1. Aghaei Bajestan S, Rasouli A, Sørensen L, Doosalivand H. The impact of ADHD symptoms on insomnia severity in adolescents: the mediating role of emotion dysregulation, self-compassion, and experiential avoidance. BMC Psychiatry. 2026.

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2. Demas A. Rethinking ADHD as a neurointestinal syndrome: a gut-brain-parasite hypothesis. Front Neurosci. 2025; 19: 1694628.

Neurodevelopmental conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD) are usually framed as brain-based disorders driven by genetics and neurotransmitter imbalance. At the same time, converging evidence implicates the gut-brain axis and intestinal immunity in shaping cognition and behavior. In this Hypothesis and Theory article, I propose that a subset of ADHD and related neurodivergent profiles can be usefully conceptualized as neurointestinal syndromes, emerging from co-evolutionary interactions between the gut microbiota, intestinal parasites, and host immunity. Drawing on data from ADHD, autism spectrum conditions, and migraine, I synthesize evidence for altered microbiota, increased intestinal permeability, and low-grade inflammation in neurodivergent individuals, and discuss how these changes may bias tryptophan metabolism, vagal signaling, and large-scale brain networks. I then explore a speculative evolutionary scenario in which recurrent helminth exposure, historically ubiquitous, acted as a long-term ecological force shaping gut architecture, immunoregulation, and stress responsivity. Chronic parasitic pressure, combined with microbial metabolites and epigenetic imprinting, may have contributed to the emergence of attentional profiles characterized by hypervigilance, novelty seeking, and rapid switching-traits that could have been advantageous in ancestral, pathogen-rich environments but are often maladaptive in modern settings. This framework does not romanticize ADHD nor deny its frequent clinical burden. Rather, it reframes some ADHD phenotypes as possible mismatch syndromes involving the gut-brain axis, generated when an evolutionarily tuned intestinal and immune architecture is placed in sanitized, post-industrial ecologies. Clinically, this perspective supports continued use of established CNS-targeted treatments while motivating complementary research into microbial, barrier, and vagal interventions as potential adjuncts for carefully defined ADHD subgroups.

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3. Derin S, Selman SB, Ergun AF, Ecer-Ergun T. Indirect and Conditional Associations Between ADHD and Risky Internet Use in Elementary School Children With Parent-child Conflict and Maternal Childhood Trauma. Res Child Adolesc Psychopathol. 2026; 54(1): 17.

Prior work links Attention-Deficit/Hyperactivity Disorder (ADHD) with risky internet use (RIU), yet the family and intergenerational processes that might underlie this association remain uncertain. This study examined whether the ADHD-RIU association was statistically accounted for by parent-child conflict and whether maternal childhood trauma moderated these associations. The sample comprised 120 children aged 6-12 years (58% boys, M = 8.73, SD = 1.80), including 60 with a first-time ADHD diagnosis and 60 controls. Standardized parent- and self-report measures were used to assess RIU, parent-child conflict, and maternal childhood trauma. A dual first- and second-stage moderated mediation model (PROCESS Model 58) tested whether the ADHD-RIU association was linked to parent-child conflict and whether maternal trauma moderated both the ADHD-conflict and conflict-RIU associations. Analyses statistically controlled for child sex, age, parental education, and maternal depression and anxiety. ADHD status was significantly associated with parent-child conflict (0.75, 95% CI [0.42, 1.08]), which was significantly associated with RIU (0.42, 95% CI [0.22, 0.62]). Conditional indirect associations via conflict at low (-1 SD), mean, and high (+ 1 SD) levels of maternal childhood trauma were 0.17, 0.31, and 0.49, respectively, indicating a stronger association at higher trauma levels, while no significant direct ADHD-RIU association remained after accounting for conflict. Findings suggest that the ADHD-RIU link was largely shared with parent-child conflict, and this shared association was more pronounced when mothers reported higher trauma histories. These findings highlight potential relevance for trauma-informed, family-focused approaches that address conflict when considering RIU in children with ADHD.

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4. Gregorio MV, Abdollahipour R, Valtr L, Hannesdóttir DK, Palomo-Nieto M, Ramón-Otero I. Providing choice boosts immediate force production in adolescents with ADHD. Hum Mov Sci. 2026; 106: 103463.

Children and adolescents with attention deficit hyperactivity disorder (ADHD) often struggle with motor skill performance, which can reduce their participation in sports and physical activities. This may be due to a lack of personal relevance and a sensitivity to controlling environments that reduce motivation. Since autonomy support has been shown to enhance motor performance across different motor tasks and populations, this study aimed to investigate its effects on the immediate motor performance of adolescents with ADHD during a maximum force production task. Twenty-six adolescents aged 13 to 15 (mean age = 14.1 years, 20 boys and 6 girls) participated in a within-subjects experimental design, where each performed six maximum force attempts (three attempts each hand) using a dynamometer under two conditions: choice and no-choice. In the choice condition, participants selected the order in which they used their preferred and non-preferred hands, while in the no-choice condition, they completed six attempts in an order that matched the sequence chosen by the previous participant. A 20-s rest was given between each attempt. Once participants had finished six attempts in each condition, they were asked to fill out the Intrinsic Motivation Inventory. The results showed that maximum force production, as well as self-reported interest/enjoyment, and perceived competence, were all higher in the choice condition compared to the no-choice condition. No significant differences were found in the perception of choice or pressure/tension. These findings suggest that even small opportunities for autonomy-support can improve motor performance and positively influence factors that predict intrinsic motivation specifically, interest/enjoyment and perceived competence, in adolescents with ADHD.

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5. Kassaw C, Meshcheriakova A, Yenealem Mekuriaw B, Demareva V. Prevalence and associated factors of ADHD symptoms among higher education students in Southern Ethiopia. Front Psychiatry. 2025; 16: 1566847.

INTRODUCTION: Adult Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental condition originating in childhood, manifests as persistent inattention and/or hyperactivity-impulsivity, affecting occupational and daily functioning. This study examined the prevalence and associated factors of ADHD symptoms among higher education students in southern Ethiopia, aiming to elucidate the challenges faced by this population and inform targeted support strategies. METHODOLOGY: This cross-sectional study was conducted from November to December 2024 among undergraduate students at Dilla University. ADHD symptom severity was assessed using the self-reported Adult ADHD Self-Report Scale (ASRS-v1.1). A random sampling technique was employed to select participants, and a self-administered questionnaire was used to collect data. Descriptive statistics were used to summarize the results, and multivariate logistic regression analysis was performed to identify variables associated with ADHD symptoms. RESULTS: A total of 513 respondents participated in the current study. Of all respondents, 218 (42%) were female. The mean grade point average (GPA) of respondents was 3.43, and 218 (42%) scored above this average. The prevalence of High ADHD symptoms among these higher education students was 25.1% (95% CI: 22.1%-27.7%). Compared to students with low ADHD symptoms, students with High symptoms were more likely to live in rural areas, have a current grade point average (GPA)< 3.43, study for less than four hours during exam periods, have a history of childhood infections, experience greater test anxiety, show poor cognitive function scores, and engage in high social media use. CONCLUSIONS: This study revealed that one in four students experienced High ADHD symptoms, and identified some of the associated potentially modifiable factors among university students attending Dilla University, southern Ethiopia. These findings suggest the need to screen for ADHD symptoms and explore their role in the academic success of university students. Interventions should address psychosocial and cognitive aspects of academic outcomes in higher education students in low-resource settings. Moreover, multicenter and interventional studies with larger samples are warranted to validate these results and optimize intervention strategies.

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6. Liu Y, Ge H, Shu Y, Wu M. Associations of environmental tobacco smoke with ADHD and executive function in early adulthood: results from a cross-sectional study. Front Psychiatry. 2025; 16: 1733240.

BACKGROUND: Secondhand smoke (SHS) and thirdhand smoke (THS) have been shown to increase the risk of physical health and mental health. However, the impact of SHS and THS exposure on ADHD symptoms and executive function remain to be elucidated. METHODS: Online surveys were used to recruit participants at a Chinese vocational college. The frequency of contact with smokers or detecting tobacco odors in residential environments was used to define SHS exposure, whereas the frequency of contact with surfaces contaminated by smokers was used to define THS exposure. The associations of SHS and THS exposure with the risk of ADHD symptoms and the executive function (Behavioral Regulation Index, BRI; Metacognitive Index, MI; Global Executive Composite, GEC) scores were evaluated by logistic regression analysis or linear regression analysis. RESULTS: The rate of SHS and THS exposure was 87.7% and 76.9%, with 8.2% stating SHS exposure ≥15 min at least 1 day/week. After adjustment for confounding variables, SHS exposure (≥15 minutes on ≥1 day/week) had higher odds of ADHD symptoms (OR, 1.31; 95% CI, 1.02-1.67), and higher BRI score (β, 2.34; 95% CI, 0.95-3.73), higher MI score (β, 3.12; 95% CI, 1.29-4.95), higher GEC score (β, 5.46; 95% CI, 2.26-8.66). Additionally, the higher the frequency of SHS/THS exposure and the greater the number of surrounding smoker, the higher risk of ADHD symptoms and the poorer executive function (P trend <0.001). CONCLUSIONS: SHS and THS exposure were related to the occurrence of ADHD symptoms and impaired executive function among young adults at a Chinese vocational college in this cross-sectional study. Further researches are warranted to validate these associations in more diverse populations.

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7. Maietta JE, Santangelo JM, Cook NE, Iverson GL. Interpreting Scores from Adolescents with Attention-Deficit/Hyperactivity Disorder on Sway Medical System Balance and Cognitive Modules. Arch Clin Neuropsychol. 2026; 41(1).

PURPOSE: Many high schools in the United States conduct preseason « baseline » cognitive and balance testing as part of their concussion management procedures. Prior research has identified differences in cognitive and balance test scores between youth with and without attention-deficit/hyperactivity disorder (ADHD). The present study examined whether preseason baseline scores on the Sway Medical System Balance and Cognitive Modules differed between adolescent athletes with self-reported ADHD and those without ADHD. METHOD: The Sway Medical System is a smartphone or tablet-based assessment that includes both cognitive and balance tests that can be administered at baseline and following concussion or suspected concussion. Cognitive and balance test results were examined from 23,566 adolescents (49.8% girls) between 14- and 18-year-old who underwent baseline testing during the summer of 2022. RESULTS: For both boys and girls, adolescents with ADHD obtained slightly worse scores on all four cognitive tests and the balance test (p values<.001). The effect sizes for these differences were very small-to-small (r = 0.04-0.07; Hedges' g = 0.13-0.22). CONCLUSION: Adolescents with self-reported ADHD had slightly lower scores on the Sway Medical System Balance and Cognitive Modules, with small-to-very small effect sizes that may be of limited clinical significance. The Sway Medical System currently provides normative data stratified by age and gender. Our results suggest that further stratifying by ADHD status may not be necessary for adolescents-although future research might reveal subgroups of children or young adults with ADHD that have larger score differences.

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8. Martinez AC, Green CD, Peugh JL, Becker SP. Perceived School Fairness and Academic Functioning in Early Adolescents: Differential Associations for Adolescents with or Without ADHD?. Res Child Adolesc Psychopathol. 2026; 54(1): 19.

Although substantial research has focused on the academic outcomes of youth with attention deficit/hyperactivity disorder (ADHD), less is known about factors that promote positive adaptation among these youth in the school setting. Perceived fairness, a subcomponent of school climate, is associated with improved academic functioning and may play an important role among youth with ADHD who have been shown to display heightened reactions to injustice. This study examined perceived fairness in relation to academic functioning in early adolescents and whether this association differed for adolescents with or without ADHD. Participants were 341 early adolescents (ages 10-12), with approximately half (48.7%) diagnosed with ADHD. Teachers completed measures of learning problems and study skills, and adolescents completed measures assessing perceived fairness and attitude to school. Students with ADHD perceived their school to be less fair than students without ADHD, though the effect size was small. Regression analyses controlling for adolescent medication use, demographic characteristics, and co-occurring psychopathology revealed significant main effects wherein higher levels of perceived fairness predicted lower negative attitude to school, and ADHD status predicted a more negative attitude to school and lower study skills. A significant perceived fairness × ADHD interaction was found in relation to learning problems, wherein higher perceived school fairness was more strongly associated with fewer learning problems for students with ADHD than for students without ADHD. These findings contribute to research exploring promotive factors among adolescents with and without ADHD and have implications for interventions aiming to improve academic functioning.

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9. Mazlumi M, Purmohammad M. Linking Attention Deficits to Difficulties in the Comprehension of Complex Syntax in Dyslexia. Dyslexia. 2026; 32(1): e70026.

Recent research suggests that dyslexia involves not only reading difficulties but also deficits in working memory, attention, language, and information processing. This study examined the role of auditory attention in the comprehension of syntactically complex sentences in children with dyslexia. Participants completed an auditory language comprehension test and an auditory sustained attention task. Results showed that the dyslexic group scored lower than controls on both tasks, indicating weaker auditory attention and comprehension. They gave fewer correct answers and exhibited longer reaction times, particularly as syntactic complexity increased. Dyslexic individuals also made more errors and required more time to respond, suggesting impairments in auditory language processing, likely linked to attention deficits. While increased syntactic complexity reduced performance in both groups, the dyslexic group consistently demonstrated more pronounced difficulties than their typical peers did. These findings highlight that auditory attention and syntactic complexity significantly affect sentence comprehension in children with dyslexia. The results suggest that comprehension challenges in dyslexia are not solely due to reading limitations but also involve broader cognitive processing issues. Insights into specific sentence structures and processing delays can inform the development of more sensitive diagnostic tools and targeted interventions for assessing and supporting language comprehension in dyslexic populations.

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10. Rajasingham M, Lisonkova S, Razaz N, Muraca GM. Long-Term Neurodevelopmental Outcomes After Forceps, Vacuum, and Second-Stage Cesarean Delivery. JAMA Netw Open. 2026; 9(1): e2556637.

IMPORTANCE: Prior studies have compared neurodevelopmental outcomes across delivery modes that are not interchangeable (eg, operative vs spontaneous vaginal delivery [SVD]), limiting the clinical utility of their conclusions. OBJECTIVE: To examine the association between mode of operative delivery in the second stage of labor and attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID) in children. DESIGN, SETTING, AND PARTICIPANTS: This population-based, retrospective cohort study used data from health administrative databases from British Columbia, Canada, from April 1, 2000, to December 31, 2019. The population included 504 380 nonanomalous, singleton, full-term infants who survived and did not emigrate during their first year of life. Neurodevelopmental outcomes were collected through March 31, 2022, and analyses were performed from June 2024 to August 2025. EXPOSURE: Delivery mode during the second stage of labor, categorized as SVD, forceps, vacuum, sequential instrument, or second-stage cesarean delivery (SSCD). MAIN OUTCOMES AND MEASURES: The main outcome was ADHD, ASD, and ID from 1 year to a maximum of 22 years of age. Cox proportional hazards regression models were used to assess the association between mode of operative delivery (SVDs excluded) and each neurodevelopmental outcome, adjusting for maternal and clinical characteristics. RESULTS: Among 504 380 children (253 256 males [50.2%] and 44 202 [8.8%] with a maternal history of neurodevelopmental or psychiatric disorders), 407 792 (80.9%) were delivered by SVD, 46 493 (9.2%) by vacuum, 23 140 (4.6%) by forceps, 3009 (0.6%) by sequential instrument, and 23 946 (4.7%) by SSCD. The overall rate of ADHD was 6.6 (95% CI, 6.5-6.7) per 1000 person-years; ASD, 1.8 (95% CI, 1.7-1.8) per 1000 person-years; and ID, 0.3 (95% CI, 0.2-0.3) per 1000 person-years. Compared with SSCD, children who underwent sequential instrument delivery had a 13% higher ADHD rate (7.9 [95% CI, 7.1-8.8] vs 6.6 [95% CI, 6.3-6.9] per 1000 person-years; adjusted hazard ratio [AHR], 1.13 [95% CI, 1.00-1.28]) and those who underwent vacuum delivery had a 53% higher ID rate (0.3 [95% CI, 0.3-0.4] vs 0.2 [95% CI, 0.1-0.3] per 1000 person-years; AHR, 1.53 [95% CI, 1.12-2.10]). There was no significant association with ASD and mode of delivery. CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that children who underwent operative vaginal delivery and SSCD had comparable neurodevelopmental outcomes, except among those who underwent sequential instrument delivery and vacuum delivery, which were associated with ADHD and ID, respectively. Further research is warranted to develop a better understanding of delivery mode as a potentially modifiable risk factor for neurodevelopmental disorders in childhood.

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11. Szymaniak K, Bell E, Shivakumar G, Malhi GS. Letter to the Editor regarding ‘Exposures to attention deficit hyperactivity disorder medications reported to the New South Wales Poisons Information Centre (2014-2023): A retrospective study’. Aust N Z J Psychiatry. 2026: 48674261418860.

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12. Zhang T, Adamis D. A systematic review of transcranial direct current stimulation (tDCS) for adults with attention deficit/hyperactivity disorder (ADHD). J Psychiatr Res. 2026; 195: 74-84.

BACKGROUND: Transcranial direct current stimulation (tDCS) has been proposed as a potential non-pharmacological intervention for Attention-Deficit/Hyperactivity Disorder (ADHD). While evidence from pediatric populations is growing, the effects of tDCS in adults with ADHD remain insufficiently characterized, increasing recognition of ADHD as a lifelong neurodevelopmental condition with persistent functional impairments. OBJECTIVE: This systematic review aimed to evaluate the effects of tDCS in adults with ADHD across clinical, cognitive, and neurophysiological outcome domains. METHODS: Six electronic databases were systematically searched to identify peer-reviewed controlled trials evaluating tDCS interventions in adults with clinically diagnosed ADHD through May 2025. Data extraction encompassed clinical symptom outcomes, cognitive task performance, neurophysiological findings, adverse events, medication status, and stimulation protocols. Study quality was assessed using the Downs and Black checklist. Where sufficient data were available, an exploratory random-effects meta-analysis was conducted for clinical symptom outcomes; all other outcomes were synthesized narratively. RESULTS: Eleven controlled studies (n = 415) met inclusion criteria and were included in the qualitative synthesis. Two randomized controlled trials provided sufficient data for exploratory meta-analysis of clinical symptoms. Pooled results suggested a possible beneficial effect of tDCS on inattention symptoms, accompanied by substantial heterogeneity (I(2) = 79.95 %), while no significant effect was observed for hyperactivity/impulsivity. Cognitive outcomes were heterogeneous and domain-specific, with some evidence of post-stimulation improvements in inhibitory control, working memory, and attentional measures. Two studies reported tDCS-induced modulation of frontal neurophysiological markers associated with cognitive control. Stimulation protocols varied considerably across studies, with no consistent association between specific parameters and outcomes. Adverse events were generally mild and transient, and follow-up data were limited. CONCLUSIONS: Current evidence suggests that tDCS may exert domain-specific effects on inattention and selected cognitive functions in adults with ADHD. However, conclusions remain tentative due to methodological heterogeneity, small sample sizes, and limited quantitative evidence. Future research should prioritize standardized protocols, adequately powered trials with extended follow-up periods, integration of neurophysiological biomarkers, and systematic evaluation of individual difference factors to clarify the therapeutic potential and mechanisms, and advance precision neuromodulation approaches for adult ADHD.

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