How my ADHD hides my autism

“Being an autistic ADHDer (or “AuDHDer”) has its upsides and downsides, but in this video, I want to talk about the ways that my ADHD traits hide my autistic traits.”

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Understanding neurodiversity across the general population

A new study has provided insight into how experiences and features of neurodiversity vary amongst adults.

There is variation in people’s attributes and experiences across all populations. Neurodivergent people, such as people with a diagnosis of ADHD, dyslexia, dyspraxia, or autism, may experience the world in distinctive ways. But, we are only beginning to appreciate how traits and experiences associated with neurodivergence differ across the whole population.

New research from the University of Birmingham has provided a more detailed picture of what neurodiversity looks like amongst adults in the UK.

Ian Apperly, Professor of Cognition and Development and Director of the Centre for Developmental Science at the University of Birmingham, who led the study said: “People’s experiences of neurodevelopmental conditions are highly variable, and it is common for people to have more than one condition. Previous research has found, for example, that the prevalence of ADHD among autistic people is around 40%.

“We also know that people show traits associated with neurodiversity to varying extents across the entire population; it’s not just people with a diagnosed neurodevelopmental condition whose experience is influenced by these traits. What we don’t have, is a detailed understanding of what this looks like. This raises important questions that can inform our understanding of the complexity of neurodiversity across the general population.”

Professor Apperly and his team asked 1000 people representative of the UK population aged 18-70 to report on their experiences of characteristics commonly associated with autism, ADHD, dyslexia, and other conditions. For example:

  • High scores for characteristics associated with autism were linked with experiences of challenges with social and imaginative skills, higher preference for routines, and attention to details, numbers, and patterns.
  • High scores for characteristics associated with ADHD were linked with tendencies for inattentiveness, hyperactivity and impulsiveness.
  • High scores in cortical hyperexcitability were connected with visual sensitivity, and unusual visual experiences.
  • High scores for characteristics associated with dyslexia were linked with lower fluency with reading and word-finding.

Although characteristics associated with different neurodevelopmental conditions are often considered separately, the research found that when examined at the same time there were high levels of overlap, so people reporting high characteristics for one condition, also tended to report experiences associated with other conditions.

However, the research also found evidence of distinctive characteristics associated with specific conditions, above and beyond this general shared neurodiversity.

Professor Apperly explained: “We found that there is considerable overlap in the broader characteristics associated with different neurodevelopmental conditions so that people with higher levels of characteristics associated with one condition (e.g., ADHD) are also more likely to have higher levels of characteristics associated with other neurodevelopmental conditions (e.g., autism, dyslexia, dyspraxia, tic disorders).  But we also discovered that the same traits can be explained by different underlying causes. For example, some people reported high levels of several traits associated with autism, even though they did not report high levels of neurodivergent characteristics overall, while other people reported high levels of autistic traits alongside high levels of traits associated with other conditions. And some combinations were particularly unusual. For example, people showing high levels of traits associated with dyslexia and dyspraxia tended not to show high interest in numbers and patterns.”

This study is the largest examination to date to explore the diversity in how characteristics relating to neurodevelopmental conditions are expressed amongst adults in the UK. The researchers say that it has provided critical benchmark data and a framework approach for examining neurodiversity in the whole population, including people with one or more diagnoses.

Professor Apperly concluded: “Our findings help make sense of the complexity of neurodiversity. They help us understand characteristics and experiences that might be common across neurodevelopmental conditions, as well as those that are distinctive. The study also helps us understand how two people with the same diagnosis might nonetheless have rather different characteristics and experiences. By providing a picture of how neurodiversity appears across the whole population, this research can go on to inform improvements for future studies in this area. The more we know about other people’s experiences, the better we can understand each other.”

Genetic risks of autism and ADHD may be related to more screen time in children.

"Limiting children's screen time linked to better cognition," reports BBC News.
“Limiting children’s screen time linked to better cognition,” reports BBC News.

A team led by Nagoya University Graduate School of Medicine in Japan has investigated screen time in autistic and ADHD children. Screen time refers to a person’s time on a device with a screen, such as a smartphone, computer, television, or video game system. The researchers found that children with a genetic predisposition to autism were likelier to use screens for longer periods. Meanwhile, children with ADHD gradually increased their screen time as they grew older, even if their initial screen use time was short. They published their results in the journal Psychiatry Research

People are increasingly spending time looking at their digital devices’ screens. This is especially true for children with neurodevelopmental disorders who use screens for longer periods.  

Recognizing this issue, researchers from Nagoya University and Hamamatsu University examined 6.5 million polymorphisms in 437 children’s DNA to determine the genetic tendency to autism and ADHD. Next, they calculated a genetic risk index that considers the number and size of the effects of changes in genes associated with autism/ADHD. This is known as a “polygenic risk score”. The researchers then compared the amount of time spent using screen devices among a sample of children aged 18, 32, and 40 months.  

They found that children with a higher genetic susceptibility to autism used devices with screens longer (3 hours or 4+ hours a day) from early childhood. They also found that kids with a high genetic risk of ADHD gradually increased their screen time as they grew older.  

The lead researcher, Dr Nagahide Takahashi of Nagoya University, explained: “Overall, those with a genetic risk of autism were 1.5 times more likely to be in the group with about three hours of screen time per day, and 2.1 times more likely to be in the group with more than four hours of screen time.” 

“While long periods of screen time in childhood have been suggested to be a cause of autism/ADHD, the results of this study suggest that some people may have a genetic disposition to use screens because of autsm,” he said. “Screen time may be an early sign of autism , rather than a cause, as children with autismare often more attracted to objects than people. Physicians should know that it is not fair to conclude that prolonged screen time is a risk factor for the development of autism .”  

Takahashi also cautions against overexposing children with ADHD to device screens. “Our results suggest that children at risk of ADHD are at risk of having too much screen time, especially since gaming addiction is common. As screen time tends to be longer for children who are particularly susceptible to ADHD, parents and caregivers should be cautious about it and commit before it becomes a problem.” 

These results may also help parents devise better child-rearing strategies. “Parents of children with neurodevelopmental disorders may feel guilty or be criticized by others for allowing their children screen time,” Takahashi said. “However, we would recommend offering help to caregivers including offering alternative behavioral management strategies.”  

Adults with ADHD are at increased risk for developing dementia

Adults with ADHD are at increased risk for developing dementia
Rutgers researcher explores ADHD’s link to dementia and if risks can be mitigated with ADHD treatment

Adults with attention-deficit/hyperactivity disorder (ADHD) are nearly three times more likely to develop dementia than adults without ADHD, according to a Rutgers study.

The study, coauthored by Michal Schnaider Beeri, director of the Herbert and Jacqueline Krieger Klein Alzheimer’s Research Center at Rutgers Brain Health Institute (BHI) was published in JAMA Network Open. It followed more than 100,000 older adults in Israel over 17 years to examine if adults with ADHD are at increased risk for dementia, including Alzheimer’s disease.

Although more than 3 percent of the adult population in the United States has ADHD, there is limited research on this group.

“By determining if adults with ADHD are at higher risk for dementia and if medications and/or lifestyle changes can affect risks, the outcomes of this research can be used to better inform caregivers and clinicians,” said Beeri, the Krieger Klein Endowed Chair in Neurodegeneration Research at BHI and a faculty member of the Rutgers Institute for Health, Health Care Policy and Aging Research.

Using data from a national cohort study of more than 100,000 people who were followed from 2003 to 2020, researchers analyzed those with and without ADHD and the occurrence of dementia among the groups as they aged. Researchers found the presence of adult ADHD was associated with a significantly higher risk of dementia even when other risk factors for dementia were taken into account, such as cardiovascular conditions.

ADHD in adults may materialize as a neurological process that reduces the ability for them to compensate for the effects of cognitive decline later in life, researchers said.

“Physicians, clinicians and caregivers who work with older adults should monitor ADHD symptoms and associated medications,” said Abraham Reichenberg, a professor at the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai and senior author of the study.

“Symptoms of attention deficit and hyperactivity in old age shouldn’t be ignored and should be discussed with physicians,” said Stephen Levine, a professor at the School of Public Health at the University of Haifa.

Additionally, the research suggests ADHD treatment incorporating psychostimulants may help reduce the risk of dementia in adults with ADHD as psychostimulants are known to modify the trajectory of cognitive impairment. But researchers said future studies should examine in more detail the impact of medications in patients with ADHD and how they could affect risk.

The link between mental health and ADHD is vital – so why aren’t we paying attention?

ADHD
ADHD

Adults with high levels of attention-deficit hyperactivity disorder (ADHD) symptoms are more likely to experience anxiety and depression than adults with high levels of autistic traits, according to new research led by psychologists at the University of Bath in the UK.

This study is the first to show that ADHD predicts poor mental health outcomes in adults more than other neurodevelopmental conditions, like autism.

Until now, there has been a dearth of information on the effects of ADHD on poor mental health, with far more research focusing on the impact of autism on depression, anxiety and quality of life. As a result, people with ADHD often struggle to access the clinical care they need to cope with their symptoms.

The study’s authors hope their findings will trigger new research into ADHD and ultimately improve the mental health outcomes for people with the condition. ADHD is a neurodevelopmental condition characterised by inattention and/or hyperactivity and impulsivity. The condition is estimated to affect between 3% and 9% of the population.

Blue Monday

Speaking on Blue Monday (January 16) – the third Monday of January, described by some as the gloomiest day of the year – lead researcher, Luca Hargitai, said: “Scientists have long known that autism is linked to anxiety and depression, but ADHD has been somewhat neglected.

“Researchers have also struggled to statistically separate the importance of ADHD and autism for mental health outcomes because of how frequently they occur together.”

Ms Hargitai, a PhD Researcher at Bath, added: “Our aim was to precisely measure how strongly ADHD personality traits were linked to poor mental health while statistically accounting for autistic traits.”

The new research – a collaborative effort between the Universities of Bath, Bristol and Cardiff, and King’s College London – is published this week in the prestigious journal Scientific Reports. It comes in the same month that two British TV personalities – Johnny Vegas and Sue Perkins – have opened up about their recent diagnoses of ADHD.

“The condition affects many people – both children and adults – and the fact that more people are willing to talk about it is to be welcomed,” said Ms Hargitai. “The hope is that with greater awareness will come more research in this area and better resources to support individuals in better managing their mental health.”

Overly active, as though driven by a motor

The study used a large, nationally representative sample of adults from the UK population. All participants completed gold standard questionnaires – one on autistic traits, the other on ADHD traits – responding to statements such as “I frequently get strongly absorbed in one thing” and “How often do you feel overly active and compelled to do things like a motor drove you?”

The researchers found that ADHD traits were highly predictive of the severity of anxiety and depression symptoms: the higher the levels of ADHD traits, the more likely a person is to experience severe mental health symptoms. Through innovative analytical techniques, the study authors further confirmed that having more of an ADHD personality was more strongly linked to anxiety and depression than autistic traits.

These results were replicated in computerised simulations with a 100% ‘reproducibility rate’. This showed, with great confidence, that ADHD traits are almost certainly linked to more severe anxiety and depression symptoms in adults than autistic traits.

Shifting the focus of research and clinical practice

Ms Hargitai said: “Our findings suggest that research and clinical practice must shift some of the focus from autism to ADHD. This may help to identify those most at risk of anxiety and depression so that preventative measures – such as supporting children and adults with the management of their ADHD symptoms – can be put in place earlier to have a greater impact on improving people’s wellbeing.”

According to Dr Punit Shah, senior author and associate professor of Psychology at Bath, another important aspect of the new study is that it advances scientific understanding of neurodevelopmental conditions.

“By addressing the shortcomings of previous research, our work provides fresh information about the complex links between neurodiversity and mental health in adults – an often overlooked area.

“Further research is now needed to delve deeper into understanding exactly why ADHD is linked to poor mental health, particularly in the mental processes that might drive people with ADHD traits to engage in anxious and depressive thinking.

“Currently, funding for ADHD research – particularly psychological research – is lacking. This is significantly pronounced compared to the relatively high funds directed at autism.

“As the evidence becomes clear that ADHD isn’t just a childhood condition but persists throughout life, we must adjust our research agendas to understand ADHD in adulthood better.”

Commenting on the new findings, Dr Tony Floyd, CEO of ADHD Foundation, The Neurodiversity Foundation, said: “This research demonstrates clear evidence of the increased risks of mental health comorbidities associated with adult ADHD. This is a step towards recognising the broader impact of unmanaged and untreated ADHD. We hope this research will lead to more commissioned research in this area. We also hope it will result in changes to the design and delivery of health services.

“The cost implications to the NHS of leaving ADHD untreated, and the need to better train health practitioners in primary and secondary care, are now more apparent. And of course, there are other costs too that need to be considered – to the health of UK citizens with ADHD and to their family life, employability and economic well-being. These costs are often hidden, but they are considerable.

“This research from Bath University will add to the growing national debate and the business case for a national review of health services for ADHD across a person’s lifespan.”