ADHD谈恋爱、做爱、多喝水、多吃抗炎止痛药物可以提高表现。

目的：探究大学生心理症状和学业成绩的关系。方法：于2023年10月采用大学生心理健康筛查量表对河北某高校700名大二学生进行问卷调查。在秋季学期末收集被试科学文化素质测评和基础性素质测评得分。使用SPSS 27.0进行统计分析。结果：女性的基础性素质和科学文化素质分数以及冲动、学业压力、就业压力维度显著高于男性；男性恋爱困扰分数显著高于女性。在大学生群体中，焦虑可以显著正向预测基础性素质，敏感显著正向预测科学文化素质，依赖显著反向预测基础性素质成绩和科学文化素质成绩。部分心理问题症状、基础性素质成绩和科学文化素质成绩存在显著的性别差异。焦虑、敏感和依赖可以显著预测大学生的学习成绩。结论：大学生学业成绩受部分心理症状的显著影响。

近年来脑科学领域发展迅速，在教育领域的应用日益广泛。本文对三种应用最广泛、影响力最大的脑学习方法——基于脑的学习、健脑操和赫尔曼全脑学习方法的理论依据、应用方法和实证结果进行介绍和评价，并对脑学习方法在教育领域的发展进行了展望。

运动是影响个体执行功能的重要因素及干预方式。如何制定科学、安全、有效且针对性强的运动方案是促进执行功能的关键。基于以往文献总结运动类型的分类，运动强度、频率及周期的界定标准，并从这些运动要素出发全面梳理运动对不同群体执行功能及其子成分的干预效果。研究结果表明：30分钟中等强度的急性有氧运动，中/高频率(周)、30~60分钟/次、中等强度的短周期有氧运动，高强度间歇运动，运动–认知双任务训练以及抗阻运动都能够显著改善执行功能。不同类型运动对各类人群的执行功能及其子成分具有不同程度的促进作用。未来研究需要进一步统一运动强度的标准，综合运动各要素设计科学的运动干预方案探讨其效用，深入进行理论解释和整合。

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Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide. Throughout an individual's lifetime, ADHD can increase the risk of other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. In most cases ADHD arises from several genetic and environmental risk factors that each have a small individual effect and act together to increase susceptibility. The multifactorial causation of ADHD is consistent with the heterogeneity of the disorder, which is shown by its extensive psychiatric co-morbidity, its multiple domains of neurocognitive impairment and the wide range of structural and functional brain anomalies associated with it. The diagnosis of ADHD is reliable and valid when evaluated with standard criteria for psychiatric disorders. Rating scales and clinical interviews facilitate diagnosis and aid screening. The expression of symptoms varies as a function of patient developmental stage and social and academic contexts. Although there are no curative treatments for ADHD, evidenced-based treatments can markedly reduce its symptoms and associated impairments. For example, medications are efficacious and normally well tolerated, and various non-pharmacological approaches are also valuable. Ongoing clinical and neurobiological research holds the promise of advancing diagnostic and therapeutic approaches to ADHD. For an illustrated summary of this Primer, visit: http://go.nature.com/J6jiwl.

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Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.

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Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples. © 2006 Nature Publishing Group All rights reserved.

Recent basic research on human temporal discounting is reviewed to illustrate procedures, summarize key findings, and draw parallels with both nonhuman animal research and conceptual writings on self-control. Lessons derived from this research are then applied to the challenge of analyzing socially important behaviors such as drug abuse, eating and exercise, and impulsiveness associated with attention deficit hyperactivity disorder. Attending to the broader temporal context in which behavior occurs may aid in the analysis of socially important behavior. Applying this perspective to the study of behavior in natural environments also highlights the importance of combining methodological flexibility with conceptual rigor to promote the extension of applied behavior analysis to a broader array of socially important behaviors.

The prefrontal cortex (PFC) receives input from all other cortical regions and functions to plan and direct motor, cognitive, affective, and social behavior across time. It has a prolonged development, which allows the acquisition of complex cognitive abilities through experience but makes it susceptible to factors that can lead to abnormal functioning, which is often manifested in neuropsychiatric disorders. When the PFC is exposed to different environmental events during development, such as sensory stimuli, stress, drugs, hormones, and social experiences (including both parental and peer interactions), the developing PFC may develop in different ways. The goal of the current review is to illustrate how the circuitry of the developing PFC can be sculpted by a wide range of pre- and postnatal factors. We begin with an overview of prefrontal functioning and development, and we conclude with a consideration of how early experiences influence prefrontal development and behavior.

While underlying infectious and inflammatory processes in PANS and PANDAS patients are treated, psychiatric and behavioral symptoms need simultaneous treatment to decrease suffering and improve adherence to therapeutic intervention. Psychological, behavioral, and psychopharmacologic interventions tailored to each child's presentation can provide symptom improvement and improve functioning during both the acute and chronic stages of illness. In general, typical evidence-based interventions are appropriate for the varied symptoms of PANS and PANDAS. Individual differences in expected response to psychotropic medication may require marked reduction of initial treatment dose. Antimicrobials and immunomodulatory therapies may be indicated, as discussed in Parts 2 and 3 of this guideline series.

Attention-deficit/hyperactivity disorder (ADHD) is a common brain developmental disorder in the general population that may be even more prevalent in elite athletes in certain sports. General population studies of ADHD are extensive and have reported on prevalence, symptoms, therapeutic and adverse effects of treatment and new clinical and research findings. However, few studies have reported on prevalence, symptoms and treatments of ADHD in elite athletes. This narrative review summarises the literature on symptoms, comorbidities, effects of ADHD on performance and management options for elite athletes with ADHD. The prevalence of ADHD in student athletes and elite athletes may be 7%-8%. The symptoms and characteristics of ADHD play a role in athletes' choice of a sport career and further achieving elite status. Proper management of ADHD in elite athletes is important for safety and performance, and options include pharmacologic and psychosocial treatments.

This review is an output of the International Life Sciences Institute (ILSI) Europe Marker Initiative, which aims to identify evidence-based criteria for selecting adequate measures of nutrient effects on health through comprehensive literature review. Experts in cognitive and nutrition sciences examined the applicability of these proposed criteria to the field of cognition with respect to the various cognitive domains usually assessed to reflect brain or neurological function. This review covers cognitive domains important in the assessment of neuronal integrity and function, commonly used tests and their state of validation, and the application of the measures to studies of nutrition and nutritional intervention trials. The aim is to identify domain-specific cognitive tests that are sensitive to nutrient interventions and from which guidance can be provided to aid the application of selection criteria for choosing the most suitable tests for proposed nutritional intervention studies using cognitive outcomes. The material in this review serves as a background and guidance document for nutritionists, neuropsychologists, psychiatrists, and neurologists interested in assessing mental health in terms of cognitive test performance and for scientists intending to test the effects of food or food components on cognitive function.

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During the 2012–2013 academic year, 7.7 million secondary school students took part in organized interscholastic sports, compared with just 4 million participants during the 1971–1972 year.1 Many student-athletes define themselves by their identities as athletes.2 Threats to that identity may come in the form of struggling performance; a chronic, career-ending, or time-loss injury; conflicts with coaches and teammates; or simply losing the passion for playing their sport.3–5 These challenges and associated factors may put the student-athlete in a position to experience a psychological concern or to exacerbate an existing mental health concern.2The types, severities, and percentages of mental illnesses are growing in young adults aged 18 to 25 years, an age group a little older than secondary school student-athletes.6 Given that mental illnesses being reported in the 18- to 25-year-old age group may well start before or during adolescence and given the overall numbers of student-athletes at the secondary school level, clinicians are certain to encounter student-athletes with psychological concerns. The goal of this consensus statement is to provide recommendations for developing a plan to address the psychological concerns of student-athletes at the secondary school level. The recommendations will discuss education on mental disorders in young adults, stressors unique to being a student-athlete at the secondary school level, recognition of behaviors to monitor, special circumstances faced by student-athletes that may affect their psychological health, collaborating with secondary school professionals to assist student-athletes with psychological concerns, and legal considerations. Also addressed are educational efforts for student-athletes, coaches, and parents, as well as practical steps to consider when proposing a psychological-concerns plan to administration. The interassociation work group that developed these recommendations included representatives from 8 national organizations and an attorney experienced in sports medicine and health-related litigation; all members had a special interest in and experience with psychological concerns in student-athletes. This multidisciplinary group of professionals included experts in athletic training, general medicine, psychology, psychiatry, pediatrics, secondary school counseling, sport psychology, critical-incident stress management, and law.Recommendations of the consensus statement are directed at the athletic health care team, athletic department administration and staff, and secondary school administration. This includes athletic trainers (ATs); team physicians; coaches; athletic department administrators; administrators such as principals and superintendents; secondary school nurses; and secondary school counselors. It is imperative to remember that the student-athlete is first and foremost a student of the school district and in most cases a minor child; therefore, collaboration with secondary school departments is a must.Two points about this consensus statement are critical. First, the terms psychological concern and mental disorder are used instead of mental illness because only credentialed mental health care professionals have the legal authority to diagnose a mental illness. Suspecting a mental illness in a student-athlete that affects the student-athlete's psychological health is a concern that noncredentialed mental health care professionals have. Thus, we selected psychological concerns for the title, although that term and mental disorder are interchangeable within the statement. Second, only credentialed, licensed mental health care professionals are to legally evaluate, diagnose, treat, and classify a student-athlete with a mental illness. The credentialed mental health care professional should perform that medical-legal duty and not a noncredentialed individual, no matter how caring that person may be. This consensus statement was produced to inform ATs about developing a plan to recognize potential psychological concerns in secondary school student-athletes and to establish an effective mechanism for referring the student-athlete into the mental health care system for assessment and treatment by a credentialed mental health care professional. This consensus statement does not make recommendations regarding mental illness evaluation or care. Rather, our intent was to assist the AT, in collaboration with the athletic department and secondary school administration, in facilitating the evaluation and care of the student-athlete suspected of a psychological concern by credentialed mental health care professionals. Throughout this statement, the terms psychological and mental are used; various authors in both the text and in literature citations chose to use one or the other. Although the terms are synonymous, the focus of the statement is recognition and referral, not treatment; treatment is left to the credentialed mental health care professional. Additionally, in this statement, the term secondary school is interchangeable with high school as found in the literature.This statement mirrors the 2013 document "Interassociation Recommendations for Developing a Plan to Recognize and Refer Student-Athletes With Psychological Concerns at the Collegiate Level: An Executive Summary of a Consensus Statement."2 That statement was designed for use by the AT practicing at the intercollegiate level. The current statement is designed for use by ATs practicing at the secondary school level, or in the absence of an AT at a particular secondary school, administrators may use this statement to develop a plan to address their student-athletes' psychological concerns. Ideally, a certified AT will help to develop and implement the recommendations of this consensus statement. The information contained in the collegiate and high school statements is similar but is targeted for each audience, and each statement is to be regarded as a stand-alone document for the indicated setting.The purpose of this consensus statement is for the reader to take the information provided and develop an appropriate plan for his or her institution to address the psychological concerns of student-athletes as part of a comprehensive sports medicine health care program. Specific goals of the statement are toThis consensus statement is organized as follows:The recommendations in this consensus statement use the Strength of Recommendation Taxonomy (SORT) criterion scale proposed by the American Academy of Family Physicians,7 which are based on the highest quality of evidence available. Each letter designation characterizes the quality, quantity, and consistency of evidence in the available literature to support a recommendation.Although this consensus statement uses SORT level C evidence for best practices, the educational component of mental illness in young adults is based on SORT level A evidence.Category: ACategory: ACategories: B, CCategories: A, BCategories: B, CCategory: CSimilar to physical injuries, psychological concerns can range from mild to severe, with varying effects on the life of the adolescent. In addition, some of these conditions can be lifelong, whereas others may be short-lived. Normal adolescence is a period of great change and maturation, during which emotional and behavioral difficulties are commonplace; however, the incidence of diagnosed mental health conditions remains consistent across studies, and psychological concerns must be appropriately recognized and treated.In 2001, the US Surgeon General10 defined mental health as "the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity." Approximately 1 in every 4 to 5 youths in this country experiences impairment during his or her lifetime as a result of a mental health disorder.11 The prevalence of many emotional and behavioral disorders in children and adolescents is higher than that of some well-known physical ailments, such as asthma and diabetes.11The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5),8 states that "a mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotional regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning." The definition8 further states that mental disorders are "usually associated with significant distress or disability in social, occupational, or other important activities." It is important to note that classifying a mental disorder only describes the mental disorder an individual has; it does not describe the individual.8 Thus, labeling a student-athlete as a "maniac" or a "druggie" further stigmatizes individuals with mental disorders. The diagnosis of a mental disorder should also have clinical utility, meaning it should assist clinicians in determining the treatment plan and prognosis for the patient. Having the diagnosis of a mental disorder is not equivalent to needing treatment.8Most DSM-5 disorders have a numeric International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code, and the DSM-5 disorders are grouped into 22 major diagnostic classes, categorizing hundreds of mental disorders.8 The DSM-5 diagnosis is applied to an individual's current presentation, not to a previous diagnosis.8 It is imperative that the DSM-5 not be applied by untrained individuals. Only those with appropriate clinical training and diagnostic skills may diagnose an individual with a mental disorder. The criteria in the DSM-5 serve as a guideline for the mental health care professional to form a clinical judgment and are not merely a recipe to follow.8In a recent study, nearly 1 in 3 adolescents (31.9%) met the criteria for anxiety disorder, 19.1% were affected by behavioral disorders, 14.3% experienced mood disorders, and 11.4% had substance-use disorders.11 The early onset of major classes of mental disorders has been documented.6 Of the affected adolescents,11 half experienced symptoms of their anxiety disorder by age 6, of their behavioral disorder by age 11, of their mood disorder by age 13, and of their substance-use disorder by age 15. Comorbidity rates of affected individuals have been reported at 40%, and 22.2% described having a mental disorder with severe impairment or distress that interfered with daily life.11The average age of onset for major depression and dysthymia is between 11 and 14 years of age.12 The rate of outpatient treatment for depression13 increased markedly in the United States between 1987 and 1997, with 75.3% of those individuals being treated with antidepressant medication in 2007.The US Substance Abuse and Mental Health Services Administration6 reported in 2012 that 45.9 million American adults aged 18 or older, 20% of the survey population, experienced a mental illness in 2010. Of those aged 12 to 17 years, 8% (1.9 million) had experienced a major depressive episode in 2010, which was defined as having a depressed mood or loss of interest in daily activities that lasted at least 2 weeks.6Most seriously impairing and persistent mental disorders found in adults are associated with onset during childhood or adolescence and have high comorbidity.14 Of adolescents aged 13 to 17 years who had experienced childhood adversity (ie, parental loss, parental maltreatment, parental maladjustment, or economic hardship), 58.3% reported at least 1 childhood adversity and 59.7% reported multiple childhood adversities; childhood adversities were strongly associated with the onset of psychiatric disorders. The prevalence ranged from 15.7% with fear disorders to 40.7% with behavioral disorders. A total of 28.2% of all onsets of psychiatric disorders were associated with 1 or more childhood adversities.15 Disorder onset was somewhat predictable and provides clues to the best times for intervention. The median age of disorder onset was 6 years for anxiety, 11 years for behavior, 13 years for mood, and 15 years for substance use.16Epidemiologic surveys estimate that as many as 30% of the adult population in the United States meet the criteria for a year-long DSM mental disorder.17,18 Fewer than half of individuals diagnosed with a mental disorder receive treatment.19,20 Mental disorders are widespread, with serious cases concentrated in a relatively small proportion of patients with high comorbidity.21Anxiety disorders are reported often in mental-disorder surveys21 and appear to exact significant and independent tolls on health-related quality of life.22Mental health care professionals are discovering more information on various mental health disorders. For example, intermittent explosive disorder is much more common than previously recognized.23 The typical onset is at age 14 years, with significant comorbidity of mental disorders that have later ages of onset. Only 28.8% of patients ever received treatment for their anger.23Anxiety disorders, such as panic disorders and social phobia, were the most common conditions, affecting 31.9% of teens. Next were behavioral disorders, including ADHD, which affect 19.1% of teens. Mood disorders, including major depressive disorder, were third at 14.3% and substance-use disorders were fourth at 11.4%.2 Comorbidity is also a significant concern within this age group, given that nearly 40% of patients with 1 class of disorder also met the criteria for a second class of disorder at some point in their lives.In a landmark study funded by the National Institute of Mental Health, the prevalence of a broad range of mental disorders in a nationally representative sample of US adolescents was examined. Participants in the National Comorbidity Survey Replication–Adolescent Supplement consisted of youths aged 13 to 18 years. One in 10 children had a serious emotional disturbance that interfered with daily activities. In addition, few affected youths received adequate mental health care. Mood disorders affected 14.3% of teens, including twice as many girls as boys. The prevalence of these disorders increased with age: a nearly 2-fold increase between age 13 to 14 years and age 17 to 18 years. One in 3 adolescents (31.9%) met the criteria for an anxiety disorder, ranging from 2.2% for generalized anxiety disorder to 19.3% for a specific phobia. These disorders are more common in girls.11Concerns about adolescent mental health are shared by many countries. In a review24 of community survey studies from around the world, approximately one-fourth of youths experienced a mental disorder during the past year and about one-third did so across their lifetimes.The incidence of depression increases with age. It is 1% to 2% at age 13, climbs to 3% to 7% at age 15, and continues to increase throughout early adulthood. Results are mixed when it comes to the effects of social class, race, and ethnicity.11 Although rare in children, the prevalence of bipolar disorder (mania and hypomania) ranges from 0% to 0.9% in those aged 14 to 18 and from 0% to 2.1% over a lifetime. As far as comorbidity, both major depressive disorder and bipolar disorder are associated with multiple other conditions, including ADHD, anxiety disorder, oppositional defiant disorder, and conduct disorder.25,26 Half of all adult mental disorders have their onset during adolescence, and suicide is the third leading cause of death among adolescents.27Data from the National Health and Nutrition Examination Survey28 revealed the following regarding adolescent medication use for psychological concerns:By 2020, it is estimated that psychiatric and neurologic conditions will account for 15% of the total burden (in terms of both prevalence and financial costs) of all diseases. Identified gaps in resources for childhood mental health that can be targeted for improvement can be categorized as economic, staffing, training, and policy.24 Approximately 25% of affected youth will have a second mental health disorder. This incidence actually increases 1.6 times for each additional year from age 2 (18.2%) to age 5 (49.7%). In addition, children with a physical illness are more likely to develop depression and those with an emotional disorder have an increased risk of developing physical disorders.29,30Considering the number of student-athletes within secondary school athletic departments and the statistical data on mental disorders in the United States, particularly those affecting adolescents, there is a high probability that most secondary school athletic teams include student-athletes who experience 1 or more psychological concerns. The AT, in collaboration with the athletic department and secondary school administration, should develop a plan to recognize student-athletes with psychological concerns and facilitate an effective referral system to mental health care professionals for evaluation and treatment.To maintain a competitive advantage, universities may recruit increasingly younger players, which affects secondary school coaches, student-athletes, and their families. Many student-athletes report higher levels of negative emotional states than non–student-athlete adolescents and have been identified as having higher incidence rates for sleep disturbances, loss of appetite, mood disturbances, short tempers, decreased interest in training and competition, decreased self-confidence, and inability to concentrate.Some of these changes in mood can also be related to overtraining.31,32 Due to pressures to win, competitions for athletic scholarships, and the adoption of professional training methods to ensure these outcomes, overtraining has become a way of life for many of our young athletes. They may compete year-round, often with multiple teams, and both train and compete multiple times each week. However, an emphasis on work without time for rest and recovery can lead to physical and psychological staleness and burnout.33–35Student-athletes often exhibit sport identity foreclosure,36 and the greater this rigid identification, the more negative the psychological reaction can be when real and perceived barriers arise in their sporting lives. Stressors of athletic participation may include being cut from a team, dealing with injury, performance challenges, mistakes in play, dealing with success, pressure to overspecialize or overtrain, and early termination from sport.37–39Demands and stressors on the student-athlete can be physical (eg, physical conditioning, injuries, environmental conditions), mental (eg, game strategy, meeting coaches' expectations, attention from media and fellow students, time spent in sport, community-service requirements, and less personal and family time), and academic (eg, classes, study time, projects, papers, examinations, attaining and maintaining the required grade point average to remain on the team, and earning and maintaining a collegiate or academic scholarship). These stressors place numerous expectations on a student-athlete.40Pressure on a student-athlete is common when there is no off-season and training continues throughout the year. The student-athlete is exposed to a predictable pattern of lack of sleep and underrecovery, putting him or her at risk for anxiety and depression.41–53 Recovery is closely related to well-being and performance, yet many student-athletes are mired in persistent cycles of chronic fatigue.46 For student-athletes, the complex combination of long-term training and uncontrollable life variables often leads to overtraining, putting them at risk for physical, mental, and emotional health problems.All too often, athletes are portrayed as superhuman, larger than life, and unaffected by stress or concerns of a clinical nature.54–58 Although many individuals are equipped to meet these physical and mental expectations, a segment of the student-athlete population will have difficulty. The stressors of being a student-athlete can trigger a new psychological concern, exacerbate an existing concern, or cause a past concern to resurface. Triggering events and stressors to be aware of are described in Table 1.The AT, team and others in the athletic department (eg, athletic coaches, academic support staff, school are in to and with student-athletes on a daily In most athletic department and secondary school have the of the and the student-athlete may to them for or with a personal concern or during a student-athletes may or students, or family However, some student-athletes, will not be aware of how a is affecting or are will not inform These student-athletes may in a way to others that is when a AT, team or a student-athlete's health, the is of a physical and on participation the student-athlete's mental health may be However, both physical and mental health are important for the student-athlete's that may be symptoms of a psychological concern in a student-athlete are provided in Table although the is not may or in may be in and may range in to a mental health care professional should be as the number and of behaviors increase or the behavior is a change from the student-athlete's of the 2 most common mental disorders, depression and anxiety, are found in 3 and AT, and should consider the student-athlete's psychological to a physical matter how it is a cause of stress to the Each student-athlete is so the or symptoms described by 1 student-athlete may not be the as those experienced by with the injury, particularly one that is time or may be a significant of to stress in various it with little whereas others or A student-athlete who an for the first time at the secondary school level will a for the physical and emotional to and which the AT can help the student-athlete During this time of psychological and physical stress associated with an injury, the student-athlete's behavior should be symptoms of psychological concern is part of the comprehensive care plan for often fear their to The AT should be aware of this the student-athlete of his or her to and the student-athlete for symptoms that a developing psychological of includes the and psychological effects on student-athletes this A student-athlete who a should be for changes in behavior or psychological a student-athlete experiences a the school is to with the In the absence of a school AT, the should work to and psychological changes in the US for substance-use disorders is whereas and is and and is With there is a to increase in the prevalence of these disorders, which to be somewhat more in Of collegiate student-athletes who experienced psychological concerns, particularly reported high rates in high A total of of US high school students indicated that some or use during the school and of to that of with or on social other to on the use of by student-athletes are exposed to use in high In a collegiate population for as well as anxiety, and other psychiatric reported high levels of and associated with were found between reported and depression and psychiatric care should be to the of substance and use among their athletes to Having an mental illness anxiety, bipolar disorder, or it more likely that student-athletes will use or the adolescent and young adult population, the prevalence of behavior disorders, including ADHD, is disorder affects to in a more than 3 to 1 and impairing behavior result in levels of or or their a chronic is often characterized by levels of or and meet the criteria for in both to the the of is by the number of as well as the level of impairment in social and work is in patients with many symptoms in of those required for symptoms that are severe, or significant impairment as a result of the is diagnosed in individuals symptoms are between minor and in children and adolescents can be it is important that all the diagnostic criteria are met conditions are and other conditions that can cause symptoms are including the Disorder and can be by parents, and adolescents and are in symptoms of are found in Table disorders affect twice as often as but the incidence in both increases with age. is In studies of adults, the estimated lifetime prevalence of disorders is relatively to for and to for who not meet criteria for disorders of or into a of disorder not In the clinical to be diagnosed more than or some the focus on and behaviors Although of such as or is associated with disorders, some athletes may develop a substance-use and symptoms of disorders are found in Table is a of youth and can cause physical, social, and academic The by not only affects the but can also affect and and the overall health and of and The for and as by youth or group of youths who are not or current that an or perceived and is multiple times or is likely to be may or distress on the targeted including physical, psychological, social, or educational young person can be a a or can take place physical, or social methods of and can in person or In of being include the loss of playing or of or or sports In addition, adolescent athletes are to their or coaches have been to and to remain of the on revealed that a student is being include the that a student be others include the that the AT who a student is or being first the and the school The to this is similar to the required an AT that an is a mental health The AT is not to address the with the student and in a However, a referral to the and school that the AT has the

Atopic dermatitis (AD) is a common chronic inflammatory skin condition characterised by pruritus and recurrent eczematous patches and plaques. It impacts sleep and its visibility can lead to stigmatisation, low self-esteem, social withdrawal, reduced quality of life (QOL), and psychological burden. This study explores the relationship between AD and mental health, including possible causation pathways. A literature review was conducted in PubMed without using limiters. AD carries higher odds of suicidality and an increased risk of depression, anxiety, alexithymia, and obsessive-compulsive disorder (OCD) across all severities. While some studies report an association of AD with attention deficit hyperactivity disorder (ADHD), and possibly autism spectrum disorder (ASD), others do not. There is increasing evidence that AD contributes to chronic low-grade inflammation and cognitive impairment (CI). Causative factors for mental health complications of AD likely include both psychosocial and biological variables. AD is associated with higher levels of cutaneous and circulating proinflammatory cytokines; these can breach the blood-brain barrier and trigger central nervous system events, including oxidative stress, neurotransmitter breakdown, altered serotonin metabolism, and reduced neurogenesis in several brain regions. Excessive inflammation in AD may thus contribute to CI, depression, and suicidality. AD providers should be vigilant about mental health.

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We review work on the effectiveness of different forms of cognitive enhancement, both pharmacological and non-pharmacological. We consider caffeine, methylphenidate, and modafinil for pharmacological cognitive enhancement (PCE) and computer training, physical exercise, and sleep for non-pharmacological cognitive enhancement (NPCE). We find that all of the techniques described can produce significant beneficial effects on cognitive performance. However, effect sizes are moderate, and consistently dependent on individual and situational factors as well as the cognitive domain in question. Although meta-analyses allowing a quantitative comparison of effectiveness across techniques are lacking to date, we can conclude that PCE is not more effective than NPCE. We discuss the physiological reasons for this limited effectiveness. We then propose that even though their actual effectiveness seems similar, in the general public PCE is perceived as fundamentally different from NPCE, in terms of effectiveness, but also in terms of acceptability. We illustrate the potential consequences such a misperception of PCE can have.

Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are generally asymptomatic or have mild acute symptoms with low rates of hospitalization (<2%) and death (<0.03%).1 After initial infection, some children, including those who experienced mild or asymptomatic disease, develop other postacute manifestations of COVID, including multisystem inflammatory syndrome in children (MIS-C, not discussed in this statement) or postacute sequelae of SARS-CoV-2 infection. The latter post-COVID condition may be known as long COVID, long-haul COVID, postacute COVID-19, long-term effects of COVID, or chronic COVID.2 This guidance statement uses the terminology of postacute sequelae of SARS-CoV-2 infection (PASC). Data are limited on the epidemiology of and risk factors for PASC in children and adolescents. The prevalence of PASC symptoms in children varied considerably between studies from 4 to 66%.1, 3-5 There is also large variation in the reported frequency of persistent symptoms. Recent studies have suggested that possible risk factors for PASC in pediatric patients may be older age, female gender, and history of allergic disease.6 In general, Hispanic or Latino (Hispanic) and non-Hispanic Black (Black) children had higher cumulative rates of COVID-19-associated hospitalizations (16.4 and 10.5 per 100,000, respectively) than did non-Hispanic White (White) children (2.1), although it is not currently known if hospitalization is a risk factor for PASC in children.6 Studies have also investigated the effects of the pandemic itself on the care of children with developmental disabilities,7-10 with a recent study finding that, other than age, intellectual disability was the strongest independent risk factor for COVID-19 mortality.11 More studies in this area are needed. Limited guidance exists regarding the assessment and treatment of manifestations of PASC in children and adolescents. Additional challenges in the diagnosis of PASC include the overlap of psychosocial effects (eg, social isolation, loss of routine with school and activities, fear of illness, loss of family members or friends) of the pandemic on children.12-14 Although there may be overlap with adult presentations and intervention options, pediatric management and rehabilitation of PASC have unique considerations, and adult guidance cannot be systematically transcribed to pediatrics. First, the approach to the child may differ; developmentally, some young children or those with developmental disabilities may have difficulty describing their symptoms. Pediatric histories from vested parties (parents, caregivers, coaches, teachers) are vital and subsequently help guide diagnosis and management. Compared to adults, children have fewer preexisting chronic health conditions, and some conditions that may increase risk of PASC, such as type 2 diabetes, are uncommon in pediatrics.15 Therefore, children may not require the same laboratory or radiographic tests as adults. Finally, from a psychosocial perspective, children are often previously healthy; thus, the symptoms of PASC can represent a stark departure from baseline for individuals and their families and present with increased stress or urgency to address. With this in mind, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) Multi-Disciplinary PASC Collaborative (PASC Collaborative) convened a pediatric workgroup to address the urgent need for interim assessment and treatment guidance in the care of children and adolescents with PASC. The following information is meant to assist the primary care physician and initial specialty evaluations for children and adolescents with PASC. The PASC Collaborative was created, in part, to develop expert recommendations and guidance from established PASC centers with extensive experience in managing patients with PASC. The PASC Collaborative is following an iterative modified Delphi approach to achieve consensus on assessment and treatment recommendations for a series of Consensus Guidance Statements focused on the most prominent PASC symptoms.16-18 As with other PASC Collaborative guidance statements, a detailed literature review was performed before initiation of the modified Delphi approach, and the full description of our methodology has been published in detail previously.19 As the assessment and treatment recommendations for each systemic section of this specific guidance statement were developed and refined, review of emerging studies and current literature was conducted on an ongoing basis. This monitoring of the literature occurred until finalization of the manuscript and throughout the review process to ascertain that the best available and current evidence was used. In the expansion of the PASC Collaborative to include a Pediatric Workgroup the intent was to recognize that assessment and treatment standards differ in younger populations requiring a pediatric specialization focus. Achieving consensus on the assessment and treatment recommendations for children and adolescents with PASC followed the same published modified Delphi approach with one adjustment to reflect the specialized expertise of the Pediatric Workgroup. The second wave of voting, to ensure the completeness and evidence base of recommendations, was conducted at the workgroup level as opposed to the full PASC Collaborative level. The Pediatric Workgroup then referred their consensus-based recommendations to the full PASC Collaborative for a final consensus vote prior to finalization. The PASC Collaborative Pediatric Workgroup is composed of approximately 30 pediatric specialists representing eight clinics or institutions from across the United States with engagement from patients or caregivers to gain the patient perspective in the care process. The Pediatric Workgroup recognizes that patients with health manifestations due to PASC typically present with a cluster of symptoms that cross multiple body systems and may overlap. The recommendations and discussion presented in this report are intended to reflect common presenting symptoms and organ system manifestations seen by pediatric specialists and those that pediatricians, family medicine practitioners, and pediatric subspecialists may encounter (Table 1). Importantly, the recommendations provided in the Guidance Statement should not preclude clinical judgment and must be applied in the context of the specific patient, with adjustments for patient preferences, comorbidities, and other factors. As with any treatment plan, clinicians treating patients with PASC are encouraged to discuss the unknowns of PASC treatments and prognosis, as well as the benefits and risks of any treatment approach. Fatigue (generalized, exercise intolerance, or postexertional malaise) Sleep disturbances Fever Anxiety Depression/low mood Increased somatic symptoms unexplained by systemic findings School avoidance Regression of academic or social milestones Dizziness/lightheadedness Orthostatic intolerance Headache Nausea Syncope or presyncope Headache Tremulousness Paresthesias or numbness Dizziness and vertigo Difficulty with attention/concentration Difficulty with memory Cognitive fatigue or "brain fog" Shortness of breath or dyspnea Chest (thoracic) pain or tightness Cough Difficulty with activity/exercise intolerance Palpitations or tachycardia Dizziness/lightheadedness Syncope Chest pain Difficulty with activity/exercise intolerance Weakness Muscle, bone, or joint pain Nausea/vomiting/reflux Abdominal pain Bowel irregularities (constipation/diarrhea) Weight loss Lack of appetite The primary care system is often the first point of contact for patients with PASC and may provide the bulk of therapeutic management. For patients with complex medical needs, multidisciplinary and interdisciplinary approaches are often beneficial.20-27 Multidisciplinary clinics to treat the population with PASC first opened in the spring of 2020, and as the pandemic continued, clinics focusing on the needs of the pediatric population emerged although they may not be accessible to all,28 in which case the primary care clinician will have a larger role in coordinating the specialty evaluation(s) and care. Previsit symptom checklists or screening tools may help facilitate information gathering and optimize the time providers have with patients and their caregivers at the initial evaluation.21, 27, 29, 30 Goals of the initial visit are to (1) determine symptoms and their impact on patient function; (2) assess what additional detailed evaluations may be helpful; (3) identify "red flag" symptoms that warrant urgent further testing and/or referral to subspecialists; and (4) differentiate PASC from preexisting or new conditions that require a different therapeutic approach. PASC is a clinical diagnosis and can be supported by positive polymerase chain reaction (PCR), antigen, and/or antibody testing for SARS-CoV-2; however, negative testing may not rule out PASC for multiple reasons. Some patients with PASC will not have a positive test for SARS-CoV-2 because of lack of testing, waning antibody levels, or false-negative testing.31, 32 As pediatric SARS-CoV-2 vaccination rates increase; the role of antibody testing may decrease unless providers specifically order antinucleocapsid antibodies. A strong epidemiological link (eg, SARS-CoV-2 positive close contact) or distinctive clinical features of COVID-19 (anosmia/ageusia) without an alternative diagnosis may also be considered evidence of prior infection. The evaluation should begin with a thorough history and review of systems, followed by a comprehensive physical examination and additional studies as warranted. Key areas to focus on in an initial evaluation are summarized in Table 2. This initial evaluation can guide the need for additional assessment considerations and treatment options based on findings (Tables 3–11). Description of the acute SARS-CoV-2 infection or "inciting event" Characterize pertinent PASC symptoms1, 20, 25, 34 Factors that limit activity or result in fatigue should be noted, with attention to nutrition, sleep, exercise, and mental health.2, 27 Refer to Tables 3-11 for further guidance on assessment parameters. Assess for level of functional activity limitations Past medical, surgical, family, and social history Review the past medical history. Specific attention should be placed on preexisting conditions including mental and behavioral health,2, 35 surgeries or hospitalizations, and vaccination status including for SARS-CoV-2. Physical examination: Assessment: Clinicians should incorporate history, prior laboratory or microbiological testing, and physical exam findings in making a diagnosis of PASC. Concerning symptoms and signs ("red flags") should be addressed and may require additional targeted evaluation prior to further therapies or management strategies related to PASC. Labs/radiology (2) Follow-up plan and referrals – Follow symptom-based treatment strategies as outlined in the specific sections that follow (Tables 3-11 ). Evaluation: •Full physical exam including thorough neuromuscular exam and provocative musculoskeletal tests specific to any areas of pain •Consider orthostatic vital signs/standing test if experiencing lightheadedness/ dizziness (See Autonomic Dysfunction/POTS section in Table 5 for more information) •Consider formal testing of physical functioning and endurance (examples include 6-minute walk test (40), 30 second sit to stand test if feasible) •Bloodwork: complete blood count, comprehensive metabolic panel, thyroid-stimulating hormone/free T4, iron panel, ferritin, vitamin D •Consider magnesium, vitamin B12, erythrocyte sedimentation rate/C-reactive protein, celiac screening based on additional symptoms. Refer to Tables 4-10 for additional testing recommendations if concerned for comorbid conditions contributing to fatigue or EI. Interventions/considerations: Medications: Lifestyle modifications: Physical activity: Sleep difficulty symptoms may include insomnia (difficulty falling asleep, sleep deprivation), difficulty with sleep maintenance, sleep events (eg, restless leg syndrome, sleep apnea), hypersomnia (excessive daytime sleepiness) Interventions/considerations: Behavioral sleep interventions: When to Refer and to Whom: Psychology or therapist for cognitive behavioral therapy for insomnia if behavioral interventions are not sufficient and/or to treat comorbid mental health concern (anxiety, depression) Sleep medicine specialist if abnormalities on PSG or concern for sleep disorder Fatigue is a common symptom in children with PASC with a broad differential.20, 25-27, 41 Physical activity/exercise intolerance is also reported, which often overlaps with symptoms of fatigue.3, 20, 42 Physical inactivity is a well-documented risk to both overall physical and mental health43; thus, it is important to help mobilize those with physical activity intolerance in a timely fashion to minimize lasting effects of decreased activity or poor exercise tolerance. Some patients with prolonged fatigue may meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is a clinical diagnosis of exclusion. ME/CFS is characterized by profound fatigue occurring for at least 6 months with significant impairment in day-to-day functioning including physical functioning, school performance, and extracurricular activities.44 Postexertional malaise and unrefreshing sleep are hallmarks of the disorder, and cognitive impairment and orthostatic intolerance are also commonly cooccurring conditions.45 The relationship between ME/CFS and SARS-CoV-2 infection is unclear at this point, but ME/CFS has been noted after other viral illnesses, most prominently primary infection with Epstein–Barr virus.37, 46 If patients with PASC report symptoms of postexertional malaise or "crashing" after mild physical or cognitive activity, they should be educated on "pacing" and careful attention should be made to avoid postexertional malaise and exacerbation of symptoms; patients may benefit from referral to pediatric rehabilitation medicine. (See Appendix 1 for a link to Centers for Disease Control and Prevention resources for ME/CFS.) Recommendations for physical activity programs should be tailored to each individual patient and take into account access to exercise opportunities and equipment (ie, gym class, recess, safe neighborhood, bicycle). There have been some suggested protocols for return to play in pediatric and adult recreational athletes following mild-to-moderate COVID43, 47 using a graduated exercise approach48; however, these types of programs may cause symptom exacerbation in those with postexertional malaise. A more gradual approach of slowly increasing physical activity through a subsymptom threshold exercise program similar to protocols recommended for postconcussion syndrome may be better tolerated.49 Oversight by a physical therapist or occupational therapist (in those with more significant symptoms limiting activities of daily living) may be helpful for more specific guidance. Recommendations for physical activity including any restrictions may need to be translated to school and other settings such as sports and extracurriculars (see Pediatric Accommodations section). Sleep is critical for optimal function and development across multiple body systems. Insufficient sleep may be associated with mood changes, impaired attention and concentration, and decreased immune response. Post-COVID sleep difficulties are often reported in children.3, 50-52 It is unclear whether sleep difficulties are a manifestation of having COVID-19, related to other psychological or medical conditions, a product of increased psychosocial distress, or some combination of factors.53 Mental health concerns for individuals with PASC (Table 4) can be influenced by biological (direct effects of infection) and psychosocial (disrupted quality of life, isolation, loss of loved ones and routine) factors.54 This has resulted in an increase in the prevalence of anxiety, depression, irritability, boredom, inattention, and new-onset psychological symptoms in youth during the COVID-19 pandemic.55 Many children have undergone the trauma of losing a loved one to COVID-19 and may experience symptoms of grief, exacerbating psychological and physical symptoms of PASC. Additionally, the pandemic has exacerbated difficulty with access to mental health care for many populations such as racial and ethnic minority groups and gender/sexual minority individuals.56 One study demonstrated that children, girls, those with Hispanic ethnicity, those with public versus private insurance, and those with more significant medical comorbidity were more likely to exhibit PASC neuropsychiatric symptoms,57 although these demographic and socioeconomic factors need to be studied further. With the increase in mental health problems since the start of the pandemic it is particularly important to screen for mental health symptoms in all youth with PASC, and in particular, screen for suicidal ideation especially if there are known past attempts, past suicidal ideation, or changes in mood. Of note, emergency room visits for suicidal ideation and attempts started increasing in early 2020 for adolescents (ages 12–17 years) in the United States and have sustained at higher levels, especially for adolescent females.58 Patient history and symptom assessment: Anxiety Depression Evaluation/scales to consider: *Note: the PHQ-9 contains a suicidality question; clinicians should be prepared with a plan if score is positive. Suicidality Anxiety is the most common mental health concern in adults with PASC symptoms54 and studies have supported newly emerging anxiety symptoms in youth.55 Children with primarily social anxiety may have a recurrence of symptoms upon return to in-person school after a prolonged absence (which may be prolonged due to PASC). Therefore, school avoidance should be monitored closely. Adolescents and young adults with disabilities may have differential impacts related to anxiety during the pandemic, especially if they identify with a minoritized racial/ethnic group and should be screened and monitored closely.59 Depression has been documented in adult PASC and to a lesser extent in some pediatric studies, both in patients with and without premorbid depression.60, 61 These symptoms are occasionally also associated with changes in behavior that may be uncharacteristic for the youth (eg, increased irritability, social withdrawal). Clinical experience suggests there may be an increase in somatization and SSRDs in some pediatric cases of PASC; however, one should not assume PASC symptoms are all related to a SSRD and thorough medical investigation into any newly emerging physical symptom is always recommended. If considering a diagnosis of a somatic symptom disorder or functional neurological symptom disorder, it is recommended to refer and collaborate with medical subspecialties (eg, neurology, rheumatology, pediatric rehabilitation medicine, and gastroenterology) prior to diagnosis. When the diagnosis of functional neurologic symptoms disorder or other somatic disorder is made, patients should be referred to a specialized multi-disciplinary clinic or program and/or psychology when available.62 In adult studies, 25% of patients experiencing PASC had posttraumatic symptoms up to 50 days post COVID-19 infection.63 To date, rates of PTSD for youth with PASC have not been reported. PTSD symptoms may be elevated in children with history of hospitalization, prolonged period in intensive care, or history of multiple procedures.64 In addition, one of the unfortunate outcomes of the pandemic has been the increase in prevalence of child maltreatment.63, 65 In a small study, the amassing of COVID-19 stressors was found to be a key risk factor implicated in higher parent-perceived stress, whereas anxiety and depression were associated with both higher parent-perceived stress and child abuse potential.66 This consequently increases the odds of PTSD and is critical for physicians to be vigilant for signs of PTSD and potential underlying maltreatment both in patients with and without PASC. When mental health concerns are identified and have a negative impact on functioning or are associated with significant distress, referral for evidence-based therapy (eg, cognitive behavioral is and in some cases of and/or referral to may be on and resources of symptoms can be based on symptom and level of the primary care a perspective, families may benefit from in a who has experience with individuals with chronic and cognitive behavioral such as for chronic which may also be helpful to for this may also benefit from to for their youth or behavioral management strategies for young orthostatic tachycardia syndrome is a chronic disorder of the system characterized by symptoms (Table which are orthostatic in It is a condition primarily between the of and is commonly by infection, or can be in decreased quality of and limited to in school and/or Interventions/considerations: Lifestyle modifications: Physical activity with When to refer and to In to there are other of such as orthostatic orthostatic tachycardia and treatment for of management (see Table and on orthostatic symptoms and quality of with increased and has been to orthostatic and quality of in some patients with there are and for although that increase blood decrease and increase are often In children with orthostatic symptoms who not meet full criteria for management should be and can be considered to help with symptom management. Although there are case the of following COVID-19 infection in there is limited literature available on pediatric presenting symptoms of PASC, including and overlap with symptoms of and In addition, it is important to screen for mental health concerns as symptoms of may present to somatic symptoms of anxiety and depression for which referral to mental health may be and concerns of fatigue and attention generally increased attention in these with and and elevated those with children with PASC should (see Table 6 and Accommodations and intervention (eg, behavioral to ensure these cognitive and mood difficulties not the to in school settings or in the testing is recommended to assist in the level and types of school these children may benefit from and to therapeutic A comprehensive evaluation is not always unless a child had preexisting developmental disabilities or neurological conditions (eg, history, A targeted evaluation be (eg, for most a cognitive assessment until symptoms function increases the risk for additional and Patient history and symptom assessment: Anxiety and mood symptoms Patient Anxiety and pediatric symptom mental health and symptoms section for further Interventions/considerations: in with comorbid medical conditions School may be with a of as symptoms (eg, test in decreased cognitive during These school may be tailored or modified following formal testing when needed. When to refer and to in cognitive status (eg, increased or concerns on screening based on clinical Accommodations and/or strategies are after months of for "red as well as signs of by an underlying are common in children with 20, 27, Recommendations for evaluation and management are in with pediatric from the American Academy of and American Headache neurological examination or a history for system A primary type (eg, in patients with PASC has not been identified and some patients multiple Orthostatic are common in children with (Table The of treatment and for patients and families on behavioral and factors that may Clinicians should as in children with PASC and may require a approach treatment may to treatment with a daily to decrease or many patients with PASC experience a of of treatment may be by treatments commonly for other PASC symptoms. For a of cognitive which a symptoms. such as which some providers in treatment of and orthostatic intolerance in a child with PASC. in children with or other body can treat both and other possible pain symptoms. for for sleep and appetite or for anxiety may be for when these comorbid conditions are When a daily for it is important to start at low be of and treatment based on comorbid symptoms. In children and adolescents with PASC, respiratory symptoms are commonly reported (Table has been found to be associated with a higher risk of evaluation of patients with PASC and persistent symptoms should at and with a low threshold to refer to a Some studies have function tests are most often in children with whereas more than of children had mild and In patients with evaluation for or intolerance (eg, 6-minute walk test or 1 sit to stand is Additional tests may be if symptoms or there are findings on exam or an initial Assess frequency of Assess activity Review respiratory post-COVID Review of symptoms should of if or which Evaluation: of decreased breath of If history of optimize treatment with and per If history of of on or therapy and per respiratory should also be

We first identified the hyperthermia-induced altered functional connectivity patterns. The changes in the functional connectivity network might be a possible explanation for the cognitive performance and work behavior alteration.

Neuroinflammation is recognised as one of the potential mechanisms mediating the onset of a broad range of psychiatric disorders and may contribute to nonresponsiveness to current therapies. Both preclinical and clinical studies have indicated that aberrant inflammatory responses can result in altered behavioral responses and cognitive deficits. In this review, we discuss the role of inflammation in the pathogenesis of neuropsychiatric disorders and ask the question if certain genetic copy-number variants (CNVs) associated with psychiatric disorders might play a role in modulating inflammation. Furthermore, we detail some of the potential treatment strategies for psychiatric disorders that may operate by altering inflammatory responses.

Caregivers may need to adjust communication methods when delivering information to cognitively impaired patients.

Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and psychological distress. Research suggests people with FM experience increased somatosensory sensitization which generalizes to other sensory modalities and may indicate neural hyperexcitability. However, the available evidence is limited, and studies including measures of neural responsivity across sensory domains and both central and peripheral aspects of the neuraxis are lacking. Thirty-nine participants (51.5 ± 13.6 years of age) with no history of neurological disorders, psychosis, visual, auditory, or learning deficits, were recruited for this study. People with FM (N = 19) and control participants (CNT, N = 20) did not differ on demographic variables and cognitive capacity. Participants completed a task that combined innocuous auditory stimuli with electrocutaneous stimulation (ECS), delivered at individually-selected levels that were uncomfortable but not painful. Event-related potentials (ERPs) and electrodermal activity were analyzed to examine the central and sympathetic indices of neural responsivity. FM participants reported greater sensitivity to ECS and auditory stimulation, as well as higher levels of depression, anxiety, ADHD, and an array of pain-related experiences than CNT. In response to ECS, the P50 deflection was greater in FM than CNT participants, reflecting early somatosensory hyperexcitability. The P50 amplitude was positively correlated with the FM profile factor obtained with a principal component analysis. The N100 to innocuous tones and sympathetic reactivity to ECS were greater in FM participants, except in the subgroup treated with gabapentinoids, which aligns with previous evidence of symptomatic improvement with GABA-mimetic medications. These results support the principal tenet of generalized neural hyperexcitability in FM and provide preliminary mechanistic insight into the impact of GABA-mimetic pharmacological therapy on ameliorating the neural excitation dominance.

Dopamine is an important neuromodulator that exerts widespread effects on the central nervous system (CNS) function. Disruption in dopaminergic neurotransmission can have profound effects on mood and behavior and as such is known to be implicated in various neuropsychiatric behavioral disorders including autism and depression. The subsequent effects on other neurocircuitries due to dysregulated dopamine function have yet to be fully explored. Due to the marked social deficits observed in psychiatric patients, the neuropeptide, oxytocin is emerging as one particular neural substrate that may be influenced by the altered dopamine levels subserving neuropathologic-related behavioral diseases. Oxytocin has a substantial role in social attachment, affiliation and sexual behavior. More recently, it has emerged that disturbances in peripheral and central oxytocin levels have been detected in some patients with dopamine-dependent disorders. Thus, oxytocin is proposed to be a key neural substrate that interacts with central dopamine systems. In addition to psychosocial improvement, oxytocin has recently been implicated in mediating mesolimbic dopamine pathways during drug addiction and withdrawal. This bi-directional role of dopamine has also been implicated during some components of sexual behavior. This review will discuss evidence for the existence dopamine/oxytocin positive interaction in social behavioral paradigms and associated disorders such as sexual dysfunction, autism, addiction, anorexia/bulimia, and depression. Preliminary findings suggest that whilst further rigorous testing has to be conducted to establish a dopamine/oxytocin link in human disorders, animal models seem to indicate the existence of broad and integrated brain circuits where dopamine and oxytocin interactions at least in part mediate socio-affiliative behaviors. A profound disruption to these pathways is likely to underpin associated behavioral disorders. Central oxytocin pathways may serve as a potential therapeutic target to improve mood and socio-affiliative behaviors in patients with profound social deficits and/or drug addiction.

To detect erroneous action outcomes is necessary for flexible adjustments and therefore a prerequisite of adaptive, goal-directed behavior. While performance monitoring has been studied intensively over two decades and a vast amount of knowledge on its functional neuroanatomy has been gathered, much less is known about conscious error perception, often referred to as error awareness. Here, we review and discuss the conditions under which error awareness occurs, its neural correlates and underlying functional neuroanatomy. We focus specifically on the anterior insula, which has been shown to be (a) reliably activated during performance monitoring and (b) modulated by error awareness. Anterior insular activity appears to be closely related to autonomic responses associated with consciously perceived errors, although the causality and directions of these relationships still needs to be unraveled. We discuss the role of the anterior insula in generating versus perceiving autonomic responses and as a key player in balancing effortful task-related and resting-state activity. We suggest that errors elicit reactions highly reminiscent of an orienting response and may thus induce the autonomic arousal needed to recruit the required mental and physical resources. We discuss the role of norepinephrine activity in eliciting sufficiently strong central and autonomic nervous responses enabling the necessary adaptation as well as conscious error perception.

Considering the neuroscientific findings on reward, learning, value, decision-making, and cognitive control, motivation can be parsed into three sub processes, a process of generating motivation, a process of maintaining motivation, and a process of regulating motivation. I propose a tentative neuroscientific model of motivational processes which consists of three distinct but continuous sub processes, namely reward-driven approach, value-based decision-making, and goal-directed control. Reward-driven approach is the process in which motivation is generated by reward anticipation and selective approach behaviors toward reward. This process recruits the ventral striatum (reward area) in which basic stimulus-action association is formed, and is classified as an automatic motivation to which relatively less attention is assigned. By contrast, value-based decision-making is the process of evaluating various outcomes of actions, learning through positive prediction error, and calculating the value continuously. The striatum and the orbitofrontal cortex (valuation area) play crucial roles in sustaining motivation. Lastly, the goal-directed control is the process of regulating motivation through cognitive control to achieve goals. This consciously controlled motivation is associated with higher-level cognitive functions such as planning, retaining the goal, monitoring the performance, and regulating action. The anterior cingulate cortex (attention area) and the dorsolateral prefrontal cortex (cognitive control area) are the main neural circuits related to regulation of motivation. These three sub processes interact with each other by sending reward prediction error signals through dopaminergic pathway from the striatum and to the prefrontal cortex. The neuroscientific model of motivational process suggests several educational implications with regard to the generation, maintenance, and regulation of motivation to learn in the learning environment.

Dancing, which is integrally related to music, likely has its origins close to the birth of Homo sapiens, and throughout our history, dancing has been universally practiced in all societies. We hypothesized that there are differences among individuals in aptitude, propensity, and need for dancing that may partially be based on differences in common genetic polymorphisms. Identifying such differences may lead to an understanding of the neurobiological basis of one of mankind's most universal and appealing behavioral traits--dancing. In the current study, 85 current performing dancers and their parents were genotyped for the serotonin transporter (SLC6A4: promoter region HTTLPR and intron 2 VNTR) and the arginine vasopressin receptor 1a (AVPR1a: promoter microsatellites RS1 and RS3). We also genotyped 91 competitive athletes and a group of nondancers/nonathletes (n = 872 subjects from 414 families). Dancers scored higher on the Tellegen Absorption Scale, a questionnaire that correlates positively with spirituality and altered states of consciousness, as well as the Reward Dependence factor in Cloninger's Tridimensional Personality Questionnaire, a measure of need for social contact and openness to communication. Highly significant differences in AVPR1a haplotype frequencies (RS1 and RS3), especially when conditional on both SLC6A4 polymorphisms (HTTLPR and VNTR), were observed between dancers and athletes using the UNPHASED program package (Cocaphase: likelihood ratio test [LRS] = 89.23, p = 0.000044). Similar results were obtained when dancers were compared to nondancers/nonathletes (Cocaphase: LRS = 92.76, p = 0.000024). These results were confirmed using a robust family-based test (Tdtphase: LRS = 46.64, p = 0.010). Association was also observed between Tellegen Absorption Scale scores and AVPR1a (Qtdtphase: global chi-square = 26.53, p = 0.047), SLC6A4 haplotypes (Qtdtphase: chi-square = 2.363, p = 0.018), and AVPR1a conditional on SCL6A4 (Tdtphase: LRS = 250.44, p = 0.011). Similarly, significant association was observed between Tridimensional Personality Questionnaire Reward Dependence scores and AVPR1a RS1 (chi-square = 20.16, p = 0.01). Two-locus analysis (RS1 and RS3 conditional on HTTLPR and VNTR) was highly significant (LRS = 162.95, p = 0.001). Promoter repeat regions in the AVPR1a gene have been robustly demonstrated to play a role in molding a range of social behaviors in many vertebrates and, more recently, in humans. Additionally, serotonergic neurotransmission in some human studies appears to mediate human religious and spiritual experiences. We therefore hypothesize that the association between AVPR1a and SLC6A4 reflects the social communication, courtship, and spiritual facets of the dancing phenotype rather than other aspects of this complex phenotype, such as sensorimotor integration.

DRD4 VNTR genotype varies considerably within and among populations and has been subject to relatively recent, local selective pressures. Individual differences in sexual behavior are likely partially mediated by individual genetic variation in genes coding for motivation and reward in the brain. Conceptualizing these findings in terms of r/K selection theory suggests a mechanism for selective pressure for and against the 7R+ genotype that may explain the considerable global allelic variation for this polymorphism.

Emotions arise from activations of specialized neuronal populations in several parts of the cerebral cortex, notably the anterior cingulate, insula, ventromedial prefrontal, and subcortical structures, such as the amygdala, ventral striatum, putamen, caudate nucleus, and ventral tegmental area. Feelings are conscious, emotional experiences of these activations that contribute to neuronal networks mediating thoughts, language, and behavior, thus enhancing the ability to predict, learn, and reappraise stimuli and situations in the environment based on previous experiences. Contemporary theories of emotion converge around the key role of the amygdala as the central subcortical emotional brain structure that constantly evaluates and integrates a variety of sensory information from the surroundings and assigns them appropriate values of emotional dimensions, such as valence, intensity, and approachability. The amygdala participates in the regulation of autonomic and endocrine functions, decision-making and adaptations of instinctive and motivational behaviors to changes in the environment through implicit associative learning, changes in short- and long-term synaptic plasticity, and activation of the fight-or-flight response via efferent projections from its central nucleus to cortical and subcortical structures.

Mental disorders are prevalent, place considerable burden on the economy and lead to suffering for those with the disorders and their loved ones. However, there is a flipside. Evidence suggests that people with mental disorders can flourish and productively contribute to society through entrepreneurship. This paper explores the relationship between mental disorders and entrepreneurship. It builds a research agenda to propose that researchers explore the role of mental disorders in the entrepreneurial context. We show how such research will advance this new field of research, but also how it can develop novel insights and theories in entrepreneurship and contribute to theories on the psychology of work, career choice, and clinical psychology.

Further understanding relationships between psychiatric conditions other than major depression (such as ADHD, BPD, and PTSD as exemplified here) and chronic pain can positively impact understanding of these disorders, and treatment of both psychiatric conditions and chronic pain.

The hypothalamic neuropeptide and hormone oxytocin are of fundamental importance for maternal, social, and sexual behavior. Deviations in oxytocin levels have also been associated with anxiety, autism spectrum disorders (ASD), depression, ADHD (attention deficit hyperactivity disorder), and schizophrenia. Both oxytocin and dopamine are often considered reward- and feel-good hormones, and dopamine is associated with the above-mentioned behaviors and, and dopamine is also associated with the above-mentioned behaviors and disorders. Although being structurally totally different, oxytocin, a peptide, and dopamine, a monoamine, they have a number of similar effects. They are synthesized both in the brain and in the periphery, and they affect each other's release and receptors. In addition, oxytocin and dopamine are released in response to, for example, social interaction, sex, feeding, and massage. This review discusses interactions between oxytocin and dopamine with a specific focus on behavioral effects and possible roles of oxytocin and dopamine in various mental disorders and functional diversities.

A few studies have examined the changes in substance- and behavior-related "wanting" and "liking" of human subjects, the key properties of Incentive Sensitization Theory (IST). The aim of this study was to examine the dissociation between "wanting" and "liking" as a function of usage frequency, intensity, and subjective severity in individuals across four substances (alcohol, nicotine, cannabis, and other drugs) and ten behaviors (gambling, overeating, gaming, pornography use, sex, social media use, Internet use, TV-series watching, shopping, and work). Also, the potential roles of impulsivity and reward deficiency were investigated in "wanting," "liking," and wellbeing. The sex differences between "wanting" and "liking" were also examined. Based on our findings using structural equation modeling with 749 participants (503 women, <i>M</i> _<i>age</i> = 35.7 years, <i>SD</i> = 11.84), who completed self-report questionnaires, "wanting" increased with the severity, frequency, and intensity of potentially problematic use, while "liking" did not change. Impulsivity positively predicted "wanting," and "wanting" positively predicted problem uses/behaviors. Reward deficiency positively predicted problem uses/behaviors, and both impulsivity and problem uses/behaviors negatively predicted wellbeing. Finally, women showed higher levels of "wanting," compared to men. These findings demonstrate the potential roles of incentive sensitization in both potentially problematic substance uses and behaviors.

Anxiety disorders affect approximately one third of people during their lifetimes and are the ninth leading cause of global disability. Current treatments focus on therapy and pharmacological interventions. However, therapy is costly and pharmacological interventions often have undesirable side-effects. Healthy people also regularly suffer periods of anxiety. Therefore, a non-pharmacological, intuitive, home intervention would be complementary to other treatments and beneficial for non-clinical groups. Existing at-home anxiety aids, such as guided meditations, typically employ visual and/or audio stimuli to guide the user into a calmer state. However, the tactile sense has the potential to be a more natural modality to target in an anxiety-calming device. The tactile domain is relatively under-explored, but we suggest that there are manifold physiological and affective qualities of touch that lend it to the task. In this study we demonstrate that haptic technology can offer an enjoyable, effective and widely accessible alternative for easing state anxiety. We describe a novel huggable haptic interface that pneumatically simulates slow breathing. We discuss the development of this interface through a focus group evaluating five prototypes with embedded behaviours ('breathing', 'purring', 'heartbeat' and 'illumination'). Ratings indicated that the 'breathing' prototype was most pleasant to interact with and participants described this prototype as 'calming' and 'soothing', reminding them of a person breathing. This prototype was developed into an ergonomic huggable cushion containing a pneumatic chamber powered by an external pump allowing the cushion to 'breathe'. A mixed-design experiment (n = 129) inducing anxiety through a group mathematics test found that the device was effective at reducing pre-test anxiety compared to a control (no intervention) condition and that this reduction in anxiety was indistinguishable from that of a guided meditation. Our findings highlight the efficacy of this interface, demonstrating that haptic technologies can be effective at easing anxiety. We suggest that the field should be explored in more depth to capture the nuances of different modalities in relation to specific situations and trait characteristics.

The 7 repeat (7R) allele of the dopamine receptor D4 gene has been associated with attention deficit hyperactivity disorder and risk taking. On the cross-population scale, 7R allele frequencies have been shown to be higher in populations with more of a history of long-term migrations. It has also been shown that the 7R allele is associated with individuals having multiple ancestries. Here, we conduct a replication of this latter finding with two independent samples. Measures of subjects' ancestry are used to examine past reproductive bonds. The individuals' history of interracial/ancestral dating and their feelings about this are also assessed. Tentative support for an association between multiple ancestries and the 7R allele was found. These results are dependent upon the method of questioning subjects about their ancestries, with only finer-scale measures of ancestry being associated with 7R. Interracial dating and feelings about interracial pairing were not related to the presence of the 7R allele. This study provides continued support for a role for the 7R allele in migration and/or mate choice patterns. However, replications and extensions of this study are needed and the way ancestry/race is assessed must be carefully considered.

Background and aims Many patients presenting multiple behaviors including drug and food abuse as well as other pathological repetitive unwanted activities such as gambling, self-mutilation and paraphilias may not be appropriately diagnosed. Here we present a case of a male presenting many of these seemingly diverse behaviors and finally diagnosed with reward deficiency syndrome (RDS) by his attending physician. Methods The use of the dopamine agonist, ropinirole after two weeks showed improvement in terms of sexual behavior but tolerance set in and was discontinued especially when an infraction occurred with the patient's insurance. In this article, we carefully explore the potential of ropinirole to downregulate dopamine receptors causing adenylate cyclase receptor supersensitivity and tolerance a feature of neurotransmitter cross-talk. Based on previous scientific evidence showing KB220Znutrigenomic amino-acid therapy (NAAT) to rapidly (post one-hour) activate dopaminergic pathways in both the pre-frontal cortex cingulate gyrus (relapse loci) and ventral tegmental area-caudate-accumbens-putamen (craving and emotion loci) the patient was prescribed NAAT. Results and discussion Within one week of utilization the repetitive paraphilia was eliminated. There were also a number of other positive effects such as enhanced focus that persisted even after the patient stopped using KB220Z suggesting neuroplasticity (e.g. altruistic thoughts). However, these observed profound benefits require more in-depth study, especially in a large cohort against a placebo. While this report focused on a rapid response rather than long-term benefits previously associated with NAAT, it is somewhat encouraging and longer term required follow-up and larger placebo controlled studies are warranted before any definitive conclusions could be gleaned from this case report.

Hypersexuality has been defined as abnormally increased sexual activity. Epidemiological and clinical studies have shown that this non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Hypersexual disorder is conceptualized as a non-paraphilic sexual desire disorder with impulsivity. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The nucleus accumbens, situated within the ventral striatum, mediates the reinforcing effects of drugs of abuse, such as cocaine, alcohol, nicotine, and food as well as music. Indeed, it is believed that this structure mandates behaviors elicited by incentive stimuli. These behaviors include natural rewards like feeding, drinking, sexual behavior, and exploratory locomotion. An essential rule of positive reinforcement is that motor responses will increase in magnitude and vigor if followed by a rewarding event. Here, we are hypothesizing that there is a common mechanism of action (MOA) for the powerful effects drugs, music, food, and sex have on human motivation. The human drive for the three necessary motivational behaviors "hunger, thirst, and sex" may all have common molecular genetic antecedents that, if impaired, lead to aberrant behaviors. We hypothesize that based on a plethora of scientific support hypersexual activity is indeed like drugs, food, and music that activate brain mesolimbic reward circuitry. Moreover, dopaminergic gene and possibly other candidate neurotransmitter-related gene polymorphisms affect both hedonic and anhedonic behavioral outcomes. There is little known about both the genetics and epigenetics of hypersexuality in the current literature. However, we anticipate that future studies based on assessments with clinical instruments combined with genotyping of sex addicts will provide evidence for specific clustering of sexual typologies with polymorphic associations. There have been some studies using electrophysiological techniques that do not support the view that hypersexuality is indeed similar to substance abuse and other behavioral addictions. The authors are also encouraging both clinical and academic scientists to embark on research using neuroimaging tools to examine natural dopaminergic agonistic agents targeting specific gene polymorphisms to "normalize" hypersexual behavior.

Sense of agency refers to the feeling of control over one's own actions. The strength of this sense varies inter-individually. This means that people differ in their perception concerning the intensity of their intentions and actions. The current study aims to determine the factors influencing this sense of agency on a personality level. Furthermore, it gives insight into the correlative relation between the strength of the sense of agency and substance use. The study involved 210 participants who were tested for the experiment (intentional binding paradigm for sense of agency, hand paradigm for intentionality bias, questionnaires FAD-Plus, NI-20, substance use). Significant determinants in personality were narcissism (vulnerable subtype) and substance use (consumption in general beyond cannabis, and particularly for the substances cannabis, ecstasy, and cocaine). Both personality types were associated with a weaker sense of agency compared to controls. For both results, alterations in the dopaminergic system need to be discussed. The present results confirm prior hypotheses that dopamine seems to play a crucial role in perception of agency. Possibly a higher accessibility of dopamine increases sense of agency (hyper-binding), whereas a lower accessibility of dopamine decreases sense of agency (hypo-binding). A second aim of the study was to see whether there is a connection between sense of agency and intentionality bias. The perception of intention in others differs widely; some people tend to see arbitrary or accidental actions as unintentional, and others quickly label actions as 'intentional' although the information is not distinct for a categorization. This cognitive error is called intentionality bias. Results could not confirm a relationship between the two constructs-one's own intention and judging intention in others. This may be due to a lack of connection between the two constructs or to methodological aspects. Further directions and limitations are discussed.

The understanding of the relationship of impulsivity with infatuation might help to clarify why some population groups show an increased risk for many negative social outcomes.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by executive dysfunction and difficulties in processing emotional facial expressions, yet the large-scale neural dynamics underlying these impairments remain insufficiently understood. This study applied network-based EEG source analysis to examine oscillatory cortical activity during cognitive and emotional Go/NoGo tasks in individuals with ADHD. EEG data from 272 participants (ADHD n equals 102, controls n equals 170, age range 6 to 60 years) were analyzed using exact low-resolution brain electromagnetic tomography combined with functional independent component analysis, yielding ten frequency-resolved cortical networks. Mixed-effects ANCOVAs were conducted on independent component loadings with Group, Task, and Condition as factors and age and sex as covariates. ADHD participants showed statistically significant but small increases in activation across several networks, including a gamma-dominant inferior temporal component showing a Group effect and a Group by Condition interaction with stronger NoGo-related activation in ADHD. Two additional components showed similar but weaker NoGo-selective patterns. A main effect of Task emerged only for one temporal delta component, with higher activation during the VCPT than the ECPT. No Group by Task interactions were observed. Behavioral results replicated the established ADHD performance profile, with slower responses, greater variability, and higher error rates, particularly during the emotional ECPT. Overall, the findings reveal subtle alterations in oscillatory brain networks during inhibitory processing in ADHD, with modest effect sizes embedded within substantial within-group variability. These results support a dimensional view of ADHD neurobiology and highlight the limited discriminative power of network-level EEG markers.

The primary tasks of a cognitive system is to survive and to maximize a life-long utility function, like the number of offsprings. A direct computational maximization of life-long utility is however not possible in complex environments, especially in the context, of real-world time constraints. The central role of emotions is to serve as an intermediate layer in the space of policies available to agents and animals, leading to a large dimensional reduction of complexity. We review our current understanding of the functional role of emotions, stressing the role of the neuromodulators mediating emotions for the diffusive homeostatic control system of the brain. We discuss a recent proposal, that emotional diffusive control is characterized, in contrast to neutral diffusive control, by interaction effects, viz by interferences between emotional arousal and reward signaling. Several proposals for the realization of synthetic emotions are discussed in this context, together with key open issues regarding the interplay between emotional motivational drives and diffusive control.

The concept of neurodiversity, encompassing conditions such as Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), dyslexia, and dyspraxia, challenges traditional views of these neurodevelopmental variations as disorders and instead frames them as natural cognitive differences that contribute to unique ways of thinking and problem-solving. Within the software development industry, known for its emphasis on innovation, there is growing recognition of the value neurodivergent individuals bring to technical teams. Despite this, research on the contributions of neurodivergent individuals in Software Engineering (SE) remains limited. This interdisciplinary Socio-Technical Grounded Theory study addresses this gap by exploring the experiences of neurodivergent software engineers with ASD and ADHD, examining the cognitive and emotional challenges they face in software teams. Based on interviews and a survey with 25 neurodivergent and 5 neurotypical individuals, our theory describes how neurodivergent cognitive dysfunctions affect SE performance, and how the individuals' individual journey and various accommodations can regulate this effect. We conclude our paper with a list of inclusive Agile practices, allowing organizations to better support neurodivergent employees and fully leverage their capabilities.

Understanding the interaction of neural and cardiac systems during cognitive activity is critical to advancing physiological computing. Although EEG has been the gold standard for assessing mental workload, its limited portability restricts its real-world use. Widely available ECG through wearable devices proposes a pragmatic alternative. This research investigates whether ECG signals can reliably reflect cognitive load and serve as proxies for EEG-based indicators. In this work, we present multimodal data acquired from two different paradigms involving working-memory and passive-listening tasks. For each modality, we extracted ECG time-domain HRV metrics and Catch22 descriptors against EEG spectral and Catch22 features, respectively. We propose a cross-modal XGBoost framework to project the ECG features onto EEG-representative cognitive spaces, thereby allowing workload inferences using only ECG. Our results show that ECG-derived projections expressively capture variation in cognitive states and provide good support for accurate classification. Our findings underpin ECG as an interpretable, real-time, wearable solution for everyday cognitive monitoring.

In this paper, we describe the research on how perceptual load can affect programming performance in people with symptoms of Attention Deficit / Hyperactivity Disorder (ADHD). We asked developers to complete the Barkley Deficits in Executive Functioning Scale, which indicates the presence and severity levels of ADHD symptoms. After that, participants solved mentally active programming tasks (coding) and monotonous ones (debugging) in the integrated development environment in high perceptual load modes (visually noisy) and low perceptual load modes (visually clear). The development environment was augmented with the plugin we wrote to track efficiency metrics, i.e. time, speed, and activity. We found that the perceptual load does affect programmers' efficiency. For mentally active tasks, the time of inserting the first character was shorter and the overall speed was higher in the low perceptual load mode. For monotonous tasks, the total time for the solution was less for the low perceptual load mode. Also, we found that the effect of perceptual load on programmers' efficiency differs between those with and without ADHD symptoms. This effect has a specificity: depending on efficiency measures and ADHD symptoms, one or another level of perceptual load might be beneficial. Our findings support the idea of behavioral assessment of users for providing appropriate accommodation for the workforce with special needs.

Attention-deficit/hyperactivity disorder (ADHD) is increasingly being diagnosed in both children and adults, but the neural mechanisms that underlie its distinct symptoms and whether children and adults share the same mechanism remain poorly understood. Here, we used a nested-spectral partition (NSP) approach to study the resting-state brain functional networks of ADHD patients (n=97) and healthy controls (HCs, n=97) across the lifespan (7-50 years). Compared to the linear lifespan associations of brain functional segregation and integration with age in HCs, ADHD patients have a quadratic association in the whole brain and in most functional systems, whereas the limbic system dominantly affected by ADHD has a linear association. Furthermore, the limbic system better predicts hyperactivity, and the salient attention system better predicts inattention. These predictions are shared in children and adults with ADHD. Our findings reveal a lifespan association of brain networks with ADHD symptoms and provide potential shared neural bases of distinct ADHD symptoms in children and adults.

Neurodiversity describes brain function variation in individuals, including Attention deficit hyperactivity disorder (ADHD) and Autism spectrum disorder. Neurodivergent individuals both experience challenges and exhibit strengths in the workplace. As an important disorder included under the neurodiversity term, an estimated 5.0% to 7.1% of the world population have ADHD. However, existing studies involving ADHD in the workplace are of general nature and do not focus on software engineering (SE) activities. To address this gap, we performed an exploratory qualitative case study on the experiences of people with ADHD working in SE. We find that people with ADHD struggle with several important SE-related activities, e.g., task organisation and estimation, attention to work, relation to others. Furthermore, they experience issues with physical and mental health. In terms of strengths, they exhibit, e.g., increased creative skills, perform well when solving puzzles, and have the capability to think ahead. Our findings align well with existing clinical ADHD research, and have important implications to SE practice.

Attention Deficit Hyperactivity Disorder (ADHD) remains highly stigmatized in many cultural contexts, particularly in China, where ADHD-related behaviors are often moralized rather than understood as neurodevelopmental differences. As a result, challenges of self-perception, social misunderstanding, and collaboration between ADHD and non-ADHD individuals remain largely unaddressed. We present Misty Forest, a VR-based collaborative game that explores ADHD through asymmetric co-play. The system translates empirically grounded ADHD behavioral patterns -- such as fluctuating attention and time blindness -- into complementary roles that require mutual coordination between players. Rather than compensating for deficits, the design treats cognitive differences as a source of interdependence. In a controlled study with mixed ADHD--non-ADHD dyads, Misty Forest led to higher task completion, increased self-acceptance among ADHD participants, improved ADHD knowledge, and greater empathy among non-ADHD players. These findings suggest that neurodiversity-centered interactive design can foster understanding, reciprocity, and inclusive collaboration.

The brain's attention system is a complex and adaptive network of brain regions that enables individuals to interact effectively with their surroundings and perform complex tasks. This system involves the coordination of various brain regions, including the prefrontal cortex and the parietal lobes, to process and prioritize sensory information, manage tasks, and maintain focus. In this study, we investigate the intricate mechanisms underpinning the brain's attention system, followed by an exploration within the context of augmented reality (AR) settings. AR emerges as a viable technological intervention to address the multifaceted challenges faced by individuals with Attention Deficit Hyperactivity Disorder (ADHD). Given that the primary characteristics of ADHD include difficulties related to inattention, hyperactivity, and impulsivity, AR offers tailor-made solutions specifically designed to mitigate these challenges and enhance cognitive functioning. On the other hand, if these ADHD-related issues are not adequately addressed, it could lead to a worsening of their condition in AR. This underscores the importance of employing effective interventions such as AR to support individuals with ADHD in managing their symptoms. We examine the attentional mechanisms within AR environments and the sensory processing dynamics prevalent among the ADHD population. Our objective is to comprehensively address the attentional needs of this population in AR settings and offer a framework for designing cognitively accessible AR applications.

Adolescents with Attention-deficit/hyperactivity disorder (ADHD) have difficulty processing speech with background noise due to reduced inhibitory control and working memory capacity (WMC). This paper presents a pilot study of an audiovisual Speech-In-Noise (SIN) task for young adults with ADHD compared to age-matched controls using eye-tracking measures. The audiovisual SIN task consists of varying six levels of background babble, accompanied by visual cues. A significant difference between ADHD and neurotypical (NT) groups was observed at 15 dB signal-to-noise ratio (SNR). These results contribute to the literature of young adults with ADHD.

While videos have become increasingly prevalent in delivering information across different educational and professional contexts, individuals with ADHD often face attention challenges when watching informational videos due to the dynamic, multimodal, yet potentially distracting video elements. To understand and address this critical challenge, we designed FocusView, a video customization interface that allows viewers with ADHD to customize informational videos from different aspects. We evaluated FocusView with 12 participants with ADHD and found that FocusView significantly improved the viewability of videos by reducing distractions. Through the study, we uncovered participants' diverse perceptions of video distractions (e.g., background music as a distraction vs. stimulation boost) and their customization preferences, highlighting unique ADHD-relevant needs in designing video customization interfaces (e.g., reducing the number of options to avoid distraction caused by customization itself). We further derived design considerations for future video customization systems for the ADHD community.

ADHD is being recognized as a diagnosis which persists into adulthood impacting economic, occupational, and educational outcomes. There is an increased need to accurately diagnose and recommend interventions for this population. One consideration is the development and implementation of reliable and valid outcome measures which reflect core diagnostic criteria. For example, adults with ADHD have reduced working memory capacity when compared to their peers (Michalek et al., 2014). A reduction in working memory capacity indicates attentional control deficits which align with many symptoms outlined on behavioral checklists used to diagnose ADHD. Using computational methods, such as eye tracking technology, to generate a relationship between ADHD and measures of working memory capacity would be useful to advancing our understanding and treatment of the diagnosis in adults. This chapter will outline a feasibility study in which eye tracking was used to measure eye gaze metrics during a working memory capacity task for adults with and without ADHD and machine learning algorithms were applied to generate a feature set unique to the ADHD diagnosis. The chapter will summarize the purpose, methods, results, and impact of this study.

This paper applies a hidden Markov model to the problem of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis from resting-state functional Magnetic Resonance Image (fMRI) scans of subjects. The proposed model considers the temporal evolution of fMRI voxel activations in the cortex, cingulate gyrus, and thalamus regions of the brain in order to make a diagnosis. Four feature dimen- sionality reduction methods are applied to the fMRI scan: voxel means, voxel weighted means, principal components analysis, and kernel principal components analysis. Using principal components analysis and kernel principal components analysis for dimensionality reduction, the proposed algorithm yielded an accu- racy of 63.01% and 62.06%, respectively, on the ADHD-200 competition dataset when differentiating between healthy control, ADHD innattentive, and ADHD combined types.

Hyperactivity is one of the hallmakrs of ADHD. Aberrant dopamine signaling is a major theme in ADHD and dopamine production is directly linked to the intensity and persistence of hyperactive conduct. The strength and persistence of hyperactivity responses in Drosophila to startle stimuli were measured in a study to determine the effects of sugar on dopamine development. A total of four experimental groups, namely 1%,3%, and 5% glucose, as well as a control group were taken for the diet of Drosophila, and these four different amounts of glucose were introduced to the growth medium where Drosophila was cultured. The movements of Drosophila in the four treatment groups were captured using a camera. This experiment was carried out five times, each time using a different batch of Drosophila. Each group's average velocity over time was also reported. The web adaptation of Drosophila Activity Monitor(DAM) was used to analyze the captured movies from the camera. Furthermore, when it came to hyperactivity persistence, all four treatment classes were statistically different (p0.05). Since the strength and persistence of hyperactive behavior are directly correlated to dopamine output, this study shows that higher glucose intake is associated with more hyperactivity, for both the intensity(ΔV) and persistence.

We propose that dACC, AI and caudolateral OFC(clOFC) project to lateral habenula (LHb) and D2 loop of ventral striatum (VS), forming a functional adversity processing circuit, directed towards inhibitory avoidance and self-control. This circuit learns what is bad or harmful to us and predicts risks, to stop us from going/moving for bad or suboptimal choices that decrease our well-being and survival chances. Proposed dACC role is to generate a WARNING signal when things are going (or might end) bad or wrong to prevent negative consequences: pain, harm, loss or failure. The AI signals about bad low aversive qualities, which make us sick or cause discomfort. These cortical inputs activate directly and indirectly (via D2 loop of VS) the LHb, which inhibits dopamine and serotonin release (and is reciprocally inhibited by VTA, DRN) to avoid choosing and doing things leading to harm or loss, but also to make us feel worse, down when overstimulated. We propose that dopamine attenuates the output of the adversity processing circuit, thus decreasing inhibitory avoidance and self-control, while serotonin attenuates dACC, AI, clOFC, D1 loop of VS, LHb, amygdala and pain pathway. Thus, by reciprocal inhibition, by causing dopamine and serotonin suppression - and by being suppressed by them, the adversity processing circuit competes with reward processing circuit for control of choice behaviour and affective states. We propose stimulating effect of dopamine and calming inhibitory effect of serotonin on the active avoidance circuit involving amygdala, linked to threat processing, anger, fear, self-defense and violences. We describe causes and roles of dopamine and serotonin signaling, and mental dysfunctions. We add new idea on vACC role in signaling that we are doing well and in inducing serotonin, when we gain/reach safety, comfort, valuable resources, social/biological rewards, affection or goals.

Current theories from biosocial (e.g.: the role of neurotransmitters in behavioral features), ecological (e.g.: cultural, political, and institutional conditions), and interpersonal (e.g.: attachment) perspectives have grounded interpersonal and romantic relationships in normative social experiences. However, these theories have not been developed to the point of providing a solid theoretical understanding of the dynamics present in interpersonal and romantic relationships, and integrative theories are still lacking. In this paper, mathematical models are use to investigate the dynamics of interpersonal and romantic relationships, which are examined via ordinary and stochastic differential equations, in order to provide insight into the behaviors of love. The analysis starts with a deterministic model and progresses to nonlinear stochastic models capturing the stochastic rates and factors (e.g.: ecological factors, such as historical, cultural and community conditions) that affect proximal experiences and shape the patterns of relationship. Numerical examples are given to illustrate various dynamics of interpersonal and romantic behaviors (with emphasis placed on sustained oscillations, and transitions between locally stable equilibria) that are observable in stochastic models (closely related to real interpersonal dynamics), but absent in deterministic models.

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder with limited objective diagnostic tools, highlighting the urgent need for objective, biology-based diagnostic frameworks in precision psychiatry. We integrate urinary metabolomics with an interpretable machine learning framework to identify biochemical signatures associated with ADHD. Targeted metabolomic profiles from 52 ADHD and 46 control participants were analyzed using a Closest Resemblance (CR) classifier with embedded feature selection. The CR model outperformed Random Forest and K-Nearest Neighbor classifiers, achieving an AUC > 0.97 based on a reduced panel of 14 metabolites. These metabolites including dopamine 4-sulfate, N-acetylaspartylglutamic acid, and citrulline map to dopaminergic neurotransmission and amino acid metabolism pathways, offering mechanistic insight into ADHD pathophysiology. The CR classifier's transparent decision boundaries and low computational cost support integration into targeted metabolomic assays and future point of care diagnostic platforms. Overall, this work demonstrates a translational framework combining metabolomics and interpretable machine learning to advance objective, biologically informed diagnostic strategies for ADHD.