This paper examined the emotional impact of diagnosis disclosure on recently diagnosed people with dementia. Thirty patient/caregiver dyads attending a Geriatric Day Hospital Program in Ottawa, Canada participated in this qualitative exploratory study. Data sources included: (a) audio-tapes of diagnosis disclosure meeting, (b) in-depth interviews with patients and caregivers within one week of disclosure, and (c) focus group interviews with caregivers within one month. Patients exhibited a range of emotional responses which can be divided into three broad categories: (a) responses suggesting a lack of insight and/or an active denial of the diagnosis, (b) grief reactions/emotional crisis related to the experience of actual or anticipated losses associated with dementia, and (c) positive coping responses to maximize the disease outcome. Participants went through stages of emotional response to their diagnosis: not noticing symptoms, noticing & covering up, or noticing & revealing; diagnostic process & disclosure; confirming or shock; denial, crisis, or maximizing; disorganization or adaptation. There is a need to develop a better understanding of the experience of people with dementia at the critical point of diagnosis disclosure in order to design supportive interventions to maximize adaptive coping responses.

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This paper reports the findings of a descriptive, exploratory, qualitative study of patient and caregiver perspectives of the disclosure of a dementia diagnosis. Data were collected at 3 points in time: (1) the disclosure meeting, (2) patient and caregiver interviews, and (3) focus group interviews. Thirty patient-caregiver dyads participated in the disclosure meetings at the Geriatric Day Hospital at the Ottawa Hospital, Ottawa, Canada. Within a week of the disclosure of diagnosis, 27 (90%) patients and 29 (97%) caregivers were interviewed in their homes, and 12 caregivers participated in 3 focus group interviews within 1 month after the disclosure meeting. Most patients and caregivers said they preferred full disclosure of the diagnosis. Patients expressed satisfaction with the physician providing the diagnosis and with their caregivers being present at the disclosure meeting, however, wanted more information about their condition. Caregivers provided further insight regarding the patient response, and suggested the need to emphasize hope in the face of a difficult diagnosis, the use of progressive disclosure to allow the person (and caregivers) to prepare, and the provision of detail about the disease and its progression.

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Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood disorders, affecting around 6.5% of youths worldwide. One common and impairing correlate of ADHD is aggressive behaviour which likely acts as a major contributor to the negative outcomes associated with ADHD. ADHD symptoms and aggression are both heterogeneous and it has been speculated that certain symptoms of ADHD might map more closely to certain types of aggressive behaviour. This study uses a symptom-level analysis to investigate the concurrent and temporal links between symptoms of ADHD and aggressive behaviours. This allows insights into whether specific symptoms are more likely to be connected which is highly important to refine intervention targets aiming to reduce aggressive behaviours associated with ADHD.Method: Using Gaussian Graphical Models and Graphical Vector Autoregression Models, cross-sectional and longitudinal networks of ADHD symptoms and aggressive behaviours, measured using parent-reported Social Behaviour Questionnaires (SBQ), were estimated. Participants included 1379 children taking part in the longitudinal Swiss z-proso cohort study at ages 7, 9 and 11. Results: Cross-sectional networks indicated that impulsivity symptoms and fidgeting were connected to reactive aggression under different types of provocation, with fidgeting also connected to a form of proactive aggression, namely dominating other children. The longitudinal network highlighted that ADHD symptoms and aggressive behaviours share a multitude of reciprocal temporal relations with inattentive ADHD symptoms preceding both reactive and proactive aggression. Conclusion: Findings from the current study present preliminary evidence indicating that interventions should focus on both hyperactive/impulsive and inattentive symptoms in order to reduce aggressive behaviours in children with ADHD. They further highlight that it is important to target feedback loops resulting from aggressive behaviours. Future research is needed to better understand the mechanisms through which ADHD and aggressive behaviours become linked.