By Christina Caron Julianna McLeod, 26, had her first psychotic episode while taking Vyvanse for attention deficit hyperactivity disorder last year. Ms. McLeod, who lives in Ontario, Canada, had taken the drug before but paused while pregnant with her first child and didn’t start taking it again until six months postpartum. Although the dose was 40 milligrams, she often forgot when she had last taken a pill. So she took one whenever she remembered — and may have ended up taking more than her prescribed daily dose. The delusions that she experienced made her feel euphoric and highly energetic. “I felt like my brain was exploding with connections,” she said. In her mind, she was a “super detective” who was uncovering the people and organizations that were secretly engaging in child sex trafficking. She even began to believe that someone was drugging her and her baby. Psychosis and mania are each known side effects of stimulant medications, and the Food and Drug Administration has added warnings to the medications’ labels saying that they may cause symptoms like hallucinations, delusional thinking or mania. But these side effects are considered rare — experienced by an estimated 1 in 1,000 patients — and have not been extensively researched. It can take months for someone to fully recover. A new study published on Thursday in The American Journal of Psychiatry suggests that dosage may play a role. It found that among people who took high doses of prescription amphetamines such as Vyvanse and Adderall, there was a fivefold increased risk of developing psychosis or mania for the first time compared with those who weren’t taking stimulants. The researchers defined a high dose as more than 40 milligrams of Adderall, 100 milligrams of Vyvanse or 30 milligrams of dextroamphetamine. The medium dosage (20 to 40 milligrams of Adderall, 50 to 100 milligrams of Vyvanse or 16 to 30 milligrams of dextroamphetamine) was associated with a 3.5 times higher risk of psychosis or mania. There was no increased risk of psychosis or mania among those who used methylphenidate drugs, like Concerta or Ritalin, regardless of the dose. © 2024 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 29478 - Posted: 09.14.2024

By Christina Caron Patients and caregivers have struggled for two years to find stimulant medications like Adderall, Vyvanse and Concerta to treat attention deficit hyperactivity disorder. Some spend hours each month going from pharmacy to pharmacy to find a drug, while others are forced to switch to a different brand or formulation, or go without medication for weeks. This week the Drug Enforcement Administration announced a potential solution: It is raising the amount of lisdexamfetamine (Vyvanse) that can be produced by U.S. manufacturers this year by nearly 24 percent to meet demand in the United States and abroad. Vyvanse is an amphetamine that has been approved for use in children and adults with A.D.H.D. and has become commonly prescribed after the generic version was introduced last year. According to the D.E.A., the latest data shows that demand for the drug has been rising globally. But right now every manufacturer of generic Vyvanse listed on the Food and Drug Administration website is experiencing a shortage. Many health care providers who specialize in treating patients with A.D.H.D. said that the D.E.A.’s decision was a positive development but that it was unclear just how much of an effect it might have on the shortage. “Obviously it’s not going to solve the problem completely,” said Ami Norris-Brilliant, clinical director of the Division of A.D.H.D., Learning Disorders, and Related Disorders at the Icahn School of Medicine at Mount Sinai in New York City. “But I think anything that helps increase drug availability is a good thing.” It is not the first time that the D.E.A. has increased production quotas for A.D.H.D. drugs. Last year it announced a new 2023 limit for methylphenidate, which is used to make drugs like Ritalin and Concerta, raising the allotted amount by 27 percent for 2023. The drug remains in shortage, however, in the extended release formulation. © 2024 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 29473 - Posted: 09.11.2024

By Christina Caron The 6-year-old boy sitting across from Douglas Tynan, a child and adolescent clinical psychologist based in Delaware, clearly did not have attention deficit hyperactivity disorder. Dr. Tynan was sure of that. But the boy’s first-grade teacher disagreed. He could be inattentive in class, but at home his behavior wasn’t out of the ordinary for a child his age. A voracious reader, he told Dr. Tynan that he liked to bring his own books to school because the ones in class were too easy. What his teacher had not considered was that the child was most likely academically gifted, as his mother had been as a child, Dr. Tynan said. (Studies have shown that Black children, like the boy in his office, are less likely to be identified for gifted programs.) Further testing revealed that Dr. Tynan was correct. The child wasn’t inattentive in school because of A.D.H.D. It was because he was bored. A.D.H.D. is a neurodevelopmental disorder that begins in childhood and typically involves inattention, disorganization, hyperactivity and impulsivity that cause trouble in two or more settings, like at home and at school. But those symptoms — for children and adults alike — can overlap with a multitude of other traits and disorders. In fact, difficulty concentrating is one of the most common symptoms listed in the American Psychiatric Association’s diagnostic manual, and it’s associated with 17 diagnoses, according to a study published in April. Patients need a careful evaluation to avoid either being misdiagnosed with A.D.H.D. or having a missed A.D.H.D. diagnosis. Here’s a look at some common problems that can mimic A.D.H.D. Mental health conditions like anxiety, depression or oppositional defiant disorder can show up as A.D.H.D.-like symptoms. © 2024 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 29404 - Posted: 07.27.2024

By Jack Goulder Late last summer, in the waiting room of a children’s mental health clinic, I found Daniel, a softly spoken 16-year-old boy, flanked by his parents. He had been referred to the clinic for an assessment for attention deficit hyperactivity disorder (ADHD). As we took our seats on the plastic sofas in the consulting room, I asked him to tell me about the difficulties he was having. Tentatively, his gaze not leaving the floor, he started talking about school, about how he was finding it impossible to focus and would daydream for hours at a time. His exam results were beginning to show it too, his parents explained, and ADHD seemed to run in the family. They wanted to know more about any medication that could help. I had just begun a six-month placement working as a junior doctor in the clinic’s ADHD team. Doctors often take a temporary post before they formally apply to train in a speciality. Since medical school I had always imagined I would become a psychiatrist, but I wanted to be sure I was making the right choice. Armed with a textbook and the memory of some distant lectures, I began my assessment, running through the questions listed in the diagnostic manual. Are you easily distracted? Do you often lose things? Do people say you talk excessively? He answered yes to many of them. Are you accident-prone? He and his parents exchanged a knowing laugh. With Daniel exhibiting so many of the symptoms, I told them, this sounded like ADHD. I felt a sense of relief fill the room. Later that afternoon, I took Daniel’s case to a meeting where the day’s new referrals were discussed. Half a dozen senior doctors, nurses, psychologists and psychotherapists sat around the table and listened as each case was presented, trying to piece together the story being told and decide what to do next. When it was my turn, I launched into my findings, laying out what Daniel had told me and what I had gleaned from his parents about his childhood. © 2024 Guardian News & Media Limited

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 29397 - Posted: 07.18.2024

By Christina Caron Just before Katie Marsh dropped out of college, she began to worry that she might have attention deficit hyperactivity disorder. “Boredom was like a burning sensation inside of me,” said Ms. Marsh, who is now 30 and lives in Portland, Ore. “I barely went to class. And when I did, I felt like I had a lot of pent-up energy. Like I had to just move around all the time.” So she asked for an A.D.H.D. evaluation — but the results, she was surprised to learn, were inconclusive. She never did return to school. And only after seeking help again four years later was she diagnosed by an A.D.H.D. specialist. “It was pretty frustrating,” she said. A.D.H.D. is one of the most common psychiatric disorders in adults. Yet many health care providers have uneven training on how to evaluate it, and there are no U.S. clinical practice guidelines for diagnosing and treating patients beyond childhood. Without clear rules, some providers, while well-intentioned, are just “making it up as they go along,” said Dr. David W. Goodman, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. This lack of clarity leaves providers and adult patients in a bind. “We desperately need something to help guide the field,” said Dr. Wendi Waits, a psychiatrist with Talkiatry, an online mental health company. “When everyone’s practicing somewhat differently, it makes it hard to know how best to approach it.” Can A.D.H.D. symptoms emerge in adulthood? A.D.H.D. is defined as a neurodevelopmental disorder that begins in childhood and is typically characterized by inattention, disorganization, hyperactivity and impulsivity. Patients are generally categorized into three types: hyperactive and impulsive, inattentive, or a combination of the two. © 2024 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 29318 - Posted: 05.23.2024

By Amitha Kalaichandran In May, I was invited to take part in a survey by the National Academies of Sciences, Engineering, and Medicine to better delineate how long Covid is described and diagnosed as part of The National Research Action Plan on Long Covid. The survey had several questions around definitions and criteria to include, such as “brain fog” often experienced by those with long Covid. My intuition piqued, and I began to wonder about the similarities between these neurological symptoms and those experienced by people with attention-deficit/hyperactivity disorder, or ADHD. As a medical journalist with clinical and epidemiological experience, I found the possible connection and its implications impossible to ignore. We know that three years of potential exposure to SARS-CoV-2, in combination with the shift in social patterns (including work-from-home and social isolation), has impacted several aspects of neurocognition, as detailed in a recent report from the Substance Abuse and Mental Health Services Administration. A 2021 systematic review found persistent neuropsychiatric symptoms in Covid-19 survivors, and a 2021 paper in the journal JAMA Network Open found that executive functioning, processing speed, memory, and recall were impacted in patients hospitalized with Covid-19. Long Covid may indeed be linked to developing chronic neurocognitive issues, and even dementia may be accelerated. The virus might impact the frontal lobe, the area that governs executive function — which involves how we make decisions and plan, use our working memory, and control impulses. In October, a paper in Cell reported that long Covid brain fog could be traced to serotonin depletion driven by immune system proteins called viral-associated interferons. Similarly, the symptoms of attention-deficit/hyperactivity disorder, or ADHD, are believed to be rooted structurally in the frontal lobe and possibly from a naturally low level of the neurotransmitter dopamine, with contributions from norepinephrine, serotonin, and GABA. This helps explain why people with ADHD, who experience inattention, hyperactivity, and impulsivity, among other symptoms, may seek higher levels of stimulation: to activate the release of dopamine. However, a deficit in serotonin can also trigger ADHD. The same neurotransmitter, when depleted, may be responsible for brain fog in long Covid.

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 29038 - Posted: 12.09.2023

By Clay Risen William E. Pelham Jr., a child psychologist who challenged how his field approached attention deficit hyperactivity disorder in children, arguing for a therapy-based regimen that used drugs like Ritalin and Adderall as an optional supplement, died on Oct. 21 in Miami. He was 75. His son, William E. Pelham III, who is also a child psychologist, confirmed the death, in a hospital, but did not provide a cause. Dr. Pelham began his career in the mid-1970s, when the modern understanding of mental health was emerging and psychologists were only just beginning to understand A.D.H.D. — and with it a new generation of medication to treat it. Through the 1980s and ’90s, doctors and many parents embraced A.D.H.D. drugs like Ritalin and Adderall as miracle medications, though some, including Dr. Pelham, raised concerns about their efficacy and side effects. Dr. Pelham was not opposed to medication. He recognized that drugs were effective at rapidly addressing the symptoms of A.D.H.D., like fidgeting, impulsiveness and lack of concentration. But in a long string of studies and papers, he argued that for most children, behavioral therapy, combined with parental intervention techniques, should be the first line of attack, followed by low doses of drugs, if necessary. And yet, as he pointed out repeatedly, the reality was far different: The Centers for Disease Control and Prevention reported in 2016 that while six in 10 children diagnosed with A.D.H.D. were on medication, fewer than half received behavioral therapy. In one major study, which he published in 2016 along with Susan Murphy, a statistician at the University of Michigan, he demonstrated the importance of treatment sequencing — that behavioral therapy should come first, then medication. He and Dr. Murphy split a group of 146 children with A.D.H.D., from ages 5 to 12, into two groups. One group received a low dose of generic Ritalin; the other received nothing, but their parents were given instruction in behavioral-modification techniques. After two months, children from both groups who showed no improvement were arranged into four new groups: The children given generic Ritalin received either more medication or behavioral modification therapy, and the children given behavioral modification therapy received either more intense therapy or a dose of medication. © 2023 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28984 - Posted: 11.04.2023

By Dana G. Smith Do you: Cut the tags out of your clothes? Relive (and regret) past conversations? Have episodes of burnout and fatigue? Zone out while someone is talking? Become hyper-focused while working on a project? Take on dozens of hobbies? Daydream? Forget things? According to TikTok, you might have attention deficit hyperactivity disorder. Videos about the psychiatric condition are all over the social media app, with the #adhd hashtag receiving more than 17 billion views to date. Many feature young people describing their specific (and sometimes surprising) symptoms, like sensitivity to small sensory annoyances (such as clothing tags) or A.D.H.D. paralysis, a type of extreme procrastination. After viewing these videos, many people who were not diagnosed with A.D.H.D. as children may question whether they would qualify as adults. As with most psychiatric conditions, A.D.H.D. symptoms can range in type and severity. And many of them “are behaviors everyone experiences at some point or another,” said Joel Nigg, a professor of psychiatry at Oregon Health & Science University. The key to diagnosing the condition, however, requires “determining that it’s serious, it’s extreme” and it’s interfering with people’s lives, he said. It’s also critical that the symptoms have been present since childhood. Those nuances can be lost on social media, experts say. In fact, one study published earlier this year found that more than half of the A.D.H.D. videos on TikTok were misleading. If a video (or article) has you thinking you may have undiagnosed A.D.H.D., here’s what to consider. Approximately 4 percent of adults in the United States have enough symptoms to qualify for A.D.H.D., but only an estimated one in 10 of them is diagnosed and treated. For comparison, roughly 9 percent of children in the United States have been diagnosed with the condition, and three-quarters have received medication or behavioral therapy for it. One reason for the lack of diagnoses in adults is that when people think of A.D.H.D., they often imagine a boy who can’t sit still and is disruptive in class, said Dr. Deepti Anbarasan, a clinical associate professor of psychiatry at the NYU Grossman School of Medicine. But those stereotypical hyperactive symptoms are present in just 5 percent of adult cases, she said. © 2023 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28646 - Posted: 01.27.2023

Researchers at the National Institutes of Health have successfully identified differences in gene activity in the brains of people with attention deficit hyperactivity disorder (ADHD). The study, led by scientists at the National Human Genome Research Institute (NHGRI), part of NIH, found that individuals diagnosed with ADHD had differences in genes that code for known chemicals that brain cells use to communicate. The results of the findings, published in Molecular Psychiatry(link is external), show how genomic differences might contribute to symptoms. To date, this is the first study to use postmortem human brain tissue to investigate ADHD. Other approaches to studying mental health conditions include non-invasively scanning the brain, which allows researchers to examine the structure and activation of brain areas. However, these studies lack information at the level of genes and how they might influence cell function and give rise to symptoms. The researchers used a genomic technique called RNA sequencing to probe how specific genes are turned on or off, also known as gene expression. They studied two connected brain regions associated with ADHD: the caudate and the frontal cortex. These regions are known to be critical in controlling a person’s attention. Previous research found differences in the structure and activity of these brain regions in individuals with ADHD. As one of the most common mental health conditions, ADHD affects about 1 in 10 children in the United States. Diagnosis often occurs during childhood, and symptoms may persist into adulthood. Individuals with ADHD may be hyperactive and have difficulty concentrating and controlling impulses, which may affect their ability to complete daily tasks and their ability to focus at school or work. With technological advances, researchers have been able to identify genes associated with ADHD, but they had not been able to determine how genomic differences in these genes act in the brain to contribute to symptoms until now.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28559 - Posted: 11.19.2022

By Fenit Nirappil A national shortage of Adderall has left patients who rely on the pills for attention-deficit/hyperactivity disorder scrambling to find alternative treatments and uncertain whether they will be able to refill their medication. The Food and Drug Administration announced the shortage last week, saying that one of the largest producers is experiencing “intermittent manufacturing delays” and that other makers cannot keep up with demand. Some patients say the announcement was a belated acknowledgment of a reality they have faced for months — pharmacies unable to fill their orders and anxiety about whether they will run out of a medication needed to manage their daily lives. Experts say it is often difficult for patients to access Adderall, a stimulant that is tightly regulated as a controlled substance because of high potential for abuse. Medication management generally requires monthly doctor visits. There have been other shortages in recent years. “This one is more sustained,” said Timothy Wilens, an ADHD expert and chief of child and adolescent psychiatry at Massachusetts General Hospital who said access issues stretch back to spring. “It’s putting pressure on patients, and it’s putting pressure on institutions that support the patients.” Erik Gude, a 28-year-old chef who lives in Atlanta, experiences regular challenges filling his Adderall prescription, whether it’s pharmacies not carrying generic versions or disputes with insurers. He has been off the medication for a month after his local pharmacy ran out.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 28520 - Posted: 10.22.2022

By Greg Miller If you’re lucky enough to live to 80, you’ll take up to a billion breaths in the course of your life, inhaling and exhaling enough air to fill about 50 Goodyear blimps or more. We take about 20,000 breaths a day, sucking in oxygen to fuel our cells and tissues, and ridding the body of carbon dioxide that builds up as a result of cellular metabolism. Breathing is so essential to life that people generally die within minutes if it stops. It’s a behavior so automatic that we tend to take it for granted. But breathing is a physiological marvel — both extremely reliable and incredibly flexible. Our breathing rate can change almost instantaneously in response to stress or arousal and even before an increase in physical activity. And breathing is so seamlessly coordinated with other behaviors like eating, talking, laughing and sighing that you may have never even noticed how your breathing changes to accommodate them. Breathing can also influence your state of mind, as evidenced by the controlled breathing practices of yoga and other ancient meditative traditions. In recent years, researchers have begun to unravel some of the underlying neural mechanisms of breathing and its many influences on body and mind. In the late 1980s, neuroscientists identified a network of neurons in the brainstem that sets the rhythm for respiration. That discovery has been a springboard for investigations into how the brain integrates breathing with other behaviors. At the same time, researchers have been finding evidence that breathing may influence activity across wide swaths of the brain, including ones with important roles in emotion and cognition. “Breathing has a lot of jobs,” says Jack L. Feldman, a neuroscientist at the University of California, Los Angeles, and coauthor of a recent article on the interplay of breathing and emotion in the Annual Review of Neuroscience. “It’s very complicated because we’re constantly changing our posture and our metabolism, and it has to be coordinated with all these other behaviors.” © 2022 Annual Reviews

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 2: Functional Neuroanatomy: The Cells and Structure of the Nervous System
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 28508 - Posted: 10.08.2022

William E. Pelham, Jr. For decades, many physicians, parents and teachers have believed that stimulant medications help children with ADHD learn because they are able to focus and behave better when medicated. After all, an estimated 6.1 million children in the U.S. are diagnosed with attention-deficit/hyperactivity disorder, and more than 90% are prescribed stimulant medication as the main form of treatment in school settings. However, in a peer-reviewed study that several colleagues and I published in the Journal of Consulting and Clinical Psychology, we found medication has no detectable effect on how much children with ADHD learn in the classroom. At least that’s the case when learning – defined as the acquisition of performable skills or knowledge through instruction – is measured in terms of tests meant to assess improvements in a student’s current academic knowledge or skills over time. Compared to their peers, children with ADHD exhibit more off-task, disruptive classroom behavior, earn lower grades and score lower on tests. They are more likely to receive special education services and be retained for a grade, and less likely to finish high school and enter college – two educational milestones that are associated with significant increases in earnings. In this study, funded by the National Institute of Mental Health, we evaluated 173 children between the ages of 7 and 12. They were all participants in our Summer Treatment Program, a comprehensive eight-week summer camp for children with ADHD and related behavioral, emotional and learning challenges. Children got grade-level instruction in vocabulary, science and social studies. The classes were led by certified teachers. The children received medication the first half of summer and a placebo during the other half. They were tested at the start of each academic instruction block, which lasted approximately three weeks. They then took the same test at the end to determine how much they learned. © 2010–2022, The Conversation US, Inc.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28366 - Posted: 06.11.2022

Daniel Lavelle With ADHD, thoughts and impulses intrude on my focus like burglars trying to break into a house. Sometimes these crooks carefully pick the backdoor lock before they silently enter and pilfer all the silverware. At other times, stealth goes out of the window; they’re kicking through the front door and taking whatever they like. Either way, I was supposed to be reading a book just now, but all I can think about is how great it would be if I waded into a river to save a litter of kittens from tumbling down a waterfall just in the nick of time. I’ve got the kittens in my hand, and the crowd has gone wild; the spectres of Gandhi, Churchill and Obi-Wan Kenobi hover over the riverbank, nodding their approval while fireworks crackle overhead … I snap back and realise I’ve read three pages, only I don’t remember a single line. I reread the same pages, but the same thing happens, only now I’m so hung up on concentrating that another fantasy has hijacked my attention. This time I’m imagining that I’m super-focused, so focused that Manchester United have called and told me they want me to be their special penalty taker. These Walter Mitty, borderline narcissistic episodes persist for a while until I give up and go and be distracted somewhere else. Advertisement Unfortunately, I don’t take Ritalin, a stimulant prescribed to daydreamers like me, so when it comes to focusing I need all the help I can get. Enter Swiss developer and typographic designer Renato Casutt, who has spent six years trying to develop a typographical trick that helps people read more quickly and efficiently. “Bionic reading” is a font people can use on their devices via apps for iPhone and other Apple products. It works by highlighting a limited number of letters in a word in bold, and allowing your brain – or, more specifically, your memory – to fill in the rest. © 2022 Guardian News & Media Limited

Related chapters from BN: Chapter 17: Learning and Memory; Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 15: Language and Lateralization
Link ID: 28358 - Posted: 06.07.2022

By Christina Caron When Chris Lawson began dating Alexandra Salamis, the woman who would eventually become his partner, he was “Mr. Super Attentive Dude,” he said, the type of guy who enjoyed buying cards and flowers for no reason other than to show how much he loved her. But after they moved in together in 2015, things changed. He became more distracted and forgetful. Whether it was chores, planning social events or anything deadline-driven — like renewing a driver’s license — Ms. Salamis, 60, had to continually prod Mr. Lawson to get things done. Invariably, she just ended up doing them herself. “I was responsible for nothing,” Mr. Lawson, 55, admitted. Ms. Salamis, who is not one to mince words, described that period of their relationship as “like living with a child,” later adding, “I hated him, frankly.” But when she brought up her frustrations, Mr. Lawson would become defensive. And as she continued to nag, she started to feel more like a parent than a partner, something they both resented. Then in 2019, at a friend’s suggestion, the pair read an article about how attention deficit hyperactivity disorder, or A.D.H.D., can affect romantic relationships. “We both kind of looked at each other and our jaws dropped,” Ms. Salamis said. The couple, who live in Ottawa, had discovered something millions of others have realized, often after years of conflict: One of them — in this case, Mr. Lawson — most likely had A.D.H.D., a neurodevelopmental disorder often characterized by inattention, disorganization, hyperactivity and impulsivity. When one or both members of a couple have A.D.H.D., the relationship typically has unique challenges, which are usually exacerbated when the disorder goes undiagnosed, experts say. Studies suggest that people with A.D.H.D. have higher levels of interpersonal problems than their peers do, and marriages that include adults with A.D.H.D. are more likely to be unsatisfying. Forums like the one found on the popular website A.D.H.D. and Marriage are often filled with stories of frazzled, emotionally spent spouses stuck in unhealthy, yearslong patterns. But if a couple makes a strong effort to learn more about the disorder, manage its symptoms and find more effective ways to communicate, they can revitalize their relationship. © 2022 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 28209 - Posted: 02.19.2022

By Emma Yasinski By the time kids diagnosed with attention deficit hyperactivity disorder meet with clinical psychologist Mary O’Connor, they have often been taking multiple medications or unusually high doses of stimulants like Ritalin. “They may have had a trial of stimulants that worked initially,” she says, but when the effect waned, their physicians prescribed higher doses, sometimes to the point of toxicity. O’Connor researches fetal alcohol spectrum disorders at the University of California, Los Angeles, where she has provided both diagnosis and treatment to children exposed to alcohol in the womb. At one end of the spectrum sits fetal alcohol syndrome, characterized by facial abnormalities, growth problems, and intellectual disabilities. The other end of the spectrum is characterized by subtler symptoms, including poor judgement and impulsivity — in other words, what looks to many like ADHD. But experts say standard ADHD treatments often don’t work as well for children exposed to alcohol in-utero. And lack of awareness, a shortage of specialists, and social stigma have combined to limit families’ ability to receive an accurate diagnosis and support for FASD, a condition that is underdiagnosed in the United States and could affect between 1 and 5 percent of this country’s children. The lack of diagnoses, scientists say, stifles research on treatments and may even cloud data on therapies for other disorders.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 14: Attention and Higher Cognition
Link ID: 28206 - Posted: 02.16.2022

By Emily Willingham As with most decision points around pregnancy, cannabis use is a fraught subject. Researchers can’t assess it in randomized trials because dosing pregnant people with the psychoactive substance is unethical. The next best thing is studies with enough participants who use cannabis on their own, allowing for comparisons with those who do not. The findings of one such study, published on November 15 in the Proceedings of the National Academy of Sciences USA, highlight symptoms of increased anxiety, hyperactivity and aggression in children whose parents used cannabis during pregnancy. And its analysis of placental tissue points to changes in the activity of immunity-related genes. Today pregnant people “are being bombarded with a lot of ads to treat nausea and anxiety during pregnancy” with cannabis, says the paper’s senior author Yasmin Hurd, director of the Addiction Institute at Mount Sinai. “Our studies are about empowering them with knowledge and education so that they can make decisions.” The results are “very striking, very much a first,” says Daniele Piomelli, a professor and director of the Center for the Study of Cannabis at the University of California, Irvine, who was not involved in the work. Pregnancy studies in rodents and even in sheep, which have a placenta more like ours, have required cautious interpretations of findings that show effects on offspring behavior and function, he says. The new study is one of the first to tackle the question in people “in a systematic way,” Piomelli adds. © 2021 Scientific American

Related chapters from BN: Chapter 7: Life-Span Development of the Brain and Behavior; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 4: Development of the Brain
Link ID: 28078 - Posted: 11.17.2021

By Katherine Ellison Jessica McCabe crashed and burned at 30, when she got divorced, dropped out of community college and moved in with her mother. Eric Tivers had 21 jobs before age 21. Both have been diagnosed with attention-deficit/hyperactivity disorder, and both today are entrepreneurs who wear their diagnoses — and rare resilience — on their sleeves. With YouTube videos, podcasts and tweets, they’ve built online communities aimed at ending the shame that so often makes having ADHD so much harder. Now they’re going even further, asking: Why not demand more than mere compassion? Why not seek deeper changes to create a more ADHD-friendly world? “I’ve spent the last five or six years trying to understand how my brain works so that I could conform, but now I’m starting to evolve,” says McCabe, 38, whose chipper, NASCAR-speed delivery has garnered 742,000 subscribers — and counting — to her YouTube channel, “How to ADHD.” “I think we no longer have to accept that we live in a world that is not built for our brains.” With Tivers, she is planning a virtual summit on the topic for next May. As a first step, with the help of Canadian cognitive scientist Deirdre Kelly, she says she’ll soon release new guidelines to assess products and services for their ADHD friendliness. Computer programs that help restless users meditate and a chair that accommodates a variety of seated positions are high on the list to promote, while error-prone apps or devices will be flagged. Kelly also envisions redesigning refrigerator vegetable drawers, so that the most nutritious food will no longer be out of sight and mind. In the past two decades, the world has become much kinder to the estimated 6.1 million children and approximately 10 million adults with ADHD, whose hallmark symptoms are distraction, forgetfulness and impulsivity. Social media has made all the difference.

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27960 - Posted: 08.25.2021

By Katherine Ellison ADHD — the most common psychiatric disorder of childhood —  lasts longer for more people than has been widely assumed, according to new research. “Only 10 percent of people really appear to grow out of ADHD,” says the lead author, psychologist Margaret Sibley, associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. “Ninety percent still struggle with at least mild symptoms as adults — even if they have periods when they are symptom free.” The study challenges a widely persistent perception of a time-limited condition occurring mostly in childhood. Indeed, one of the earliest names for attention deficit/hyperactivity disorder was “a hyperkinetic disease of infancy,” while its most common poster child has long been a young, White, disruptive male. Previous research has suggested the condition essentially vanishes in about half of those who receive diagnoses. But in recent years, increasing numbers of women, people of color and especially adults have been seeking help in managing the hallmark symptoms of distraction, forgetfulness and impulsivity. By the most recent estimates, 9.6 percent of children ages 3 to 17 have been diagnosed with ADHD. Yet researchers report that only 4.4 percent of young adults ages 18 to 44 have the disorder, suggesting that if the new estimates are valid, there may be some catching up to do. Sibley’s paper paints a picture of an on-again, off-again condition, with symptoms fluctuating depending on life circumstances. © 1996-2021 The Washington Post

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27946 - Posted: 08.14.2021

By Christina Caron Q: How common is adult A.D.H.D.? What are the symptoms and is it possible for someone who was not diagnosed with it as a child to be diagnosed as an adult? A: Attention deficit hyperactivity disorder, or A.D.H.D., is a neurodevelopmental disorder often characterized by inattention, disorganization, hyperactivity and impulsivity. It is one of the most common mental health disorders. According to the World Federation of A.D.H.D., it is thought to occur in nearly 6 percent of children and 2.5 percent of adults. In the United States, 5.4 million children, or about 8 percent of all U.S. children ages 3 to 17, were estimated to have A.D.H.D. in 2016, the Centers for Disease Control and Prevention reported. For decades, experts believed that A.D.H.D. occurred only among children and ended after adolescence. But a number of studies in the ’90s showed that A.D.H.D. can continue into adulthood. Experts now say that at least 60 percent of children with A.D.H.D. will also have symptoms as adults. It’s not surprising that so many people are now wondering whether they might have the disorder, especially if their symptoms were exacerbated by the pandemic. The Attention Deficit Disorder Association, an organization founded in 1990 for adults with A.D.H.D, saw its membership nearly double between 2019 and 2021. In addition, Children and Adults With Attention-Deficit/Hyperactivity Disorder, or CHADD, reported that the highest proportion of people who call their A.D.H.D. help line are adults seeking guidance and resources for themselves. © 2021 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27933 - Posted: 08.07.2021

By Branko van Hulst, Sander Werkhoven, Sarah Dursto “A rose by any other name would smell as sweet.” It is an often-used quote, and for good reason. Juliet tragically underestimated the impact of the Montague surname. She was not the first, nor the last, to underestimate the power of the names we give. In psychiatry, handbooks determine which names (or classifications) we give to the difficulties that people face. We use them so that when we say ADHD, schizophrenia or depression, people have a more or less consistent idea of what we mean. Moreover, it enables us to study groups of people with the same classification and learn about treatments and prognostics. However, a severe and often overlooked side effect of this practice is that these names implicitly suggest causality. The classificatory terms we use all refer to disorders that cause symptoms, and therefore suggest that we understand the causes of the problems. Which we do not. At the very least, the term disorder suggests a common causal structure, which goes against all our current knowledge on causal heterogeneity in psychiatry. Moreover, these classifications are applied to individuals and therefore suggest that causes lie mainly with the affected individual. The most common psychiatric handbooks (DSM-5 and ICD-11) are clear on the status of their classifications: they are purely descriptive and are not based on underlying causes. Still, in practice, we say things like “he is inattentive at school because he has ADHD.” It is a circular statement: a child is inattentive because of his inattentiveness. When we say that someone has an attention deficit, we are inclined to look for the cause of the problem. But when we say someone has an attention deficit disorder, we might wrongly assume we have already found the cause. Or, in a milder version, assume the cause to be located somewhere in the (brain of the) individual. © 2021 Scientific American,

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 27725 - Posted: 03.11.2021