk. Physicians should caution these adolescents and their parents about that risk and advise them on ways and means of accident prevention.

The impact of attention deficit hyperactivity disorders on brainstem dysfunction in nocturnal enuresis.

Baeyens D, Roeyers H, Hoebeke P, Antrop I, Mauel R, Walle JV.

Department of Psychology, Developmental Disorders, Ghent University, Ghent, Belgium; Pediatric Uro/Nephrological Center, Ghent University Hospital, Ghent, Belgium.

J Urol. 2006 Aug;176(2):744-8.

PURPOSE: In a specialized university setting the prevalence of attention deficit hyperactivity disorder in general and particularly the inattentive subtype attention deficit hyperactivity disorder of the predominantly inattentive subtype is highly increased. We replicated previous research findings that enuresis is associated with a brainstem deficit and investigated the impact of attention deficit hyperactivity disorder on this brainstem deficit in enuresis.

RESULTS: In an automatic attentional task the enuresis groups showed decreased brainstem inhibition compared to that in the control and attention deficit hyperactivity disorder groups (p <0.006). In a controlled attentional task children with and without enuresis who had attention deficit hyperactivity disorder of the predominantly inattentive subtype were unable to show attentional modulation in all age groups (p <0.02).

Social incompetence in children with ADHD: Possible moderators and mediators in social-skills training.

de Boo GM, Prins PJ.

Faculty of Social and Behavioral Sciences, Department of Clinical Psychology, Roetersstraat 15, 1018 WB Amsterdam, The Netherlands.

Clin Psychol Rev. 2006 Jun 27; [Epub ahead of print]

Children with attention-deficit/hyperactivity disorder (ADHD) often encounter problems in social interactions with peers and are confronted with peer rejection and social isolation. The most common approach to social problems in children is social skills training. This intervention concept represents a variable mixture of cognitive-behavioral intervention elements. In this article the outcome of social skills training (SST) for children with ADHD is reviewed. Four experimental SSTs are detected and analyzed for potential mediators and moderators of treatment efficacy. Candidate mediators (social cognitive skills, parenting style and medication-induced reduction of key symptoms) are discussed within an empirical and theoretical context. Candidate moderators (subtype, comorbidity, gender and age) are evaluated for their empirical support. It is argued that, although fragmented, there is ample evidence and knowledge to adapt the SST-paradigm towards the specific needs of children suffering from ADHD and to guide future research towards more effective, "well established" interventions.



The evolution of hyperactivity, impulsivity and cognitive diversity.

Williams J, Taylor E.

Institute of Psychiatry, Kings College London Department of Child Psychiatry de Crespigny Park, Denmark Hill, London SE5 8AF, UK.

J R Soc Interface. 2006 Jun 22;3(8):399-413.

The evolutionary status of attention deficit/hyperactivity disorder (ADHD) is central to assessments of whether modern society has created it, either physically or socially; and is potentially useful in understanding its neurobiological basis and treatment. The high prevalence of ADHD (5-10%) and its association with the seven-repeat allele of DRD4, which is positively selected in evolution, raise the possibility that ADHD increases the reproductive fitness of the individual, and/or the group. However, previous suggestions of evolutionary roles for ADHD have not accounted for its confinement to a substantial minority. Because one of the key features of ADHD is its diversity, and many benefits of population diversity are well recognized (as in immunity), we study the impact of groups' behavioural diversity on their fitness. Diversity occurs along many dimensions, and for simplicity we choose unpredictability (or variability), excess of which is a well-established characteristic of ADHD.Simulations of the Changing Food group task show that unpredictable behaviour by a minority optimizes results for the group. Characteristics of such group exploration tasks are risk-taking, in which costs are borne mainly by the individual; and information-sharing, in which benefits accrue to the entire group. Hence, this work is closely linked to previous studies of evolved altruism.We conclude that even individually impairing combinations of genes, such as ADHD, can carry specific benefits for society, which can be selected for at that level, rather than being merely genetic coincidences with effects confined to the individual. The social benefits conferred by diversity occur both inside and outside the 'normal' range, and these may be distinct. This view has the additional merit of offering explanations for the prevalence, sex and age distribution, severity distribution and heterogeneity of ADHD.