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An exploration of sleep and family factors in young children at familial risk for ADHD

2020-12-22, Keating, Jennifer, Bramham, Jessica, McNicholas, Fiona, Carr, Alan, Hasshim, Nabil, Downes, Michelle

Objective: The aim of the current study was to examine relations between sleep problems and family factors and early markers of ADHD in young children with and without a familial risk for ADHD. Methods: Differences in sleep behavior and family functioning in children under 6 years with (n = 72) and without (n = 139) a familial risk for ADHD were investigated. The influence of family and sleep factors on the development of early temperament markers of ADHD (effortful control and negative affect) was explored. Parents/caregivers completed questionnaires on family functioning, child sleep behavior, and general regulatory behaviors. Results: A significant difference was observed between high-risk and low-risk groups for family functioning in the infant/toddler (<3 years) and preschool (>3 years) cohorts. Parents of infants/toddlers in the high-risk group reported poorer infant sleep. However, there were no sleep differences reported for the preschool cohort. Family functioning was found to predict effortful control, while sleep quality predicted negative affect. Conclusion: The results of this study highlight potential family and sleep issues for young children with a familial history of ADHD and the potential influence of these factors on early temperament markers of ADHD. Future research should explore these relations further in order to better establish whether early sleep and family interventions could mitigate later ADHD symptomatology.

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Sensory modulation and negative affect in children at familial risk of ADHD

2021-05, Keating, Jennifer, Bramham, Jessica, Downes, Michelle

Background/aims: Sensory modulation difficulties are commonly reported in patients with ADHD, however there has been little focus on the development of these difficulties in young children at a higher risk of later ADHD diagnosis. This study investigated whether children with a familial history of ADHD show greater sensory modulation difficulties. We also explored whether sensory modulation was linked to negative affectivity, which has been highlighted as a potential early marker of ADHD. Methods: Parents of children under 6 years with a family history of ADHD (n = 65) and no family history (n = 122) completed questionnaires on sensory modulation and temperament. Results: Children from families with ADHD were reported to display extreme patterns of hyperresponsiveness and hyporesponsiveness, relative to controls. No differences emerged for the sensory seeking domain. Some children within the high-risk group reported high scores across all three sensory modulation patterns. Regression analysis revealed that hyperresponsiveness predicted higher levels of negative affect. Conclusions/implications: This study is the first to report greater sensory modulation difficulties in children at familial risk of ADHD. Future research should establish whether children with sensory modulation and temperament difficulties in early childhood are more vulnerable to developing ADHD.

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Differential diagnosis and comorbidity of ADHD and anxiety in adults

2017-09-12, Grogan, Katie, Gormley, Isobel Claire, Rooney, Brendan, Bramham, Jessica, et al.

Objectives: The aim of the present study was to examine symptom profiles of people diagnosed with ADHD and/or anxiety in order to determine the validity of widely used ADHD and anxiety rating scales for differential diagnostic use and to develop modified measures that take symptom overlap into account. Design: A cross sectional design was used to assess differences in rating scale scores between a clinical (n=52) and control (n=74) sample as well as differences among subgroups of the clinical sample (22 ADHD; 16 ADHD+ANX; 14 ANX). Method: Participants completed an online questionnaire where they responded to the Conners’ Adult ADHD Rating Scale (CAARS; Conners et al., 1999) and State Trait Anxiety Inventory scales (STAI; Spielberger et al., 1983). Results: Results showed that the CAARS and STAI had limited sensitivity and specificity, and may lack in ability to differentially diagnose ADHD and/or anxiety. Cluster analysis was used to guide the proposal of modifications for the two scales, which were to use inattentive items only for the CAARS and to exclude state anxiety-present items on the STAI for use in differential diagnosis. Further parametric analysis supported these proposed modifications. Conclusions: Clinicians should be made aware of the limitations of the CAARS and STAI scales in terms of specificity, when used to inform differential diagnosis of ADHD and anxiety. Further analysis on the psychometric properties of these modified scales is needed in order to confirm that they are valid and reliable scales.

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Motor Imagery in Clinical Disorders: Importance and Implications

2015-02-18, Moran, Aidan P., Bramham, Jessica, Collet, Christian, et al.

One of our most remarkable mental capacities is the ability to use our imagination voluntarily to mimic or simulate sensations, actions, and other experiences. For example, we can "see" things in our mind’s eye, "hear" sounds in our mind’s ear, and imagine motor experiences like running away from, or perhaps "freezing" in the face of, danger. Since the early 1900s, researchers have investigated "mental imagery" or the multimodal cognitive simulation process by which we represent perceptual information in our minds in the absence of sensory input.

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Sensory modulation difficulties and assessment in children with attention deficit hyperactivity disorder: a systematic review

2022, Keating, Jennifer, Gaffney, Rebecca, Bramham, Jessica, Downes, Michelle

This systematic review aims to (1) establish how different types of assessment measure sensory modulation difficulties in children with ADHD, and (2) to examine whether sensory modulation difficulties can be separated from ADHD symptomatology. The review protocol was registered with PROSPERO (CRD42018091730). PRISMA guidelines were used. Three databases (PsycINFO, PubMed, CINAHL) were searched using a predetermined search string from 1980 to 2020. Twenty-five studies met inclusion criteria. Sensory modulation difficulties are more likely to be reported when caregiver-report or behavioural measures are used, relative to physiological methods. Despite the focus to date on difficulties in auditory and tactile processing in this patient population, the reported studies show no evidence for these difficulties being more prevalent than difficulties in other sensory domains. Caregiver reports show evidence for differences in children with sensory modulation difficulties and ADHD, and those with ADHD only. This review reports variability in the prevalence of sensory modulation difficulties in children with ADHD that is dependent on the tools used to measure this domain. Approaches to the assessment of sensory modulation, and the implications for clinical practice, are considered.

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Systematic review of cognitive reserve in multiple sclerosis: Accounting for physical disability, fatigue, depression, and anxiety

2023-11, Stein, Clara, O'Keeffe, Fiadhnait, Strahan, Orla, McGuigan, Christopher, Bramham, Jessica

Background: Cognitive reserve (CR) describes an individual's ability to adapt cognitive processes in response to brain atrophy, and has been reported to explain some of the discrepancy between brain atrophy and cognitive functioning outcomes in multiple sclerosis (MS). CR in MS is typically investigated by assessing an individual's pre- and/or post-diagnosis enrichment, which includes premorbid intellectual abilities, educational level, occupational attainment, and engagement in cognitively enriching leisure activities. Common MS symptoms (e.g., physical disability, fatigue, depression, anxiety) may impact an individual's ability to engage in various CR-enhancing activities post-diagnosis. It is unknown to what extent these MS symptoms have been taken into account in MS research on CR. As such, we identified whether studies assessed CR using measures of premorbid or continuous (including post-diagnosis) enrichment. For studies investigating continuous enrichment, we identified whether studies accounted for MS-impact, which MS symptoms were accounted for, and how, and whether studies acknowledged MS symptoms as potential CR-confounds. Methods: Three electronic databases (PsycINFO, PubMed, Scopus) were searched. Eligible studies investigated CR proxies (e.g., estimated premorbid intellectual abilities, vocabulary knowledge, educational level, occupational attainment, cognitively enriching leisure activities, or a combination thereof) in relation to cognitive, brain atrophy or connectivity, or daily functioning outcomes in adult participants with MS. We extracted data on methods and measures used, including any MS symptoms taken into account. Objectives were addressed using frequency analyses and narrative synthesis. Results: 115 studies were included in this review. 47.8% of all studies investigated continuous enrichment. Approximately half of the studies investigating continuous enrichment accounted for potential MS-impact in their analyses, with only 31.0% clearly identifying that they treated MS symptoms as potential confounds for CR-enhancement. A narrative synthesis of studies which investigated CR with and without controlling statistically for MS-impact indicated that accounting for MS symptoms may impact findings concerning the protective nature of CR. Conclusion: Fewer than half of the studies investigating CR proxies in MS involved continuous enrichment. Just over half of these studies accounted for potential MS-impact in their analyses. To achieve a more complete and accurate understanding of CR in MS, future research should investigate both pre-MS and continuous enrichment. In doing so, MS symptoms and their potential impact should be considered. Establishing greater consistency and rigour across CR research in MS will be crucial to produce an evidence base for the development of interventions aimed at improving quality of care and life for pwMS.

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A Systematic review of autistic children’s prosocial behaviour

2022-10, Ryan-Enright, Theresa, O'Connor, Rachel, Bramham, Jessica, Taylor, Laura K.

Background: Prosocial behaviour (e.g., comforting, helping, sharing) is associated with important positive life outcomes. Historical and recent theory, evidence and personal accounts within the autism community present a mixed picture regarding Autistic children’s prosocial engagement. This systematic review consolidates, for the first time, how empirical studies have been measuring Autistic children’s prosocial behaviour to date (objective one). This review clarifies what knowledge the evidence provides, specifically how the type (e.g., comforting, helping, sharing), target (e.g., parent, experimenter, Autistic or neurotypical peer) and timing (e.g., young, middle, and late childhood) affect Autistic children’s prosocial behaviour (objective two). Methods: Relevant published records were identified through systematic searches of three electronic databases: PsychINFO, PubMED and Embase. Thirty studies presented in 29 articles met eligibility criteria and were included for data-extraction, quality assessment and narrative synthesis. Results: The most common methodologies used were found to be: in-person paradigms, games, informant reports, and self-reports. Reliability and validity efforts were inconsistent. It is hoped these findings will act as a benchmark for development of future research in the area. Outcomes were found to be much more positive about Autistic children’s engagement in prosocial behaviour than diagnostic criteria and historical theory suggests, with Autistic children often engaging in prosocial behaviour to the same frequency as comparison groups despite unfamiliar and neurotypical targets. Narrative synthesis revealed moderating variables and differing patterns and styles of Autistic children’s prosocial behaviour. Conclusions: Findings encourage Autistic strengths-based approaches and caution is expressed regarding findings possibly linked to Autistic masking.

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Premorbid cognitive functioning influences differences between self-reported cognitive difficulties and cognitive assessment in multiple sclerosis

2023-05-22, Stein, Clara, O'Keeffe, Fiadhnait, McManus, Caoimhe, Tubridy, Niall, Gaughan, Maria, McGuigan, Christopher, Bramham, Jessica

Cognitive difficulties are reported in up to 60% of people with MS (pwMS). There is often a discrepancy between self-reported cognitive difficulties and performance on cognitive assessments. Some of this discrepancy can be explained by depression and fatigue. Pre-MS cognitive abilities may be another important variable in explaining differences between self-reported and assessed cognitive abilities. PwMS with high estimated premorbid cognitive functioning (ePCF) may notice cognitive difficulties in daily life whilst performing within the average range on cognitive assessments. We hypothesised that, taking into account depression and fatigue, ePCF would predict (1) differences between self-reported and assessed cognitive abilities and (2) performance on cognitive assessments. We explored whether ePCF predicted (3) self-reported cognitive difficulties. Eighty-seven pwMS completed the Test of Premorbid Functioning (TOPF), the Brief International Cognitive Assessment for MS (BICAMS), self-report measures of cognitive difficulty (MS Neuropsychological Questionnaire; MSNQ), fatigue (MS Fatigue Impact Scale; MFIS) and depression (Hospital Anxiety and Depression Scale; HADS). Results revealed that, taking into account covariates, ePCF predicted (1) differences between self-reported and assessed cognitive abilities, p < .001 (model explained 29.35% of variance), and (2) performance on cognitive assessments, p < .001 (model explained 46.00% of variance), but not (3) self-reported cognitive difficulties, p = .545 (model explained 35.10% of variance). These results provide new and unique insights into predictors of the frequently observed discrepancy between self-reported and assessed cognitive abilities for pwMS. These findings have important implications for clinical practice, including the importance of exploring premorbid factors in self-reported experience of cognitive difficulties.