Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition affecting 5.9% of young people. Late adolescence can be a particularly challenging period for young people with ADHD, with major life transitions, new demands and increased expectations. This vulnerable phase also coincides with the transition from child and adolescent mental health care to adult ADHD services, where new UK data show that most young people with ADHD do not successfully transfer to adult services. Therefore, many young people with ADHD do not receive appropriate interventions at a time when they may need them most. Opportunities for intervention are currently not fully realised due to both the young people's disengagement from clinical services and our limited understanding of real-world targets for more holistic interventions. The current study seeks to address these needs using remote (not in-person) measurement technology (RMT). The MRC-funded project, ART-transition, will use the ADHD Remote Technology ('ART') assessment and monitoring assessments with young people with a diagnosis of ADHD aged 16-17 and the RADAR-base mobile-health platform to which it is linked. ART consists of active (e.g. questionnaires) and passive (e.g. sleep) smartphone app monitoring. In the study, the investigators will address three questions on the transition to adulthood for individuals with ADHD: what changes take place, what predicts them, and how can the investigators prevent negative outcomes and support healthy lifestyles? The investigators will remotely monitor 250 young people with ADHD over two years. The investigators will then co-design, with young people with ADHD, a prototype for a new ADHD-transition smartphone app. Our approach focuses on giving young people with ADHD greater autonomy in how they manage their ADHD, in collaboration with their clinician, and places the emphasis on modifiable environmental factors and the prevention of negative outcomes.
Study Type
OBSERVATIONAL
Enrollment
500
King's College London
London, United Kingdom
RECRUITINGADHD symptoms and functional impairment
Barkley Adult ADHD Rating scale on symptoms and functional impairment (BAARS-IV)- Self Report. 29 items. For 18 items, individuals report the frequency with which they have experienced ADHD symptoms over the past two weeks on a four-point Likert Scale (0 = 'Never' or 'Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often'). One item asks individuals to indicate the ages at which they first experienced symptoms. For the final 10 items, individuals report the extent to which their symptoms have interfered with their ability to function in various domains (e.g., home life or at work) on a four-point Likert Scale (0 = 'Never or Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often').
Time frame: Baseline and every 4 weeks up to month 24
ADHD symptoms
Non-validated daily ADHD symptom question. 1 item. Individuals report the extent to which ADHD symptoms affected their daily activities on a Likert Scale (1 = Not at all, 2 = Slightly, 3 = Somewhat, 4 = Quite a lot, 5 = A lot).
Time frame: Baseline and every day up to month 24
Anxiety (General Anxiety Disorder-7, GAD-7)
7-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days', 3 = 'Nearly every day'). Higher scores indicate higher severity of anxiety symptoms.
Time frame: Baseline and every 4 weeks up to month 24
Depression (Patient Health Questionnaire -8, PHQ-8, adapted)
8-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days, 3 = 'Nearly every day'). Higher scores indicate higher severity of depression symptoms.
Time frame: Baseline and every 4 weeks up to month 24
Aggression (Reactive-Proactive Aggression Questionnaire for Adults. RPQ-A, adapted)
23 items, 3-point Likert scale rated from 0 to 2 (0 = 'Never', 1 = 'Sometimes', 2 = 'Often'), indicating the frequency of experiencing items in the past two weeks. Higher scores indicate increased aggression.
Time frame: Baseline and every 4 weeks up to month 24
Irritability - (Affective Reactivity Index self-report, ARI-s, adapted)
7-item, 3-point Likert Scale rated from 0 to 3 (0 = 'Not True', 1 = 'Somewhat True', 2 = 'Certainly True') indicating frequency of experiencing symptoms in the past two weeks.
Time frame: Baseline and every 4 weeks up to month 24
Nicotine Dependence - The Fagerstrom Test for Nicotine Dependence
6-items. Four items are yes/no questions rated from 0 to 1, and two are multiple-choice questions rated from 0 to 3 on a 4-point Likert scale. A higher score is associated with more nicotine dependence.
Time frame: Baseline and every 4 weeks up to month 24
Alcohol Use (Alcohol Use Disorders Identification Test questionnaire, AUDIT)
10 items, with a 4-point Likert scale rated from 0 to 3. A higher score is associated with more harmful or hazardous drinking.
Time frame: Baseline and every 4 weeks up to month 24
Eating Disorders (Short Form of the Eating Disorder Examination Questionnaire, EDE-QS)
12 items. 10 items are questions about behaviours in the past seven days, rated on a scale from 0 to 3 for frequency (0 = 0 days, 1 = 1-2 days, 2 = 3-5 days, 3 = 6-7 days). 2 items are about self-perception over the past seven days, rated on a scale from 0 to 3 for extent (0 = Not at all, 1 = Slightly, 2 = Moderately, 3 = Markedly). A higher score is associated with more eating disorder behaviours.
Time frame: Baseline and every 6 months up to month 24
Self-esteem (Rosenberg Self-Esteem Scale, RSES)
10 items. 4-point Likert scale format ('Strongly Agree', 'Agree', 'Disagree, 'Strongly Disagree'). Responses are assigned 1-4 points. Higher scores indicate higher self-esteem.
Time frame: Baseline and every 6 months up to month 24
Social support and engagement with work/studies
Non-validated questionnaire
Time frame: Baseline and every 4 weeks up to month 24]
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms
Passive monitoring using the RADAR-BASE smartphone "Passive App" measuring digital signals of behaviour.
Time frame: Continuously across a 24-month time period
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms
Passive monitoring using a Fitbit wearable device measuring sleep. Device sensors, including an accelerometer and a photoplethysmographic pulse oximeter, will be combined to calculate sleep duration.
Time frame: Continuously across a 24-month time period
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms
Passive monitoring using a Fitbit wearable device measuring physical activity. Device sensors, including a gyroscope and an accelerometer, will be combined to calculate step count.
Time frame: Continuously across a 24-month time period
Markers associated with clinical symptoms - cognitive measures
Continuous Performance Test/Go No-Go Task (Combined Task)
Time frame: Baseline and every 6 months up to month 24
Markers associated with clinical symptoms - cognitive measures
Fast Task
Time frame: Baseline and every 6 months up to month 24
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