1. Aydin Ü, Wang Z, Gyurkovics M, Tong A, Cullen G, Ahmed S, Palmer J, McLoughlin G. ADHD polygenic risk predicts neural signatures of cognitive control: Evidence from midfrontal theta dynamics. Transl Psychiatry;2026 (Mar 31);16(1)

Cognitive control mechanisms ensure goal-directedness in behaviour. Difficulties in cognitive control are well-established in conditions such as attention-deficit/hyperactivity disorder (ADHD) and autism. On the neural level, midfrontal theta (4-8 Hz) activity has emerged as a reliable correlate of cognitive control processes. Previous findings showed alterations in theta-based signals in both ADHD and autism, most notably an increase in the variability of theta phases across trials in cognitive control tasks, which was predictive of increased response time variability (RTV) as well. Crucially, recent work on twin studies has provided strong evidence for the genetic underpinning of these associations. Here, for the first time, we investigated whether polygenic scores (PGS) for ADHD and autism can predict RTV and EEG-derived theta-based measures of cognitive control in 454 participants. We found that PGS for ADHD, but not autism, accounted for a significant proportion of the variance in theta phase variability, captured via inter-trial coherence (ITC), in the well-standardised arrow-flanker task (2.5% of total variance, corresponding to 3.3% of the reliable variance). Furthermore, theta-ITC showed excellent test-retest reliability in our sample, indicating psychometric robustness, which in turn, further strengthens our findings. These results provide robust evidence linking genetic risk to neural measures and suggest that core dysregulation of the temporal coordination of control processes in ADHD is under genetic influence.

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2. Cabelguen C, Challet-Bouju G, Thiabaud E, Donnio Y, Lefebvre L, Hardouin JB, Grall-Bronnec M. Randomised controlled trial on the efficacy of adding cognitive remediation therapy to methylphenidate in adult patients with attention deficit hyperactivity disorder and addictive disorders (META): CRT in ADHD and addiction – META study protocol. BMJ Open;2026 (Mar 31);16(3):e111698.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) affects 2.5% of adults in the general population, compared with more than 20% among individuals treated for addictive disorders (substance use disorders (SUD) and/or behavioural addictions (BAs)). The presence of ADHD is associated with earlier onset, greater severity and poorer prognosis of addictive disorders. In this context, pharmacological treatments, including methylphenidate (MPH), are widely recommended for adults with ADHD. However, their efficacy remains moderate and may be limited by poor adherence. The association between ADHD and addictive disorders may be explained by shared endophenotypes, particularly neuropsychological patterns, which may further amplify adherence difficulties. Cognitive remediation therapy (CRT) targets impaired cognitive functions and promotes compensatory strategies, and may thereby enhance treatment adherence and overall efficacy. However, evidence in adults with ADHD, especially those with comorbid addictive disorders, remains limited and methodologically constrained. We hypothesise that combining MPH with CRT targeting shared neuropsychological deficits will be more effective for patients with ADHD and comorbid addictive disorders. Demonstrating the efficacy of this combined approach could promote the widespread use of CRT in the multimodal management of ADHD, providing patients with access to affordable and autonomous care. The objective of this study is to evaluate whether this combined approach improves functional and symptomatic outcomes in the short and medium term. METHODS AND ANALYSIS: META (MEthylphénidate dans la comorbidité TDAH – Addiction(s)) is a multicentre, randomised, single-blind controlled trial (NCT06906328). It will include 248 adults (124 per group) with ADHD requiring MPH treatment and at least one addictive disorder (SUD and/or BA). After stabilisation of MPH dosage, eligible patients will be enrolled and randomised to either (1) active CRT+MPH using PRESCO software (HappyNeuron) or (2) control CRT+MPH using AUDITICO software (HappyNeuron). CRT sessions will take place two times weekly for 12 weeks, both at the hospital and at home. Follow-up visits will occur at the end of CRT (short-term) and 6 months after the final session (medium-term). Semistructured clinical interviews on psychiatric and addictive disorders, neuropsychological assessments and self-report questionnaires of ADHD, impulsivity, self-esteem and emotion dysregulation will be administered in an unblinded manner at baseline and follow-up assessments. The primary endpoint is defined as a reduction of at least 30% in the Weiss Functional Impairment Rating Scale total score from baseline to medium-term follow-up. ETHICS AND DISSEMINATION: The study has ethical approval from the French National Ethics Committee (24 December 2024) and follows Good Clinical Practice and Standard Protocol Items: Recommendations for Interventional Trials 2025 guidelines. Participants will provide written informed consent, and data will be pseudonymised and securely archived for 15 years. Data management and monitoring will follow internal procedures, with annual quality checks. Results will be shared with patients via a simplified summary and with professionals through publications, with preprints and final papers on a French open-access repository. TRIAL REGISTRATION NUMBER: NCT06906328.

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3. Clifford S, Davis MC, Lemery-Chalfant K. Children’s affect: Automated coding, context effects, relations with maternal affect, and heritability. Child Dev;2026 (Mar 31);97(2):506-520.

This study examined genetic and environmental influences on twins’ and parents’ positive and negative affect during a parent-child conflict discussion and a positive discussion, captured by automated facial coding. Associations with internalizing, externalizing, and ADHD symptoms were examined. Twins (N = 560 50.94%; female; Mage = 9.72, SD = .94; data collected 2017-2020) and parents (N = 302; 583 videos) were from socioeconomically diverse families, and primarily White (57.07%) or Hispanic (26.78%). Child and parent positive affect were influenced by the shared and nonshared environment and child negative affect was heritable, with similar etiology across tasks. Only child positive affect during the conflict discussion consistently related to lower internalizing, externalizing, and ADHD symptoms (R2: 1.3%-3.6% of variance). Findings support positive affect under stress as an environmentally influenced resilience factor. This study examined genetic and environmental influences on 9-year-old twin children’s positive affect (smiling, happiness) and negative affect (anger, sadness, fearfulness) during a challenging parent–child conflict discussion and a positive parent–child discussion. We used an AI method of automatically coding facial expressions. We also asked parents to report on their twins’ symptoms of internalizing (like depression), externalizing (like aggression), and ADHD using questionnaires. For twins, negative affect was partially genetically influenced. Twins’ positive affect was explained by environmental factors, and positive affect during the conflict discussion was related to lower symptoms. Parent affect was not strongly influenced by children’s genetically influenced characteristics. Our findings suggest that children’s ability to stay positive during a stressful parent–child interaction is both environmentally influenced and important for resilience. eng

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4. Fuermaier ABM, Dong H, Pollak Y, Braams BR, Dekkers TJ. ADHD Characteristics Are Linked to Divergent Risk-Taking Behaviors. J Atten Disord;2026 (Mar 31):10870547261432427.

OBJECTIVES: Decades of research on individuals with ADHD across the lifespan have consistently demonstrated an increased tendency for negative risk-taking. However, the potential for positive forms of risk-taking has been largely overlooked. Very recently, Braams et al. were the first to report an increased likelihood of prosocial risk-taking, a subtype of positive risk-taking, among adolescents with ADHD. Building on their findings, the present preregistered study investigates self-reported likelihoods of engaging in negative, positive, and prosocial risk-taking and examines their associations with ADHD characteristics, as well as internalizing symptoms as comparison measures. METHODS: This correlational study analyzed survey data from 611 participants drawn from the Dutch general population. Participants rated their likelihood of engaging in negative, positive, and prosocial risk-taking behaviors and completed standardized questionnaires assessing ADHD characteristics as well as internalizing symptoms of depression, anxiety, and stress. Correlation analyses, regression models, and categorical analyses were used to examine the unique and combined contributions of ADHD characteristics and internalizing symptoms to different forms of hypothetical risk-taking behavior. RESULTS: ADHD characteristics were robustly associated with negative risk-taking likelihood. Associations with positive and prosocial risk-taking were present but weaker and less consistent across analytical methods. Hierarchical regression analyses indicated that ADHD traits accounted for a substantial portion of the variance in risk-taking behaviors, while internalizing symptoms also contributed, though to a lesser extent. The likelihood of engaging in risk-taking behavior decreased with increasing age. CONCLUSION: Our findings support the emerging view that ADHD characteristics may be linked not only to negative but also to positive and prosocial forms of risk-taking. However, effects on positive and prosocial risk taking are more complex and warrant further research, particularly with clinical samples and psychometrically refined instruments. Our findings may foster a more nuanced understanding of ADHD and could have important implications for self-concept development and clinical care in individuals with ADHD.

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5. Pathan M, Jeun KJ, Al-Mamun MA. Impact of Medication Therapy on Social, Behavioral, and Employment Outcomes in Adults With ADHD. J Atten Disord;2026 (Mar 31):10870547261433489.

OBJECTIVE: Limited studies have explored the association between pharmacotherapy treatment and socio-behavioral and employment-related difficulties among adults with ADHD in U.S. This study aimed to evaluate and compare socio-behavioral and employment outcomes among adults with ADHD who were receiving stimulant treatment versus those who were not. METHODS: A retrospective cross-sectional study was conducted using the Medical Expenditure Panel Survey data from 2013-2019. Adults with ADHD were categorized into stimulant-treated versus not stimulant-treated groups. Multivariable logistic regression was utilized to assess the association between stimulant use and outcomes of interest (e.g., social, behavioral, and employment outcomes) and was reported using odds ratio (ORs). Propensity score matching was used to control for confounding and sub-group analyses were conducted by adherence to CNS stimulants. RESULTS: Among 1,290 (2,468,186 weighted) patients, 80.67% were stimulant-treated, and 19.33% were not treated with stimulants. No significant differences were found in the employment outcomes between the two groups in adjusted models. Sub-group analyses showed that adherent users of stimulants had higher odds of self-employment (OR = 2.10 [1.15, 3.82]) than non-adherent users. Stimulant-treated adults had higher odds of social limitations (OR = 3.16 [1.50, 6.69]), and lower odds of physical activity (OR = 0.29 [0.13, 0.66]) compared to those who were not treated with stimulants. CONCLUSION: Overall, these findings highlight important gaps in understanding the relationship between real-world functional outcomes and stimulants use in adults with ADHD and underscore the need for additional longitudinal and real-world studies to thoroughly understand the impact of ADHD medications on those outcomes.

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6. Saha D, Sarkar UK, Parvin J, Mistry B, Khan HA, Begum SA, Saha NC, Saha CK. The Effect of Combined Iron and Methylphenidate Use in Iron Deficient Attention deficit Hyperactivity Disorder (ADHD) Children of Bangladesh. Mymensingh Med J;2026 (Apr);35(2):569-577.

Iron acts as a risk factor and psychostimulant modulator in treatment of attention deficit hyperactivity disorder (ADHD) with Iron deficiency anemia (IDA). So, the aim of the study to see the comparative efficacy of combined use of methylphenidate with iron and methylphenidate alone among severe ADHD children with IDA. This randomized controlled trial conducted in the OPD, Pediatric Neurology, National Installation of Neurosciences & Hospital (NINS), Dhaka, Bangladesh; 50 children of severe ADHD with iron deficiency were enrolled. Participants were randomized into Group A (25 cases) given a combination of Methylphenidate and iron and Group B (25 cases) given Methylphenidate alone for 3 months. Conner’s rating scale, CBC and serum ferritin was evaluated after one and three months, severity was compared between treatment groups. All the hematological parameters including serum ferritin were improved from baseline. As ferritin concentration increased, the severity of T scores of ADHD index were decreased at 1 month (p=0.047) and 3 months (p=0.026) after intervention, Treatment response were found earlier in Group A (13.39±6.90 days) than in Group B (18.48±8.69). Combined therapy of methylphenidate and iron was more effective than methylphenidate alone for treating the iron deficient child with ADHD.

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7. Sasaki J, Mrazik S, Hand C, Cutler K, Koltenyuk V, Fuller SI, MacFarlane AJ. Stimulant Usage in Attention-Deficit/Hyperactivity Disorder Is Associated With Decreased Rates of Arthrofibrosis and Postoperative Complications Following Anterior Cruciate Ligament Reconstruction. J Am Acad Orthop Surg;2026 (Mar 31)

INTRODUCTION: Anterior cruciate ligament (ACL) tears are one of the most common orthopaedic injuries, and ACL reconstruction is often considered the standard of care for the active individual. Recently, attention-deficit/hyperactivity disorder (ADHD) has been shown to be a risk factor for adverse postoperative outcomes in patients undergoing ACL reconstruction. However, no studies have looked at the effect of stimulant medications on ACL reconstruction outcomes in patients with ADHD. This study aimed to compare postoperative outcomes between ADHD patients using stimulant medications and those not using stimulants following ACL reconstruction at 3- and 6-month follow-up. METHODS: This retrospective cohort study used the TriNetX database to identify patients with ADHD who underwent ACL reconstruction surgery and divided them into cohorts based on the presence or absence of stimulant medication usage. Patient cohorts were 1:1 propensity score matched on age, sex, obesity, mood disorders, anxiety disorders, and nicotine dependence. Postoperative complications were analyzed within 3 and 6 months postoperatively, evaluating arthrofibrosis, infection, wound disruption, revision surgery, emergency department (ED) visits, hospital readmission, and deep vein thrombosis. RESULTS: Within 3 and 6 months postoperatively, ADHD patients not taking stimulants were markedly more likely to return to the ED and be readmitted to a hospital compared with those who were taking stimulants. In addition, at the 6-month time point, a statistically significant increase in arthrofibrosis was seen in nonstimulant users compared with stimulant users in patients with ADHD. CONCLUSION: This study found that patients with ADHD not taking stimulant medications are at an increased risk of returning to the ED, being readmitted to the hospital, and developing arthrofibrosis compared with those patients taking stimulants following ACL reconstruction. The results display the importance of identifying modifiable risk factors for ACL reconstruction surgery so that physicians can adequately adjust treatment regimens to each patient.

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8. Suetani S, Honarparvar F, Muller P, Kesby JP, Parker S. The risk of psychosis associated with cannabis use by people with attention-deficit hyperactivity disorder: A systematic review. Australas Psychiatry;2026 (Mar 31):10398562261439662.

BackgroundGiven that both attention-deficit hyperactivity disorder (ADHD) and cannabis use are known independent risk factors for psychosis, people with ADHD who consume cannabis may be especially vulnerable. The main objective of the current study was to explore the links between ADHD, cannabis use and psychosis outcomes.MethodsA systematic review was conducted to examine the risk of psychosis among people with ADHD who are exposed to cannabis. Literature searches were conducted using four electronic bibliographic databases. The findings were synthesised following the synthesis without meta-analysis reporting guideline.ResultsThree studies meeting the inclusion criteria were identified. These studies were heterogeneous in design, and the assessment of the risk of bias found one study to be fair quality and two to be good quality. Two included studies indirectly suggested that cannabis use does not impact the risk of psychosis among people with ADHD, and one study supported cannabis having a similar impact on the risk of psychosis for people with and without ADHD.ConclusionThere have been very few studies examining the relationship between ADHD, cannabis use, and psychosis. Currently, there is very little evidence to suggest that the risk of psychosis associated with cannabis use is heightened for people diagnosed with ADHD. However, limitations in existing evidence highlight the need for further research on this topic.

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