Contents

### **Preface XI**


	- **Section 3 Advances in ADHD Prevention and Treatment 277**

## Preface

Chapter 8 **Cognitive Function in Attention Deficit Hyperactivity**

Chapter 10 **Predictors of College Success: Symptoms of ADHD,**

**Understanding of College Policies 231** Jill M. Norvilitis and Howard M. Reid

Chapter 11 **Family Difficulties in Children with ADHD, the Role of**

**Section 3 Advances in ADHD Prevention and Treatment 277**

Chapter 13 **Mindfulness Meditation — A New Preventive Intervention**

Chapter 14 **Therapy for ADHD Directed Towards Addressing the Dual**

Chapter 15 **Repetitive Transcranial Magnetic Stimulation in ADHD 331**

Chapter 16 **Updates on the Use of Natural Treatments for Attention-Deficit**

**Hyperactivity Disorder (ADHD) 351**

**Imbalances in Mental Effort and Reward as Illustrated in the Mental Effort-Reward Imbalances Model (MERIM) 303**

Pavel Theiner, Libor Ustohal, Tomáš Skřont, Martin Bareš and Tomáš

June Bryan dela Peña, Chrislean Jun Botanas, Reinholdger Tampus, Irene Joy dela Peña, Hee Jin Kim, Ike dela Peña and Jae Hoon

Chapter 12 **Evolution of a Disorder and Insights into Prevention of ADHD 279**

Yi-Yuan Tang and Rongxiang Tang

**Integrated Psychopharmacology Psychotherapy**

H.H. Aili, B. Norharlina, K.S. Manveen and W.I. Wan Salwina

Chapter 9 **The Quality of Life (QoL) in Attention Deficit Hyperactivity**

Ozden Sukran Uneri, Gulser Senses-Dinc and Zeynep Goker

**Psychological Well-being, Appreciation of the Liberal Arts, and**

**Disorder 179** Yongning Song

**VI** Contents

**Disorder (ADHD) 197**

**Treatment 243**

Sarina J. Grosswald

**for ADHD 293**

Alison Poulton

Kašpárek

Cheong

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most widely diagnosed be‐ havior disorders in childhood, with a recent study identifying a worldwide pooled preva‐ lence of 7.2 % (Thomas, Sanders, Doust, Beller, & Glasziou, 2015). Although the disorder is quite common, much remains unknown and researchers strive to examine the disorder, its causes and correlates, and its treatment. Our understanding of the biopsychosocial origins of ADHD is not definitive, and much remains to be learned in a variety of domains. While some scientists work to unlock these answers, others work to improve the lives of those with ADHD through understanding their daily functioning and through improving treatment options. Equally critical, this applied work addresses many quality-of-life concerns.

The goal of this volume is to explore the state of the art in research in ADHD around the world. The 16 chapters in this volume represent the work of 42 researchers in countries spanning the globe from Malaysia to Spain to Turkey to the United States. This broad sur‐ vey covers issues ranging from comorbidity to advances in the search for biomarkers; to ex‐ ecutive, cognitive, and social functioning; to the use of new and alternative therapies.

The first section of the book provides an overview of the disorder from a variety of perspec‐ tives. The first chapter, "Epidemiology of Attention Deficit Hyperactivity Disorder," pro‐ vides an introduction to the diagnosis, covering prevalence, treatment, gender differences, and comorbidity. Chapter 2, "The Role of Environmental Factors in Etiology of ADHD," ex‐ amines a variety of nongenetic risk factors, such as prenatal exposure to substances and psy‐ chosocial factors, suggesting avenues for further research and, potentially, avenues for prevention. One challenge in the field is that, to date, there are no definitive diagnostic tech‐ niques. Two chapters address advances in this area. Chapter 3, "Assessment of ADHD through Electroencephalographic Measures of Functional Connectivity," explores the use of recording and imaging techniques in diagnosis. Chapter 4, "Role of Dopaminergic and Nor‐ adrenergic Systems as Potential Biomarkers in ADHD Diagnosis and Treatment," examines a variety of biochemical markers to identify the most promising for future exploration. An‐ other challenge for the field is understanding how ADHD relates to other conditions in terms of both diagnosis and treatment. The final two chapters of the first section examine the role of comorbidity. Chapter 5, "Comorbid Conditions in Child and Adolescent Patients Diagnosed with Attention Deficit Hyperactivity Disorder," provides an overview of some of the most common conditions found with ADHD, highlighting treatment recommendations. Chapter 6, "The Comorbidity of ADHD and Autism Spectrum Disorders (ASDs) in Com‐ munity Pre-schoolers," explores one particular comorbid condition in depth. With the recent changes in DSM 5, children may now be diagnosed with ADHD and ASDs simultaneously. This chapter discusses the current research in symptomatology, assessment, and treatment of these two disorders.

The second section of the book considers how ADHD affects different areas of everyday functioning in those with the disorder. Chapter 7, "Executive Function in Children with At‐ tention Deficit Hyperactivity Disorder," argues that executive function deficits are a core symptom of ADHD and goes on to address the assessment and treatment implications of this, particularly through the use of imaging techniques. In Chapter 8, "Cognitive Functions in Attention Deficit Hyperactivity Disorder, Predominantly Inattentive Type (ADHD-I)," Yongning Song studies patterns of executive function deficits in a group of children with ADHD-I. Results indicate that executive function deficits are found in ADHD-I, similar to ADHD-Hyperactive/Impulsive and ADHD-Combined. Chapter 9, "The Quality of Life in Attention Deficit Hyperactivity Disorder," examines the impact of ADHD on well-being and quality of life. The authors cover strengths and weaknesses of the various measures of quali‐ ty of life as well as the impact of treatment on quality of life. Chapter 10, "Predictors of Col‐ lege Success: Symptoms of ADHD, Psychological Well-being, Appreciation of the Liberal Arts, and Understanding of College Policies," addresses another area of life, college success, impacted by ADHD. Results indicate that inattentive symptoms were more predictive of ad‐ justment to college than other mental health factors, such as depression and anxiety. Chap‐ ter 11, "Family Difficulties in Children with ADHD, the Role of Integrated Psychopharmacology-Psychotherapy Treatment," uses a case study to highlight the impor‐ tance of the role of the family in the onset, maintenance, and treatment of ADHD.

The final section of the book explores advances in the prevention and treatment of ADHD. Although some well-established treatments exist, such as behavior modification and psy‐ chostimulant medication, these treatments are not always available or effective for everyone. Thus, work continues to identify new and alternative treatments for the disorder and its pre‐ vention. Chapter 12, "Evolution of a Disorder and Insights into Prevention," examines some of the limitations of medication as a treatment for ADHD and considers potential alterna‐ tives for both prevention and treatment, such as improving sleep, the use of meditation, and omega-3 supplementation. Chapter 13, "Mindfulness Meditation—A New Preventive Inter‐ vention for ADHD," reviews the literature on the efficacy of mindfulness as a technique to improve attention and self-regulation. The authors conclude that this is a promising inter‐ vention in need of further research. In Chapter 14, "Therapy for ADHD Directed towards Addressing the Dual Imbalances in Mental Effort and Reward as Illustrated in the Mental Effort-Reward Imbalance Model (MERIM)," Alison Poulton offers a new model for under‐ standing ADHD that incorporates mood and the experience of reward. This new model leads to strategies to improve self-regulation and overall functioning. Chapter 15, "Repeti‐ tive Transcranial Magnetic Stimulation in ADHD," examines the potential role for this novel treatment. Although results from the handful of existing studies are equivocal, through the use of a case study the authors argue that further rigorous research may be fruitful. Chapter 16, "Updates on the Use of Natural Treatments for Attention Deficit Hyperactivity Disor‐ der," reviews the literature on a variety of alternatives. The authors note that some of these are better supported than others and offer suggestions for future study.

Overall, the chapters included here cover much of this diverse field. Both the professional and the casual reader alike will find something of interest, whether learning about ADHD for the first time or looking for inspiration for new research questions or potential interven‐ tions. I hope that the chapters spark new thoughts and, perhaps, debates.

This book is the result of the work of many individuals. I am particularly grateful to Ms. Iva Lipović for her assistance in coordinating this book. I also thank all of the authors who con‐ tributed to this volume: I have learned from you and been inspired by your work.

#### References

The second section of the book considers how ADHD affects different areas of everyday functioning in those with the disorder. Chapter 7, "Executive Function in Children with At‐ tention Deficit Hyperactivity Disorder," argues that executive function deficits are a core symptom of ADHD and goes on to address the assessment and treatment implications of this, particularly through the use of imaging techniques. In Chapter 8, "Cognitive Functions in Attention Deficit Hyperactivity Disorder, Predominantly Inattentive Type (ADHD-I)," Yongning Song studies patterns of executive function deficits in a group of children with ADHD-I. Results indicate that executive function deficits are found in ADHD-I, similar to ADHD-Hyperactive/Impulsive and ADHD-Combined. Chapter 9, "The Quality of Life in Attention Deficit Hyperactivity Disorder," examines the impact of ADHD on well-being and quality of life. The authors cover strengths and weaknesses of the various measures of quali‐ ty of life as well as the impact of treatment on quality of life. Chapter 10, "Predictors of Col‐ lege Success: Symptoms of ADHD, Psychological Well-being, Appreciation of the Liberal Arts, and Understanding of College Policies," addresses another area of life, college success, impacted by ADHD. Results indicate that inattentive symptoms were more predictive of ad‐ justment to college than other mental health factors, such as depression and anxiety. Chap‐ ter 11, "Family Difficulties in Children with ADHD, the Role of Integrated Psychopharmacology-Psychotherapy Treatment," uses a case study to highlight the impor‐

VIII Preface

tance of the role of the family in the onset, maintenance, and treatment of ADHD.

are better supported than others and offer suggestions for future study.

tions. I hope that the chapters spark new thoughts and, perhaps, debates.

Overall, the chapters included here cover much of this diverse field. Both the professional and the casual reader alike will find something of interest, whether learning about ADHD for the first time or looking for inspiration for new research questions or potential interven‐

The final section of the book explores advances in the prevention and treatment of ADHD. Although some well-established treatments exist, such as behavior modification and psy‐ chostimulant medication, these treatments are not always available or effective for everyone. Thus, work continues to identify new and alternative treatments for the disorder and its pre‐ vention. Chapter 12, "Evolution of a Disorder and Insights into Prevention," examines some of the limitations of medication as a treatment for ADHD and considers potential alterna‐ tives for both prevention and treatment, such as improving sleep, the use of meditation, and omega-3 supplementation. Chapter 13, "Mindfulness Meditation—A New Preventive Inter‐ vention for ADHD," reviews the literature on the efficacy of mindfulness as a technique to improve attention and self-regulation. The authors conclude that this is a promising inter‐ vention in need of further research. In Chapter 14, "Therapy for ADHD Directed towards Addressing the Dual Imbalances in Mental Effort and Reward as Illustrated in the Mental Effort-Reward Imbalance Model (MERIM)," Alison Poulton offers a new model for under‐ standing ADHD that incorporates mood and the experience of reward. This new model leads to strategies to improve self-regulation and overall functioning. Chapter 15, "Repeti‐ tive Transcranial Magnetic Stimulation in ADHD," examines the potential role for this novel treatment. Although results from the handful of existing studies are equivocal, through the use of a case study the authors argue that further rigorous research may be fruitful. Chapter 16, "Updates on the Use of Natural Treatments for Attention Deficit Hyperactivity Disor‐ der," reviews the literature on a variety of alternatives. The authors note that some of these Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of Attention-Deficit/Hyperactivity Disorder: A systematic review and meta-analysis. Pediatrics, 135, 994-1001. doi: 10.1542/peds.2014-3482

> **Jill M. Norvilitis** Department of Psychology SUNY Buffalo State Buffalo, NY USA

**Epidemiology, Etiology and Diagnosis of ADHD**
