Usability and feasibility of a cognitive-behavioral mobile app for ADHD in adults.

Objective: Cognitive-behavioral therapy (CBT) has growing evidence of efficacy for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Mobile health apps are promising tools for delivering scalable CBT. In a 7-week open study of Inflow, a CBT-based mobile app, we assessed usability and feasibility to prepare for a randomized controlled trial (RCT).

A systematic review and meta-analysis of growth mindset interventions: For whom, how, and why might such interventions work?

As growth mindset interventions increase in scope and popularity, scientists and policymakers are asking: Are these interventions effective? To answer this question properly, the field needs to understand the meaningful heterogeneity in effects. In the present systematic review and meta-analysis, we focused on two key moderators with adequate data to test: Subsamples expected to benefit most and implementation fidelity. We also specified a process model that can be generative for theory.

Growth mindsets and psychological distress: A meta-analysis.

We investigated if growth mindsets-the belief in the malleable nature of human attributes-are negatively related to psychological distress and if they are positively related to treatment value and active coping. In the meta-analysis, we included articles published between 1988 and 2019, written in English, that reported on mindsets as well as a qualifying dependent variable and included information required to calculate an effect size. With a random effects approach, meta-analytic results (k = 72 samples, N = 17,692) demonstrated that mindsets relate, albeit with minimal effects, to distress, treatment and coping.

Development and Evaluation of the ADHD Cognitions Scale for Adults.

The clinical literature on ADHD in adults suggests that "overly positive" or optimistic cognitions may contribute to impairment and failure to use self-regulation skills in this population, yet the research literature on this topic is limited. We developed the ADHD Cognitions Scale (ACS), a brief self-report measure of ADHD-related thoughts, and evaluated its psychometric properties. We collected self-report measures, inculding the ACS, from two large community samples (s = 262, 304).

Meta-analysis of cognitive-behavioral treatments for adult ADHD.

Objective: We conducted a meta-analysis of cognitive-behavioral treatment (CBT) studies for adult attention-deficit/hyperactivity disorder (ADHD), examining effects versus control and effects pre-to-post treatment to maximize the clinical and research utility of findings from this growing literature.

Method: Eligible studies tested adults meeting criteria for Diagnostic and Statistical Manual of Mental Disorders ADHD as determined by interview or using a standardized rating scale and measured ADHD symptoms or related impairment at baseline and posttreatment. We analyzed data from 32 studies from published and unpublished sources available through December 2015.

Investigating Resilience to Depression in Adults With ADHD.

Objective: ADHD is associated with elevated rates of comorbid depressive disorders, yet the nature and development of this comorbidity remain understudied. We hypothesized that a longer period of prior ADHD treatment, being less likely to engage in maladaptive cognitive/behavioral coping strategies, and less severe ADHD symptoms would predict greater likelihood of lifetime resilience to depression.

Method: Seventy-seven adults with ADHD completed diagnostic interviews, clinician-administered symptom rating scales, a stressful life events measure, and self-report questionnaires.

Incautiously Optimistic: Positively-Valenced Cognitive Avoidance in Adult ADHD.

Clinicians who conduct cognitive-behavioral therapy (CBT) targeting attention-deficit/hyperactivity disorder (ADHD) in adulthood have noted that their patients sometimes verbalize overly positive automatic thoughts and set overly optimistic goals. These cognitions are frequently related to failure to engage in compensatory behavioral strategies emphasized in CBT. In this paper, we offer a functional analysis of this problematic pattern, , and suggest methods for addressing it within CBT for adult ADHD.

Is the Relationship Between ADHD Symptoms and Binge Eating Mediated by Impulsivity?

Objective: Individuals with ADHD may be at risk of developing binge eating disorder (BED). Impulsivity correlates with both BED and ADHD; however, more research is needed to explore whether impulsivity plays an underlying role in the observed relationship between ADHD and BED.

Method: Questionnaires were used to assess ADHD and BED symptoms.

Depression in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): The Mediating Role of Cognitive-Behavioral Factors.

Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for depressive disorders but little is known about the potential cognitive and behavioral mechanisms of risk that could shape treatment. This study evaluated the degree to which cognitive-behavioral constructs associated with depression and its treatment-dysfunctional attitudes and cognitive-behavioral avoidance-accounted for variance in depressive symptoms and disorder in adults with ADHD. 77 adults clinically diagnosed with ADHD completed self-report questionnaires, diagnostic interviews, and clinician-administered symptom rating scales.

Adult attention deficit hyperactivity disorder symptoms and five-factor model traits in a clinical sample: a structural equation modeling approach.

Relationships among attention deficit hyperactivity disorder (ADHD) symptoms and adult personality traits have not been examined in larger clinically diagnosed samples. We collected multisource ADHD symptom and self-report NEO Five-Factor Inventory (Costa and McCrae [Odessa, FL: Psychological Assessment Resources, Inc, 1992) data from 117 adults with ADHD and tested symptom-trait associations using structural equation modeling. The final model fit the data.

Does executive functioning (EF) predict depression in clinic-referred adults? EF tests vs. rating scales.

Background: Deficits in executive functioning (EF) are implicated in neurobiological and cognitive-processing theories of depression. EF deficits are also associated with Attention-deficit/hyperactivity disorder (ADHD) in adults, who are also at increased risk for depressive disorders. Given debate about the ecological validity of laboratory measures of EF, we investigated the relationship between depression diagnoses and symptoms and EF as measured by both rating scales and tests in a sample of adults referred for evaluation of adult ADHD.

Description and Demonstration of CBT for ADHD in Adults.

ADHD in adulthood is a valid, prevalent, distressing, and interfering condition. Although medications help treat this disorder, there are often residual symptoms after medication treatment, and, for some patients, they are contraindicated. Compared to other disorders, such as mood and anxiety disorders, there are few resources available for clinicians wishing to conduct cognitive-behavioral treatment for this problem.

Isolating metamemory deficits in the self-regulated learning of adults with ADHD.

Unlabelled: ADHD in adulthood is associated with chronic academic impairments and problems with strategic memory encoding on standardized memory assessments, but little is known about self-regulated learning that might guide intervention.

Objective: Examine the contribution of metamemory judgment accuracy and use of learning strategies to self-regulated learning in adults with ADHD, focusing on the use of self-testing.

Method: A total of 34 adults with ADHD and 34 matched controls predicted their memory performance and regulated their learning of paired associates.

Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD.

Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined.

Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial.

Context: Attention-deficit/hyperactivity disorder (ADHD) in adulthood is a prevalent, distressing, and impairing condition that is not fully treated by pharmacotherapy alone and lacks evidence-based psychosocial treatments.

Objective: To test cognitive behavioral therapy for ADHD in adults treated with medication but who still have clinically significant symptoms.

Design, Setting, And Patients: Randomized controlled trial assessing the efficacy of cognitive behavioral therapy for 86 symptomatic adults with ADHD who were already being treated with medication.

Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated with chronic functional impairment and increased rates of comorbidity. Cognitive behavioral therapy (CBT) approaches for this disorder have emerged recently, and available evidence from open and randomized controlled trials suggests that these approaches are promising in producing significant symptom reduction. A conceptual model of how CBT may work for ADHD is reviewed along with existing efficacy studies.

Self-reported ADHD symptoms among college students: item positioning affects symptom endorsement rates.

Objective: The effect of manipulating item positioning on self-reported ADHD symptoms was examined. We assessed whether listing DSM-IV ADHD symptoms serially or interspersed affected (a) the correlation between ADHD symptoms and (b) the rate of symptom endorsement.

Method: In Study 1, an undergraduate sample (n = 102) completed a measure that listed DSM-IV ADHD symptoms serially and a measure that interspersed DSM-IV ADHD items among non-ADHD symptoms.

Life impairments in adults with medication-treated ADHD.

Objective: In developing psychosocial approaches to augment outcomes for medication-treated adults with ADHD, it is important to understand what types of life-impairments are most affected by continued ADHD symptoms that occur despite medication treatment. This may assist in delineating targets for interventions, as well as assessments of functional outcomes that are sensitive to change in this population.

Method: The sample consists of 105 adults with ADHD presenting for entry into clinical trials of CBT for residual ADHD.

Attention-Deficit/Hyperactivity Disorder Symptom Profiles in Medication-Treated Adults Entering a Psychosocial Treatment Program.

Background: Although medications are the most widely studied effective treatments for adults with attention-deficit/hyperactivity disorder (ADHD), patients treated with medications often have significant residual symptoms that may be amenable to psychosocial intervention. Few studies, however, report on the structure and severity of specific residual ADHD symptoms in adult patients who have been treated with medications. This information may be important in identifying the most important psychosocial treatment targets for medicated adults with ADHD with residual symptoms.

Recent developments in the psychosocial treatment of adult ADHD.

Adult attention-deficit/hyperactivity disorder (ADHD) is an increasingly recognized Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV psychiatric disorder associated with significant functional impairment in multiple domains. Although stimulant and other pharmacotherapy regimens have the most empirical support as treatments for ADHD in adults, many adults with the disorder continue to experience significant residual symptoms. In the present manuscript, we review the published studies examining group and individual psychosocial treatments for adult ADHD.

The expression of adult ADHD symptoms in daily life: an application of experience sampling methodology.

Objective: To use experience sampling method (ESM) to examine the impact of inattentive and hyperactive-impulsive ADHD symptoms on emotional well-being, activities and distress, cognitive impairment, and social functioning assessed in the daily lives of young adults. The impact of subjective appraisals on their experiences is also examined.

Method: Participants (n = 206) complete up to 56 in-the-moment assessments of mood and current activities using Personal Digital Assistants for 1 week.

Does ADHD in adults affect the relative accuracy of metamemory judgments?

Objective: Prior research suggests that individuals with ADHD overestimate their performance across domains despite performing more poorly in these domains. The authors introduce measures of accuracy from the larger realm of judgment and decision making--namely, relative accuracy and calibration--to the study of self-evaluative judgment accuracy in adults with ADHD.

Method: Twenty-eight adults with ADHD and 28 matched controls participate in a computer-administered paired-associate learning task and predict their future recall using immediate and delayed judgments of learning (JOLs).

Accuracy of self-evaluation in adults with ADHD: evidence from a driving study.

Research on children with ADHD indicates an association with inaccuracy of self-appraisal. This study examines the accuracy of self-evaluations in clinic-referred adults diagnosed with ADHD. Self-assessments and performance measures of driving in naturalistic settings and on a virtual-reality driving simulator are used to assess accuracy of self-evaluations.