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      Top problems of adolescents and young adults with ADHD during the COVID-19 pandemic

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          Abstract

          Objective

          ADHD symptom severity appears to be exacerbated during the COVID-19 pandemic. The present study surveyed top problems experienced by adolescents and young adults (A/YAs) with ADHD during the COVID-19 pandemic to identify possible reasons for symptom escalation and potential targets for intervention. We also explored perceived benefits of the pandemic for A/YAs with ADHD.

          Method

          At the outbreak of the COVID-19 pandemic (April–June 2020), we administered self and parent ratings about current and pre-pandemic top problem severity and benefits of the pandemic to a sample of convenience ( N = 134 A/YAs with ADHD participating in a prospective longitudinal study).

          Results

          The most common top problems reported in the sample were social isolation (parent-report: 26.7%; self-report: 41.5%), difficulties engaging in online learning (parent-report: 23.3%, self-report: 20.3%), motivation problems (parent-report: 27.9%), and boredom (self-report: 21.3%). According to parent ( d = 0.98) and self-report ( d = 1.33), these top problems were more severe during the pandemic than in prior months. Contrary to previous speculation, there was no evidence that pandemic-related changes mitigated ADHD severity. Multi-level models indicated that A/YAs with higher IQs experienced severer top problems exacerbations at the transition to the COVID-19 pandemic.

          Conclusions

          For A/YAs with ADHD, several risk factors for depression and school dropout were incurred during the early months of the COVID-19 pandemic. A/YAs with ADHD should be monitored for school disengagement and depressive symptoms during the COVID-19 pandemic. Recommended interventions attend to reducing risk factors such as increasing social interaction, academic motivation, and behavioral activation among A/YAs with ADHD.

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          Most cited references70

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          Is Open Access

          Interrater reliability: the kappa statistic

          The kappa statistic is frequently used to test interrater reliability. The importance of rater reliability lies in the fact that it represents the extent to which the data collected in the study are correct representations of the variables measured. Measurement of the extent to which data collectors (raters) assign the same score to the same variable is called interrater reliability. While there have been a variety of methods to measure interrater reliability, traditionally it was measured as percent agreement, calculated as the number of agreement scores divided by the total number of scores. In 1960, Jacob Cohen critiqued use of percent agreement due to its inability to account for chance agreement. He introduced the Cohen’s kappa, developed to account for the possibility that raters actually guess on at least some variables due to uncertainty. Like most correlation statistics, the kappa can range from −1 to +1. While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations. Judgments about what level of kappa should be acceptable for health research are questioned. Cohen’s suggested interpretation may be too lenient for health related studies because it implies that a score as low as 0.41 might be acceptable. Kappa and percent agreement are compared, and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
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            Becoming a Self-Regulated Learner: An Overview

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              Adolescent development.

              This chapter identifies the most robust conclusions and ideas about adolescent development and psychological functioning that have emerged since Petersen's 1988 review. We begin with a discussion of topics that have dominated recent research, including adolescent problem behavior, parent-adolescent relations, puberty, the development of the self, and peer relations. We then identify and examine what seem to us to be the most important new directions that have come to the fore in the last decade, including research on diverse populations, contextual influences on development, behavioral genetics, and siblings. We conclude with a series of recommendations for future research on adolescence.
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                Author and article information

                Journal
                J Psychiatr Res
                J Psychiatr Res
                Journal of Psychiatric Research
                Elsevier Ltd.
                0022-3956
                1879-1379
                14 February 2021
                April 2021
                14 February 2021
                : 136
                : 190-197
                Affiliations
                [a ]University of Washington, 1410 Campus Parkway, Seattle, WA, USA
                [b ]Seattle Children's Research Institute, 1900 9th Avenue, Seattle, WA, USA
                [c ]University of Massachusetts Lowell, 220 Pawtucket St, Lowell, MA, USA
                [d ]Florida International University, 11200 SW 8th Street, Miami, FL, USA
                Author notes
                []Corresponding author. Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, 2001 8th Ave., Suite 400, Seattle, WA, 98121, USA.
                [1]

                Reyes, Joshi, and Alexander are shared fourth authors.

                Article
                S0022-3956(21)00076-5
                10.1016/j.jpsychires.2021.02.009
                8009847
                33610946
                a79ad279-2d01-4936-8fa5-7ae371119ce8
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 2 October 2020
                : 25 January 2021
                : 8 February 2021
                Categories
                Article

                Clinical Psychology & Psychiatry
                adhd,adolescence,covid-19
                Clinical Psychology & Psychiatry
                adhd, adolescence, covid-19

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