SRH Clinic Karlsbad Langensteinbach

Karlsbad, Germany

SRH Clinic Karlsbad Langensteinbach

Karlsbad, Germany
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Fuermaier A.B.M.,University of Groningen | Tucha O.,University of Groningen | Koerts J.,University of Groningen | Grabski M.,University of Groningen | And 5 more authors.
PLoS ONE | Year: 2016

Objectives It has been shown that an increasing number of adults deliberately feign attention deficit hyperactivity disorder (ADHD)∗which demonstrates the need for new tests designed t detect feigned ADHD Method An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD i adulthood. EFT performance of 51 adults with ADHD was compared to the performance o 52 matched healthy individuals, as well as to 268 undergraduate students who were randoml allocated in a simulation design to one of four experimental conditions, i.e. a contro group, a naïve simulation group, a symptom-coached simulation group or a test-coache simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as sample of 17 clinicians experienced in the work with adults with ADHD were assessed fo further validation of the EFT Result The EFT was relatively easy to perform for both patients with ADHD and healthy comparison as shown by low error rates and non-significant group differences. However, simulatio groups differed from patients with ADHD by significant and large effects. An EFT inde for the prediction of feigned ADHD was derived based on logistic regression coefficients Receiver Operating Characteristics (ROC) demonstrated good classification accuracy o feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificit (90%) ConclusionsThis study supports the utility of the EFT for the detection of feigned adult ADHD. © 2016 Fuermaier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Tucha L.,University of Groningen | Fuermaier A.B.M.,University of Groningen | Koerts J.,University of Groningen | Buggenthin R.,University of Groningen | And 6 more authors.
Journal of Neural Transmission | Year: 2015

Neuropsychological research on adults with ADHD showed deficits in various aspects of attention. However, the majority of studies failed to explore the change of performance over time, so-called time-on-task effects. As a consequence, little is known about sustained attention performance of adults with ADHD. The aim of the present study was therefore to test the hypothesis of sustained attention deficits of adults with ADHD. Twenty-nine adults with ADHD and 30 healthy individuals were assessed on four 20-min tests of sustained attention, measuring alertness, selective attention, divided attention and flexibility. The deterioration of performance over time (time-on-task effects) was compared between patients with ADHD and healthy individuals to conclude on sustained attention performance. Compared to healthy individuals, patients with ADHD showed significant deficits of medium size in selective attention and divided attention. Furthermore, medium sustained attention deficits was observed in measures of alertness, selective attention and divided attention. This study supports the notion of sustained attention deficits of adults with ADHD. © 2015 The Author(s)


Fuermaier A.B.M.,University of Groningen | Tucha L.,University of Groningen | Evans B.L.,University of Groningen | Koerts J.,University of Groningen | And 6 more authors.
Journal of Neural Transmission | Year: 2015

Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies. © 2015 The Author(s)


Fuermaier A.B.M.,University of Groningen | Tucha L.,University of Groningen | Koerts J.,University of Groningen | Aschenbrenner S.,SRH Clinic Karlsbad Langensteinbach | And 4 more authors.
Clinical Neuropsychologist | Year: 2014

Executive dysfunction of adults with ADHD is often associated with poor self-awareness of problems, such as in emotional competence, emotional recognition, and driving competence. However, with regard to cognitive functioning, little is known about how adults with ADHD evaluate their own cognitive performance. A total of 77 adults with ADHD and 116 healthy adults were assessed with self-report scales measuring several aspects of cognition. Significance and effect sizes as well as the proportion of patients perceiving impairments were calculated. Further analysis was carried out on the frequency of patients perceiving various types of impairments. Adults with ADHD perceived themselves to have significant and severe dysfunction in all areas of cognition assessed as a group. Furthermore, the majority of patients reported multiple impairments in attention, memory and executive functioning. The present study demonstrated that adults with ADHD are aware of problems in cognitive functioning as shown by considerable perceived neuropsychological impairment in the majority of patients. Patients with ADHD tended to report cognitive impairments in multiple domains rather than impairments in specific functions. © 2014 Taylor & Francis.


Fuermaier A.B.M.,University of Groningen | Tucha L.,University of Groningen | Koerts J.,University of Groningen | Aschenbrenner S.,SRH Clinic Karlsbad Langensteinbach | And 5 more authors.
PLoS ONE | Year: 2013

Objectives: Attention deficit hyperactivity disorder (ADHD) in adults has been associated with disturbances of attention and executive functions. Furthermore, impairments of verbal and figural retrospective memory were reported. However, little is known about the effects of ADHD on prospective memory, the execution of delayed intentions in the future. Methods: The present study compared the performance of 45 adult patients with ADHD not treated with stimulant medication with the performance of 45 matched healthy individuals on a paradigm of complex prospective memory which measured task planning, plan recall, self-initiation and execution. Furthermore, the contribution of other cognitive functions to prospective memory functioning was assessed, including measures of attention, executive functions and memory. Results: A large-scale impairment could be observed in task planning abilities in patients with ADHD. Only negligible to small effects were found for plan recall, self-initiation and execution. Inhibition was identified to contribute significantly to performance on task planning. Conclusions: The present findings suggest that four cognitive components contribute to the performance of prospective memory. Impairments of prospective memory mainly emerged from deficient planning abilities in adults with ADHD. Implications on behavioral based intervention strategies are discussed. © 2013 Fuermaier et al.


Fuermaier A.B.M.,University of Groningen | Tucha L.,University of Groningen | Koerts J.,University of Groningen | Aschenbrenner S.,SRH Clinic Karlsbad Langensteinbach | And 4 more authors.
PLoS ONE | Year: 2013

Objectives: The context of memory experiences is referred to as source memory and can be distinguished from the content of episodic item memory. Source memory represents a crucial part of biographic events and elaborate memory experiences. Whereas individuals with attention deficit hyperactivity disorder (ADHD) were shown to have inefficient item memory, little is known about the context of memory experiences. Methods: The present study compared 37 adult patients with a diagnosed ADHD with 40 matched healthy participants on a word list paradigm. Memory functions of encoding, retention and source discrimination were assessed. Furthermore, standardized measures of memory and executive control were applied in order to explore a qualitative differentiation of memory components. Results: Adult patients with ADHD showed impaired performance in encoding of new information whereas the retention of encoded items was found to be preserved. The most pronounced impairment of patients with ADHD was observed in source discrimination. Regression models of cognitive functions on memory components supported some qualitative differentiation. Conclusions: Data analysis suggests a differential pattern of memory impairment in adults suffering from ADHD with a particular deficit in source discrimination. Inefficient source discrimination in adults with ADHD can affect daily functioning by limiting biographic awareness and disturbing general cognitive processes. © 2013 Fuermaier et al.


PubMed | University of Groningen, SRH Clinic Karlsbad Langensteinbach, University of Rostock and University of Regensburg
Type: | Journal: Journal of neural transmission (Vienna, Austria : 1996) | Year: 2015

Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies.


PubMed | University of Groningen, University of Regensburg and SRH Clinic Karlsbad Langensteinbach.
Type: Journal Article | Journal: Neuropsychology | Year: 2015

The assessment of cognitive functions of adults with attention deficit hyperactivity disorder (ADHD) comprises self-ratings of cognitive functioning (subjective assessment) as well as psychometric testing (objective neuropsychological assessment). The aim of the present study was to explore the utility of these assessment strategies in predicting neuropsychological impairments of adults with ADHD as determined by both approaches.Fifty-five adults with ADHD and 66 healthy participants were assessed with regard to cognitive functioning in several domains by employing subjective and objective measurement tools. Significance and effect sizes for differences between groups as well as the proportion of patients with impairments were analyzed. Furthermore, logistic regression analyses were carried out in order to explore the validity of subjective and objective cognitive measures in predicting cognitive impairments.Both subjective and objective assessment tools revealed significant cognitive dysfunctions in adults with ADHD. The majority of patients displayed considerable impairments in all cognitive domains assessed. A comparison of effect sizes, however, showed larger dysfunctions in the subjective assessment than in the objective assessment. Furthermore, logistic regression models indicated that subjective cognitive complaints could not be predicted by objective measures of cognition and vice versa.Subjective and objective assessment tools were found to be sensitive in revealing cognitive dysfunctions of adults with ADHD. Because of the weak association between subjective and objective measurements, it was concluded that subjective and objective measurements are both important for clinical practice but may provide distinct types of information and capture different aspects of functioning.


PubMed | University of Groningen, SRH Clinic Karlsbad Langensteinbach and University of Regensburg
Type: | Journal: Applied neuropsychology. Adult | Year: 2016

Neuropsychological research on adults with attention deficit hyperactivity disorder (ADHD) revealed considerable impairments in memory functions related to executive control. However, only limited evidence exists supporting the effects of pharmacological treatment using methylphenidate (MPH) on memory functions. The aim of the present study was, therefore, to explore the impact of MPH on various memory functions of adults with ADHD. Thirty-one adults with ADHD treated with MPH, 36 adults with ADHD not-treated with MPH, and 36 healthy individuals were assessed on several aspects of memory, including short-term memory, working memory, retrospective memory, prospective memory, and source memory. Multivariate statistical analyses were applied to compare memory functions between groups. Nonmedicated adults with ADHD showed considerable impairments in memory functions related to executive control. Adults with ADHD treated with MPH showed improved memory functions when compared to nonmedicated patients, but were still impaired when compared to healthy controls. The present study emphasized the severity of memory impairments of adults with ADHD. A pharmacological treatment with MPH appeared to improve memory, but does not normalize functioning. Additional treatment intervention (e.g., cognitive-behavioral therapy) is therefore necessary.


PubMed | University of Groningen, SRH Clinic Karlsbad Langensteinbach and University of Regensburg
Type: Journal Article | Journal: PloS one | Year: 2016

It has been shown that an increasing number of adults deliberately feign attention deficit hyperactivity disorder (ADHD), which demonstrates the need for new tests designed to detect feigned ADHD.An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD in adulthood. EFT performance of 51 adults with ADHD was compared to the performance of 52 matched healthy individuals, as well as to 268 undergraduate students who were randomly allocated in a simulation design to one of four experimental conditions, i.e. a control group, a nave simulation group, a symptom-coached simulation group or a test-coached simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as a sample of 17 clinicians experienced in the work with adults with ADHD were assessed for further validation of the EFT.The EFT was relatively easy to perform for both patients with ADHD and healthy comparisons as shown by low error rates and non-significant group differences. However, simulation groups differed from patients with ADHD by significant and large effects. An EFT index for the prediction of feigned ADHD was derived based on logistic regression coefficients. Receiver Operating Characteristics (ROC) demonstrated good classification accuracy of feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificity (90%).This study supports the utility of the EFT for the detection of feigned adult ADHD.

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