Objective: To assess the association between nonsyndromic craniosynostosis (NSC) and academic achievement. Methods: Registry data were analyzed on demographic background, presence of craniosynostosis and other comorbidities, grades, and results on national standardized tests (NSTs) across primary and upper secondary school, as well as the presence of academic degrees. The analysis used regression modeling on a sample of N = 1110 individuals with NSC and a matched cohort of N = 10,654 individuals. Results: There was a significant negative association between NSC and NST scores in third grade for both mathematics (aOR 0.76, 95% CI 0.60–0.99, p = .020) and Swedish (aOR 0.69, 95% CI 0.54–0.89, p = .004). The association seemed to primarily be carried by females with NSC (aORs for the interaction term 0.26–0.45, all ps <.05). Further, a slightly stronger negative association was observed in individuals with psychiatric comorbidities (aOR 0.44, 95% CI 0.22–0.90, p = .025 for mathematics; aOR 0.45, 95% CI 0.21–0.98, p = .045 for Swedish). No statistically significant association was found between NSC and NST scores or grades in later school years, or with academic degrees. Conclusions: There is evidence for a limited temporary negative association between NSC and academic achievement. A stronger negative association between NSC and academic achievement seems to be present in girls, and for individuals with psychiatric comorbidities. This has important implications for clinical management and provision of support in educational contexts.

Objective: ADHD is often a lifelong condition, and has grown increasingly prevalent over the past few decades. Adolescence is a period characterized by the quest to develop a coherent identity, yet relatively little research has examined the relationship between ADHD diagnosis and identity. The purpose of this study was to explore the importance of experiences of the healthcare system and of peer relationships in the identity formation of adolescents with ADHD.

Method: This was investigated through semi-structured interviews with 10 adolescents (n = 8 females and 2 males) aged 15 to 18 years. An inductive thematic analysis was conducted within a narrative framework.

Results: The results revealed seven main themes indicating that ADHD played a central role in the adolescents’ self-narratives: (1) limited effect of Child and Adolescent Psychiatry (CAP) contact on identity formation, (2) the ADHD concept as meaning-making, (3) heterogeneity of the role of medication on identity formation, (4) negotiation of identity in relation to others, (5) varying degrees of acceptance in different relationships, (6) perceiving oneself as a troublemaker, and (7) relationship difficulties.

Conclusions: Overall, the diagnosis constituted an important narrative and symptoms of ADHD rather than the label of ADHD tended to be stigmatizing. Furthermore, medication affected identity, and some felt pressured to medicate to adhere to social norms. A common pattern was that adolescents set aside their individual identity in favor of their relational identity.

Objective: The number of ADHD diagnoses is increasing sharply in Sweden, leading to significant strain on the child and adolescent psychiatry (CAP). The increase appears to be multifactorial and partly due to changes in diagnostic procedures and society. Heightened academic demands, fast-track assessments, popularization of ADHD, medicalization, and low stigma are proposed contributors. The perspectives of clinicians are lacking. Therefore, we investigated psychologists’ experiences of assessing ADHD within the CAP and how their experiences relate to the increase.

Method: Focus group interviews were conducted at three CAP clinics with 16 clinicians (5 men/11 women; Mage = 33 years) who currently worked with ADHD assessments. The data were analyzed using thematic analysis.

Results: The analysis resulted in three themes: High Load revolves around the long queues, high production demands, and how the short, conveyor-belt contacts with patients lead to ethical stress. Imprecise assessments concerns how assessments are largely based on second-hand information, the lack of objective methods, the increasingly brief assessments, and impressions that the high patient/parent demands for diagnosis contribute to ‘arranged’ medical histories in line with the preferred diagnosis. Pressure to diagnose concerns the expectations for a diagnosis from parents and patients, as well as the clinicians’ own impressions of what is best for the child. It is easier to diagnose ADHD in doubtful cases than to risk ‘depriving’ a child of the interventions that a diagnosis often leads to.

Discussion: There are clear indications of risk of overdiagnosis at the CAP in Sweden, despite the fact that the clinicians express that they are aware of and do not want to contribute to overdiagnosis. The CAP and society face significant challenges to avoid hollow out the validity of the ADHD diagnosis. To maintain proper assessments is important for patient safety and for the clinicians’ work environment.

Objectives: The current study examined the relation between self-rated and parent- and clinician-rated symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), by estimating rater agreement and rater differences, and whether these differed between the sexes.

Method: The sample included N = 159 adolescents with ADHD aged 15–18 years (M^age = 16.59 years, SD = .92) of which n = 58 (36.5 %) were males. Symptoms were assessed using self- and parent-ratings with the adult ADHD Self-Report Scale for Adolescents, whereas clinicians rated symptoms using the Mini International Neuropsychiatric Interview for children and adolescents conducted with the adolescents and their parent. We used intra-class correlation coefficients (ICC) to assess rater agreement and t-tests to assess differences.

Results: Males rated fewer symptoms compared to their parents and clinicians, whereas females’ self-ratings did not differ from parent and clinician ratings. Relatedly, females were in higher agreement with parents and clinicians compared to males. Females had a higher symptom severity than males in self-ratings and clinician-ratings, but not in parent-ratings. Adolescents were in higher agreement with clinicians than parents.

Conclusions: Our results indicate that adolescent males with ADHD may underestimate their symptoms whereas females may have more insight into their symptoms when compared to other raters. Adolescents are important raters of their own ADHD symptoms and their perspectives need to be taken into account in diagnostic assessments.

Background People with Williams syndrome (WS) face challenges in various areas of cognitive processing, including attention. Previous studies suggest that these challenges are particularly pronounced when disengagement of attention from a previously attended stimulus is required, as compared to shifting attention without the need to disengage. Difficulties with attention could in turn be implicated in several of the behavioral characteristics of WS. Here, disengagement and shifting of visual attention, together with pupil dilation, were independently assessed in one of the largest eye-tracking studies of WS to date.

Methods We investigated shifting, disengagement, and the effects of auditory alerting cues on pupil dilation in WS individuals (n = 45, age range = 9–58 years), non-WS individuals with intellectual disability (ID) (n = 36, age range = 6–59 years), and typically developed (TD) infants (n = 32, age range = 6–7 months), children and adults (n = 31, age range = 9–60 years), using a modified gap-overlap task. Data were analyzed using linear mixed-effect models (LMMs).

Results Individuals with WS were less likely to shift their attention to upcoming targets than TD individuals (all ages), but more likely than the ID group to do so. When they did shift attention, participants with WS and ID were slower to initiate a gaze shift than TD participants regardless of whether disengagement was needed. In the WS group, failure to shift attention was strongly predicted by higher arousal (pupil dilation), which was induced by auditory alerting cues.

Conclusions Contrasting with previous theories of attention in WS, we found no evidence for a specific challenge in disengaging attention. Instead, our results point to a more general challenge in shifting attention. Reduced attention shifting in WS may be partly explained by atypical arousal regulation. These results contribute to our understanding of the WS phenotype.

Currently, diagnostic criteria for ADHD mainly reflect behavioral symptoms, neglecting internal phenomena like mind-wandering. Recent studies found that mind-wandering explains impairment beyond ADHD symptoms in adults. To better capture ADHD-related impairment in adolescents, we aimed to elucidate whether mind-wandering is associated with impairments that are prevalent in adolescents (i.e., risk-taking behavior, homework problems, emotional dysregulation, and general impairment) beyond ADHD symptoms. Furthermore, we sought to validate the Dutch translation of the Mind Excessively Wandering Scale (MEWS). We assessed a community sample of 626 adolescents on ADHD symptoms, mind-wandering, and the impairment domains. The Dutch MEWS had good psychometric properties. Mind-wandering was linked to general impairment and emotional dysregulation beyond ADHD symptoms, but was not linked to risk-taking behavior and homework problems beyond ADHD symptoms. Internal psychological phenomena such as mind-wandering may add to the behavioral symptoms of ADHD in explaining part of the impairment that adolescents with ADHD characteristics experience.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience difficulties with emotion regulation, but treatment alternatives remain limited. This study investigates the feasibility and effectiveness of a newly developed psychological intervention aiming to increase emotion regulation skills in adolescent ADHD. A single-case experimental design with multiple baselines across participants was employed. Seven girls aged 13–17 years with ADHD completed the intervention. Outcomes of feasibility included attrition and retention rates, therapist-rated adherence, homework completion and engagement with the intervention material, as well as self- and caregiver ratings of client satisfaction and adverse outcomes. Primary outcomes of emotion dysregulation included weekly self- and caregiver ratings of the Difficulties in Emotion Regulation Scale Short Form during baseline, the intervention and a follow-up period of 2 weeks. Data was analyzed through descriptive statistics, visual inspection and effect size (Tau). The intervention was deemed feasible, although homework completion and engagement between sessions proved challenging. Six adolescents and caregivers reported lower emotion dysregulation after the intervention. However, six adolescent and four caregiver ratings demonstrated improvement before the intervention during baseline, complicating determination of intervention effects. Nevertheless, four participants showed a visual and/or statistical improvement from the intervention. Sensitivity analyses suggest that the intervention may have positive effects on emotional clarity.

Past results suggest that fear extinction and the return of extinguished fear are compromised in adolescents. However, findings have been inconclusive as there is a lack of fear extinction and extinction retention studies including children, adolescents and adults. In the present study, 36 children (6–9 years), 40 adolescents (13–17 years) and 44 adults (30–40 years), underwent a two-day fear conditioning task. Habituation, acquisition, and extinction were performed on the first day and an extinction retention test > 24 h later. Skin conductance responses were recorded during all phases of fear conditioning and functional magnetic resonance imaging (fMRI) was conducted during the fear retention test. All groups acquired and extinguished fear as measured with SCR, with no group differences in SCR during extinction retention. The groups had largely similar neural fear responses during the retention test, apart from adolescents displaying stronger amygdala fear response than children, with no differences between adolescents and adults. The findings do not support an adolescent extinction dip, and there was only marginal evidence of progressive changes in fear conditioning across development. In contrast to findings in rodents, fear conditioning in humans may elicit similar physiological responses and recruit similar neural networks from childhood to adulthood.

The number of individuals diagnosed with ADHD is rapidly increasing in Sweden, with approximately two-thirds of diagnosed children being boys. However, among older adolescents, ADHD now appears to be more common among girls. Despite this, girls remain an understudied group. The purpose of this study was to explore how girls with ADHD described their identity work amid the tension between norms of socially appropriate female behavior (conceptualized as the Me) and their true selves (conceptualized as the I). Ten participants aged 15 to 18 years were included. A thematic inductive analysis was conducted, complemented by an abductive approach incorporating a dramaturgical perspective and the concepts of Me and I, impression management, and social camouflaging. The findings broaden the understanding of identity work among girls with ADHD through four analytical themes: adjusting and suppressing behavior, navigating emotions and stereotypes, struggles in the school context, and the impact of medication. The results highlighted how participants struggled to conform to the roles expected by society, particularly within the school system. In their identity work, they also navigated the emotions that arose when confronted with the school’s idealized role model of a “female student.” Stereotypical thinking further extended to perceptions of the ADHD diagnosis. The school system played a significant role in shaping identities and influencing the participants’ experiences and self-perceptions. This process was reported to be both demanding and challenging. Schools often initiated the ADHD assessments. Following diagnosis, medication was prescribed, which, while offering some benefits from an educational perspective, also came at a cost. The price to be paid was an identity transformation—becoming someone other than who they truly were. This process infused their identity work with reflections on who they really were versus who they were expected to be in a society that places high value on academic achievement and performance. From a Swedish ADHD perspective, social factors—such as roles, norms, standards, and ideals—must be considered in relation to the rising number of diagnoses. There may be a tendency to quickly seek medical explanations for deviant behavior, particularly in school settings, which can profoundly impact identity work, especially for girls on the ADHD spectrum. Some solutions may lie beyond the medical approach and instead be sought in organizational, pedagogical, and resource-based changes. Considerably more research is needed on the understudied group of girls with ADHD to better understand their identity work and the role of both society and schools in the increasing prevalence of diagnoses.

Introduction: Attention-Deficit/Hyperactivity Disorder (ADHD) in girls and women is under-recognised and under-researched, despite increasing awareness of clinical challenges and unmet needs. This review by the Eunethydis Special Interest Group on Female ADHD, addresses current knowledge and identifies research gaps for future work. Issues in women with ADHD across the lifespan such as late diagnosis, pubertal development, sexual health, hormonal birth control, executive function difficulties, and gynaecological disorders associated with ADHD are highlighted.

Methods: The review synthesises existing literature and self-reported experiences of women with ADHD to explore the impact of hormonal fluctuations [puberty, menstrual cycle, pregnancy, (peri)menopause] on ADHD symptoms and mood disturbances. It examines the interplay of oestrogen and progesterone with dopaminergic pathways, when periods of lower oestrogen may affect cognition, as well as the manifestation of executive function deficits, and the intersection of ADHD with reproductive health.

Results: Hormonal transitions exacerbate ADHD symptoms and mood disturbances, yet pharmacological research and tailored treatments are lacking. Executive function deficits manifest differently in girls and women with ADHD and are influenced by neuropsychological and neurobiological profiles. Diagnostic practices and sociocultural factors contribute to delayed diagnoses, increasing the risk of comorbidities, impaired functioning, and diminished quality of life. Undiagnosed women have increased vulnerability to premenstrual dysphoric disorder, postpartum depression, and cardiovascular disease during perimenopause.

Discussion: Longitudinal, sex-specific studies incorporating hormonal status and lived experience are needed. Individualised interventions should be developed to address the unique needs of girls and women with ADHD. Addressing these gaps will advance more equitable diagnosis, management, and support for girls and women with ADHD, improving outcomes across the female lifespan.