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Carter L, Speyer L, Caye A, Rohde L, Murray AL. Late adolescent outcomes of different developmental trajectories of ADHD symptoms in a large longitudinal study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02516-5. [PMID: 38971931 DOI: 10.1007/s00787-024-02516-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
There exists substantial heterogeneity in the developmental trajectories of ADHD symptoms, with distinctions often made between persistent versus remittent, and early- versus late-onset. However, how these trajectories relate to late adolescent functioning and whether, in particular, later onset trajectories mark a milder subtype remains unclear. Building on earlier work that has examined early life predictors of ADHD symptom trajectories up to age 14, we applied latent class growth analysis to data from the UK Millennium Cohort Study (N = 10,262) to evaluate whether developmental trajectories of ADHD symptoms up to age 17 (from age 3) were similar to those identified up to age 14 and associated with differing levels of impairment in peer victimisation, mental health, substance use, and delinquency outcomes at age 17. Our optimal model included five trajectory groups, labelled unaffected (37.6%), mildly affected (34.8%), subclinical remitting (14.4%), adolescent onset (7.6%), and stable high (5.6%). Adolescent onset and stable high trajectories were similarly impaired across all outcomes, other than substance use. Subclinical remitting individuals were impaired on self-esteem and well-being compared to unaffected individuals. By the end of mid-adolescence, those with a later onset have similar impairments to those following an early onset/persistent trajectory. Residual impairment may remain for those on a remitting trajectory.
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Affiliation(s)
- Lara Carter
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Lydia Speyer
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Arthur Caye
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis Rohde
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Medical Council UNIFAJ and UNIMAX, São Paulo, Brazil
- National Institute of Developmental Psychiatry and National Center for Innovation and Research in Mental Health, São Paulo, Brazil
| | - Aja Louise Murray
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK.
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Tsai CJ, Lin HY, Gau SSF. Correlation of altered intrinsic functional connectivity with impaired self-regulation in children and adolescents with ADHD. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01787-y. [PMID: 38906983 DOI: 10.1007/s00406-024-01787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/16/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) has a high prevalence of co-occurring impaired self-regulation (dysregulation), exacerbating adverse outcomes. Neural correlates underlying impaired self-regulation in ADHD remain inconclusive. We aimed to investigate the impact of dysregulation on intrinsic functional connectivity (iFC) in children with ADHD and the correlation of iFC with dysregulation among children with ADHD relative to typically developing controls (TDC). METHODS Resting-state functional MRI data of 71 children with ADHD (11.38 ± 2.44 years) and 117 age-matched TDC were used in the final analysis. We restricted our analyses to resting-state networks (RSNs) of interest derived from independent component analysis. Impaired self-regulation was estimated based on the Child Behavioral Checklist-Dysregulation Profile. RESULTS Children with ADHD showed stronger iFC than TDC in the left frontoparietal network, somatomotor network (SMN), visual network (VIS), default-mode network (DMN), and dorsal attention network (DAN) (FWE-corrected alpha < 0.05). After adding dysregulation levels as an extra regressor, the ADHD group only showed stronger iFC in the VIS and SMN. ADHD children with high dysregulation had higher precuneus iFC within DMN than ADHD children with low dysregulation. Angular gyrus iFC within DMN was positively correlated with dysregulation in the ADHD group but negatively correlated with dysregulation in the TDC group. Functional network connectivity showed ADHD had a greater DMN-DAN connection than TDC, regardless of the dysregulation level. CONCLUSIONS Our findings suggest that DMN connectivity may contribute to impaired self-regulation in ADHD. Impaired self-regulation should be considered categorical and dimensional moderators for the neural correlates of altered iFC in ADHD.
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Affiliation(s)
- Chia-Jui Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiang-Yuan Lin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Susan Shur-Fen Gau
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.
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Marques S, Correia-de-Sá T, Guardiano M, Sampaio-Maia B, Ferreira-Gomes J. Emotion dysregulation and depressive symptoms mediate the association between inhibitory control difficulties and aggressive behaviour in children with ADHD. Front Psychiatry 2024; 15:1329401. [PMID: 38690203 PMCID: PMC11059059 DOI: 10.3389/fpsyt.2024.1329401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background/objectives Impulsive aggressive behaviour, although not a core symptom, is often part of the clinical presentation of attention-deficit/hyperactivity disorder (ADHD). Recently, impulsive aggression has been attributed to emotion dysregulation, which is currently conceptualised as a transdiagnostic factor and seems to contribute to the co-occurrence of other problems in ADHD. Thus, this study investigated the presence of impulsive aggressive behaviour and explored whether emotion dysregulation mediates the relationship between inhibitory control difficulties and aggressive behaviour in children with ADHD. Because ADHD may act as a risk factor for the development of other conditions, such as internalising problems, we aimed to understand whether depressive symptoms contribute to this relationship. Methods Seventy-two children were recruited from a hospital and the community, 38 of whom had ADHD and 34 were typically developing (TD). Parents completed the Child Behaviour Checklist, the Behaviour Rating Inventory of Executive Function, and the Emotion Regulation Checklist. Simple mediation and serial mediation models were performed to test our hypotheses. Results Aggressive behaviour was significantly higher in ADHD children compared to TD children. Emotion dysregulation fully mediated the relationship between inhibitory control difficulties and aggressive behaviour in ADHD children. Adding depressive symptoms to the model increased the explained variance in aggressive behaviour. Conclusion The main result of our study supports the role of emotion dysregulation and depressive symptoms in mediating the relationship between inhibitory control difficulties and impulsive aggressive behaviour in children with ADHD. This highlights that aggressive behaviour is, in part, a result of the inability of the child to appropriately regulate their emotions. Future interventions may be tailored to improve emotion regulation skills to address aggressive behaviour.
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Affiliation(s)
- Sofia Marques
- Institute of Psychology and Educational Sciences, Lusíada University, Porto, Portugal
- CIPD—Psychology for Development Research Centre, Lusíada University, Porto, Portugal
| | - Teresa Correia-de-Sá
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- INEB—Institute of Biomedical Engineering, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
| | - Micaela Guardiano
- Department of Paediatrics, Unit of Neurodevelopmental Paediatrics, University Hospital Centre of São João, Porto, Portugal
| | - Benedita Sampaio-Maia
- INEB—Institute of Biomedical Engineering, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Joana Ferreira-Gomes
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
- IBMC—Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal
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Dionne G, Mascheretti S, Feng B, Paradis H, Brendgen M, Vitaro F, Tremblay R, Boivin M. Genetic and phenotypic evidence of the predictive validity of preschool parent reports of hyperactivity/impulsivity and inattention. Dev Psychopathol 2024:1-13. [PMID: 38439652 DOI: 10.1017/s095457942400035x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
To determine the validity of parent reports (PRs) of ADHD in preschoolers, we assessed hyperactivity/impulsivity (HI) and inattention (IN) in 1114 twins with PRs at 1.5, 2.5, 4, 5, 14, 15, and 17 years, and teacher-reports at 6, 7, 9, 10, and 12. We examined if preschool PRs (1) predict high HI/IN trajectories, and (2) capture genetic contributions to HI/IN into adolescence. Group-based trajectory analyses identified three 6-17 years trajectories for both HI and IN, including small groups with high HI (N = 88, 10.4%, 77% boys) and IN (N = 158, 17.3%, 75% boys). Controlling for sex, each unit of HI PRs starting at 1.5 years and at 4 years for IN, increased more than 2-fold the risk of belonging to the high trajectory, with incremental contributions (Odds Ratios = 2.5-4.5) at subsequent ages. Quantitative genetic analyses showed that genetic contributions underlying preschool PRs accounted for up to a quarter and a third of the heritability of later HI and IN, respectively. Genes underlying 1.5-year HI and 4-year IN contributed to 6 of 8 later HI and IN time-points and largely explained the corresponding phenotypic correlations. Results provide phenotypic and genetic evidence that preschool parent reports of HI and IN are valid means to predict developmental risk of ADHD.
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Affiliation(s)
- Ginette Dionne
- School of Psychology, Université Laval, Québec City, Canada
| | - Sara Mascheretti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Bei Feng
- School of Psychology, Université Laval, Québec City, Canada
| | - Hélène Paradis
- School of Psychology, Université Laval, Québec City, Canada
| | - Mara Brendgen
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Frank Vitaro
- School of Psychoeducation, Université de Montréal, Montréal, Canada
| | - Richard Tremblay
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec City, Canada
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Flynn TB, Goble PM, Bishop NJ, Weimer AA. Early childhood hospitalization and problematic behaviors: A propensity score analysis. J Child Health Care 2024; 28:86-103. [PMID: 35582834 DOI: 10.1177/13674935221102707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Existing research suggests that children who experience poverty and hospitalization in early childhood are at risk of developing behavior problems. We examined whether the association between early childhood hospitalization and children's internalizing and externalizing behaviors were moderated by family poverty status and child sex. Participants included 224 children from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. There was no direct association between hospitalization and problematic behaviors. Poverty status during early childhood, but not child sex, significantly moderated the association between hospitalization and externalizing problems. Findings support the need for community programs that promote an integrative approach to healthcare for families experiencing poverty.
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Affiliation(s)
- Toria B Flynn
- Human Development & Family Sciences, Texas State University, San Marcos, TX, USA
| | - Priscilla M Goble
- Human Development & Family Sciences, Texas State University, San Marcos, TX, USA
| | - Nicholas J Bishop
- Human Development & Family Sciences, Texas State University, San Marcos, TX, USA
| | - Amy A Weimer
- Human Development & Family Sciences, Texas State University, San Marcos, TX, USA
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Zhang R, Wang Z. Aggressive behaviors predict greater intraindividual reaction time variability in children: Evidence from cross-lagged panel models. Aggress Behav 2024; 50:e22110. [PMID: 37624086 DOI: 10.1002/ab.22110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
Deficits in attentional control or inhibitory control are distinct features of childhood aggressive behaviors. Lower attentional control or inhibitory control is considered to predict more aggressive behaviors, while few studies have documented the possible predictive effects of aggressive behaviors on attentional control or inhibitory control. The present study examined the bidirectional relations between aggressive behaviors and both inhibitory control and attentional control in 169 Chinese primary school children (75 girls, Mage = 7.15, SDage = 0.33), annually for 3 years starting at age 7. The No-go accuracy on a Go/No-go task was used as the index of inhibitory control, and the intraindividual reaction time variability (IIRTV) of correct Go trials indicated attentional control. The aggressive behaviors subscale of the child behavior checklist-Chinese version was used to assess the children's aggressive behaviors. The results demonstrated a significant and stable predictive effect of previous aggressive behaviors on subsequent attentional control, with more aggressive behaviors predicting greater IIRTV at both the between-child and within-child levels. No significant effects of inhibitory control or attentional control on aggressive behaviors or sex-specific patterns were found. The findings suggest the negative impact of childhood aggressive behaviors on attentional control and underscore the importance of early prevention and intervention for childhood aggressive behaviors.
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Affiliation(s)
- Runzhu Zhang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Zhenhong Wang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
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Eng AG, Bansal PS, Goh PK, Nirjar U, Petersen MK, Martel MM. Evidence-Based Assessment for Attention-Deficit/Hyperactivity Disorder. Assessment 2024; 31:42-52. [PMID: 36633097 DOI: 10.1177/10731911221149957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals from all life stages, genders, and races/ethnicities. Accurate assessment of ADHD across different populations is essential as undiagnosed ADHD is associated with numerous costly negative public health outcomes and is complicated by high comorbidity and developmental change in symptoms over time. Predictive analysis suggests that best-practice evidence-based assessment of ADHD should include both ADHD-specific and broadband rating scales from multiple informants with consideration of IQ, academic achievement, and executive function when there are concerns about learning. For children under age 12, parent and teacher ratings should be averaged. For adolescents and adults, informant reports should be prioritized when self- and other-report are inconsistent. Future research should provide more stringent evaluation of the sensitivity of measures to treatment response and developmental change over time as well as further validate measures on historically understudied populations (i.e., adults, women, and racial/ethnic minorities).
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Ross HMA, Girard LC. Joint Developmental Trajectories of Conduct Problems and Hyperactivity/Inattention: Antecedent Risk Markers for Group Membership. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01614-w. [PMID: 37914982 DOI: 10.1007/s10578-023-01614-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 11/03/2023]
Abstract
This study investigated joint trajectories of conduct problems and hyperactivity/inattention from age three to nine in a cohort of 7,507 children in Ireland (50.3% males; 84.9% Irish). The parent-reported Strengths and Difficulties Questionnaire was used to collect information on conduct problems (CP) and hyperactivity/inattention (HI). Information regarding risk markers was collected when participants were nine-months-old via parent report and standardised assessments. Using a person-centred approach (i.e., group-based multi trajectory modelling), six trajectories were identified: no CP/low HI, low-stable CP/HI, low-declining CP/stable HI, desisting co-occurring CP/HI, pure-increasing HI, and high chronic co-occurring CP/HI. Specific risk markers for group membership included: male sex; birth complications; perceived difficult temperament; lower primary caregiver age and education level, and higher stress level; prenatal exposure to smoking, and indicators of lower socioeconomic status. Primary caregiver-child bonding and having siblings were protective markers against membership in elevated groups. Results suggest support for both 'pure' HI and co-occurring trajectories of CP and HI emerging in toddlerhood. However, no support was found for a 'pure' CP trajectory, which may support the suggestion that children on a persistent CP trajectory will have coexisting HI. Intervention efforts may benefit from starting early in life and targeting multiple risk markers in families with fewer resources.
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Tallberg P, Rastam M, Hallin AL, Perrin S, Gustafsson P. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:259-271. [PMID: 36126650 DOI: 10.1080/21622965.2022.2093113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from childhood/adolescence to young adulthood. This was done by examining possible improvements in parent-rated EF and performance-based measures of inattention and inhibition over a three-year interval and their relationship to ADHD outcomes in 137 clinically referred youth with ADHD (mean age = 12.4 years, SD = 3.1). Participants' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Swanson-Nolan-Pelham Scale at baseline and follow-up. Participants completed the Conners' Continuous Performance Test, Version II (CPT II) at baseline and follow-up. Statistical analyses were performed with Linear Mixed Models. The sex- and age-standardized measures Commission and Hit reaction time (RT) subscales of the CPT II and parent-rated metacognitive, and behavior regulation composites of the BRIEF were largely stable between measuring points. CPT Omissions, Hit RT standard error (reaction time variability), and parent-rated ADHD symptom scores improved slightly. BRIEF composites and reaction time variability were related to ADHD symptoms using longitudinal data. Overall, behavioral aspects of EF, as observed by parents in the home context, appear to play a significant role in the trajectory of childhood ADHD.
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Affiliation(s)
- Pia Tallberg
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Maria Rastam
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
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Morales MF, MacBeth A, Swartzman S, Girard LC. Multi-Trajectories of Conduct Problems, Hyperactivity/Inattention, and Peer Problems Across Childhood: Results from the Growing Up in Scotland Birth Cohort. Res Child Adolesc Psychopathol 2023. [PMID: 35920956 DOI: 10.1007/s10802-022-00956-8/tables/5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Using a person-centred approach, this study inspected multi-trajectories of conduct problems, hyperactivity/inattention and peer problems, and associated risk factors for group membership. The sample included 3,578 children (50.8% males) from a population birth cohort in Scotland (Growing Up in Scotland). The parental version of the Strengths and Difficulties Questionnaire (SDQ) was used when children were 4, 5, 6, 7, and 10 years old. Antecedent factors at the perinatal, child, and family levels were collected using parental reports, observation, and standardised assessments at 10, 24, and 36 months. A group-based multi-trajectory analysis was employed. Findings showed that a six-group model best fit the data. Identified groups included non-engagers, normative, decreasing externalising/low peer problems, low externalising/moderate peer problems, moderate externalising/increasing peer problems and multimorbid moderate-high chronic. Findings suggest multimorbidity between externalising behaviours and peer problems in the more elevated groups. Two common protective factors emerged across all groups: caregiver mental health and parent-infant attachment. Identified risk factors were specific to group membership. Risk factors for the most elevated group included single-parent status, social deprivation, previous neonatal intensive care unit admission, child sex, whilst children's expressive language was a protective factor. Taken together, findings contribute to the emerging literature modelling trajectories of externalising behaviours and peer problems simultaneously and have important practical implications for prevention of problems in childhood, by identifying targets at the perinatal, child, and family levels.
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Affiliation(s)
- María Francisca Morales
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Angus MacBeth
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
| | - Samantha Swartzman
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
| | - Lisa-Christine Girard
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
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Brinksma DM, Hoekstra PJ, de Bildt A, Buitelaar JK, van den Hoofdakker BJ, Hartman CA, Dietrich A. Parental rejection in early adolescence predicts a persistent ADHD symptom trajectory across adolescence. Eur Child Adolesc Psychiatry 2023; 32:139-153. [PMID: 34275051 PMCID: PMC9908736 DOI: 10.1007/s00787-021-01844-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
Despite a general decrease of attention-deficit/hyperactivity disorder (ADHD) symptoms during adolescence, these may persist in some individuals but not in others. Prior cross-sectional studies have shown that parenting style and their interaction with candidate genes are associated with ADHD symptoms. However, there is a lack of longitudinal research examining the independent and interactive effects of parenting and plasticity genes in predicting the course of attention-deficit/hyperactivity disorder (ADHD) symptoms across adolescence. Here, we investigated how children perceived their parents' parenting style (i.e., rejection, overprotection, and emotional warmth) at the age of 11, and their interaction with DRD4, MAOA, and 5-HTTLPR genotypes on parent-reported ADHD symptoms at three time points (mean ages 11.1, 13.4, and 16.2 years) in 1730 adolescents from the TRacking Adolescents' Individual Lives Survey (TRAILS). Growth Mixture Modeling in Mplus identified four ADHD symptom trajectories: low, moderate stable, high decreasing, and high persistent. Perceived parental rejection predicted class membership in the high persistent trajectory compared to the other classes (p < 0.001, odds ratios between 2.14 and 3.74). Gene-environment interactions were not significantly related to class membership. Our results indicate a role of perceived parental rejection in the persistence of ADHD symptoms. Perceived parental rejection should, therefore, be taken into consideration during prevention and treatment of ADHD in young adolescents.
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Affiliation(s)
- Djûke M Brinksma
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands.
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Multi-Trajectories of Conduct Problems, Hyperactivity/Inattention, and Peer Problems Across Childhood: Results from the Growing Up in Scotland Birth Cohort. Res Child Adolesc Psychopathol 2023; 51:55-69. [PMID: 35920956 PMCID: PMC9763152 DOI: 10.1007/s10802-022-00956-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 10/16/2022]
Abstract
Using a person-centred approach, this study inspected multi-trajectories of conduct problems, hyperactivity/inattention and peer problems, and associated risk factors for group membership. The sample included 3,578 children (50.8% males) from a population birth cohort in Scotland (Growing Up in Scotland). The parental version of the Strengths and Difficulties Questionnaire (SDQ) was used when children were 4, 5, 6, 7, and 10 years old. Antecedent factors at the perinatal, child, and family levels were collected using parental reports, observation, and standardised assessments at 10, 24, and 36 months. A group-based multi-trajectory analysis was employed. Findings showed that a six-group model best fit the data. Identified groups included non-engagers, normative, decreasing externalising/low peer problems, low externalising/moderate peer problems, moderate externalising/increasing peer problems and multimorbid moderate-high chronic. Findings suggest multimorbidity between externalising behaviours and peer problems in the more elevated groups. Two common protective factors emerged across all groups: caregiver mental health and parent-infant attachment. Identified risk factors were specific to group membership. Risk factors for the most elevated group included single-parent status, social deprivation, previous neonatal intensive care unit admission, child sex, whilst children's expressive language was a protective factor. Taken together, findings contribute to the emerging literature modelling trajectories of externalising behaviours and peer problems simultaneously and have important practical implications for prevention of problems in childhood, by identifying targets at the perinatal, child, and family levels.
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13
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Yu RA, Goulter N, McMahon RJ. Longitudinal Associations between Parental Warmth, Harsh Discipline, Child Emotion Regulation, and ODD Dimensions. Child Psychiatry Hum Dev 2022; 53:1266-1280. [PMID: 34148149 PMCID: PMC8684556 DOI: 10.1007/s10578-021-01205-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 06/04/2021] [Indexed: 11/24/2022]
Abstract
Research has yet to investigate the mediating role of emotion regulation in the relation between parental warmth and harsh discipline with oppositional defiant disorder (ODD). Further, few studies have investigated ODD as both a unitary construct and as three distinct dimensions (anger, defiance, spitefulness). Thus, the present study aimed to investigate child emotion regulation (grade 2) as a mediator of the relation between parental warmth and harsh discipline (kindergarten, grade 1, grade 2) and ODD and its dimensions (grade 3). Participants included the high-risk and normative samples from the Fast Track project (N = 753, male = 58 %, Black = 46 %). Constructs were assessed using observation and parent and teacher reports. Although results demonstrated an absence of indirect effects, emotion regulation was negatively associated with overall ODD and anger and defiance, but not spitefulness. Findings illustrate how increased attention toward the study of ODD as distinct dimensions contributes to our ability to parse out heterogeneity among children with the disorder.
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Affiliation(s)
- Rachelle A Yu
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada.
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.
| | - Natalie Goulter
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
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14
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Murray AL, Nagin D, Obsuth I, Ribeaud D, Eisner M. Young Adulthood Outcomes of Joint Mental Health Trajectories: A Group-Based Trajectory Model Analysis of a 13-Year Longitudinal Cohort Study. Child Psychiatry Hum Dev 2022; 53:1083-1096. [PMID: 34059956 PMCID: PMC9470602 DOI: 10.1007/s10578-021-01193-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/21/2022]
Abstract
Developmental trajectories of common mental health issues such as ADHD symptoms, internalising problems, and externalising problems can often be usefully summarised in terms of a small number of 'developmental subtypes' (e.g., 'childhood onset', 'adolescent onset') that may differ in their profiles or levels of clinically meaningful variables such as etiological risk factors. However, given the strong tendency for symptoms in these domains to co-occur, it is important to consider not only developmental subtypes in each domain individually, but also the joint developmental subtypes defined by symptoms trajectories in all three domains together (e.g., 'late onset multimorbid', 'pure internalising', 'early onset multimorbid'). Previous research has illuminated the joint developmental subtypes of ADHD symptoms, internalising problems, and externalising problems that emerge from normative longitudinal data using methods such as group-based trajectory modelling, as well as predictors of membership in these developmental subtypes. However, information on the long-term outcomes of developmental subtype membership is critical to illuminate the likely nature and intensity of support needs required for individuals whose trajectories fit different developmental subtypes. We, therefore, evaluated the relations between developmental subtypes previously derived using group-based trajectory modelling in the z-proso study (n = 1620 with trajectory data at ages 7, 8, 9, 10, 11, 12, 13, 15) and early adulthood outcomes. Individuals with multimorbid trajectories but not 'pure' internalising problem elevations showed higher levels of social exclusion and delinquency at age 20. These associations held irrespective of the specific developmental course of symptoms (e.g., early versus late onset versus remitting). There was also some evidence that intimate partner violence acts as a form of heterotypic continuity for earlier externalising problems. Results underline the need for early intervention to address the pathways that lead to social exclusion and delinquency among young people with multiple co-occurring mental health issues.
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Affiliation(s)
| | | | - Ingrid Obsuth
- Clinical Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Institute of Criminology, University of Cambridge, Cambridge, UK
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15
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Babinski DE, Saunders EFH, He F, Liao D, Pearl AM, Waschbusch DA. Screening for ADHD in a general outpatient psychiatric sample of adults. Psychiatry Res 2022; 311:114524. [PMID: 35349861 DOI: 10.1016/j.psychres.2022.114524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022]
Abstract
Adults (n = 805) seeking outpatient psychiatric care completed the Adult ADHD Self-Report Scale (ASRS) and measures of impairment and co-occurring psychopathology as part of a measurement-based care initiative. Diagnostic indicators of ADHD (i.e., formal diagnosis and/or medication treatment) were recorded from the electronic medical record (EMR). Agreement between screening positive for ADHD and EMR indicators for the diagnosis was explored, and clinical characteristics of adults identified with ADHD using these indicators were examined. Lastly, the contribution of ADHD to functional impairment was examined, controlling for the contribution of other demographic and psychiatric comorbidities. In the full sample, 54.78% of adults screened positive for ADHD based on the ASRS, and using EMR indicators, only 11.93% of adults were identified with ADHD. Agreement emerged between self-reported ADHD and ADHD EMR indicators, although adults screening positive for ADHD generally reported greater psychiatric complexity relative to adults identified with ADHD in the EMR. ADHD was associated with clinical impairment even when controlling for other psychiatric comorbidities. The considerable difference in prevalence of ADHD based on self-report screening versus EMR indicators suggests that ADHD may be overlooked in adult psychiatric care. Findings point to the importance of assessing adult ADHD in routine psychiatric care.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Amanda M Pearl
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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16
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Hatley-Cotter A, Saad G, Brestan-Knight E. Treatment Readiness among Primarily Latine Families Seeking Parent-Child Interaction Therapy (PCIT) in an Urban Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084784. [PMID: 35457656 PMCID: PMC9032165 DOI: 10.3390/ijerph19084784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/18/2022]
Abstract
(1) Background: Given the high prevalence of childhood mental health problems and their long-lasting negative consequences if left untreated, it is important to investigate factors that affect family engagement in psychological interventions such as Parent–Child Interaction Therapy (PCIT), including caregiver treatment readiness and readiness for change (RFC). Specifically, Latine families experience greater mental health disparities and have unique cultural factors that affect engagement. The current project examined caregiver pretreatment readiness among primarily Latine Spanish- and English-speaking families. (2) Methods: Participants were 100 caregivers (96% female) of young children ages 2 to 7 who sought PCIT services from a community mental health center in Washington, D.C. Families completed written and observational assessment measures at pretreatment and throughout PCIT, which were used for the current study. (3) Results: Caregivers reported high readiness and importance of treatment at intake, with higher RFC among Spanish-speaking caregivers. Regardless of language, caregivers who reported more frequent and problematic child misbehavior and who were from a multi-caregiver household tended to report more RFC and treatment importance at intake. Pretreatment RFC also predicted family completion of the first phase of PCIT although there was a high attrition rate for the sample as only 18% of families completed treatment. (4) Conclusions: These findings provide insight into the implementation of standard PCIT among Spanish- and English speaking families and highlight the benefits of assessing pretreatment caregiver readiness to inform clinical decision-making.
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Affiliation(s)
- Allison Hatley-Cotter
- Department of Psychological Sciences, Auburn University, 226 Thach Ave, Auburn, AL 36849, USA;
- Correspondence: ; Tel.: +1-614-722-4700
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17
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Nylén-Eriksen M, Lara-Cabrera ML, Grov EK, Skarsvaag H, Lie I, Dahl-Michelsen T, Sæterstrand TM, Mandahl A, Hafstad H, Lersveen MB, Bjørnnes AK. Fighting the waves; Covid-19 family life interference in a neurodevelopmental disorder-caregiver population. BMC Health Serv Res 2022; 22:472. [PMID: 35399084 PMCID: PMC8994698 DOI: 10.1186/s12913-022-07836-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/17/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The current COVID-19 pandemic interferes with family lives across the world, particularly families of children with neurodevelopmental disorders (NDDs) are at a greater risk for being negatively impacted by the pandemic. Together with representatives from this caregiver population the aim was to explore the interference associated with normal family life caused by the COVID-19 pandemic. Method This is a descriptive study using a cross-sectional design. Following a strategic network sampling strategy, a user-developed national survey was completed by a larger sample (N = 1,186) of parents and informal caregivers of children with NDDs. The survey utilized a combination of both closed and open-ended questions, and a logistic regression analysis was carried out to assess the association between family characteristics, characteristics of the child, and COVID-19 related family life interference. Before carrying out the regression an inductive content analysis of the open-ended question on `How has the isolation affected the family´ was carried out to construct the outcome variable. Results The initial analysis indicated that the COVID-19 pandemic induced a shift in everyday family life and a lack of guidance and support related to managing the challenges they were facing. Caregivers who reported that COVID-19 had significantly interfered with their family life, were more likely to report having anxious children, and to have experienced an increased number of conflicts at home. The logistic regression showed that both anxious children and increased conflicts considerably increased the risk for reporting family life interference compared to those that reported no increased conflicts or anxious children. Discussion Considering how the COVID-19 related increased conflicts at home and anxious children threaten the family life of the NDD caregiver population, as an external source of family stress, which might lead to negative impact on their mental and physical well-being, the need for further research in collaboration with user representatives is apparent. Our study suggests that more information should be provided to healthcare providers, social professionals, peers, people with NDDs, and caregivers of people with NDDs about the potential threats that a stressful life event such as the current pandemic can pose to their mental and physical health and their family life.
Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07836-3.
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18
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Ji D, Flouri E, Papachristou E, Francesconi M. Childhood Trajectories of Hyperactivity/Inattention Symptoms and Diurnal Cortisol in Middle Adolescence: Results from a UK Birth Cohort. J Atten Disord 2022; 26:809-821. [PMID: 34378439 PMCID: PMC8859655 DOI: 10.1177/10870547211036755] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Children with attention-deficit/hyperactivity disorder (ADHD) show hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Whether the association between hyperactivity/inattention symptoms with HPA axis dysfunction holds in the general child population too is not clear. METHOD We assessed associations between longitudinal trajectories of hyperactivity/inattention symptoms during ages 4 to 13 years and basal cortisol profiles at age 15 in a British general population cohort. RESULTS Adolescents with persistently high levels of hyperactivity/inattention symptoms since childhood showed lower total morning cortisol and a smaller diurnal decline, even after adjusting for confounders. No associations were found between any of the symptom trajectories and cortisol awakening response, diurnal slope or daily output of cortisol. CONCLUSION This study provides evidence for hypocortisolism among adolescents with chronic hyperactivity/inattention symptoms in the general population.
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Affiliation(s)
- Dongying Ji
- UCL Institute of Education, London, UK,Dongying Ji, Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
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19
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So FK, Chavira D, Lee SS. ADHD and ODD Dimensions: Time Varying Prediction of Internalizing Problems from Childhood to Adolescence. J Atten Disord 2022; 26:932-941. [PMID: 34632828 DOI: 10.1177/10870547211050947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although childhood ADHD is a risk factor for internalizing problems, it consists of separable inattention and hyperactivity dimensions that differentially predict outcomes. Oppositional defiant disorder also consists of separable dimensions (i.e., irritable, oppositional), co-occurs with ADHD, and predicts internalizing outcomes. To discern independent associations with internalizing problems, dimensions must be considered simultaneously. METHODS Controlling for age, sex, and race, we tested inattention, hyperactivity, irritability, and oppositionality as time-varying predictors of 6 to 7-year prospective change in parent- and teacher-rated internalizing problems in 230 ethnically- diverse (50% Caucasian) 5 to 10 year old youth (M = 7.4 years, 68% male) with (n = 120) and without ADHD (n = 110). RESULTS Escalating inattention and irritability, but not hyperactivity and oppositionality, uniquely predicted internalizing problems. CONCLUSION These findings suggest that inattention and irritability are unique risk factors for later internalizing problems. These dimensions may catalyze internalizing problems across development and constitute important intervention targets.
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Affiliation(s)
- Felix K So
- University of California, Los Angeles, USA
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20
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Landgren V, Fernell E, Gillberg C, Landgren M, Johnson M. Deficits in attention, motor control and perception childhood to age 30 years: prospective case-control study of outcome predictors. BMJ Open 2022; 12:e054424. [PMID: 35301207 PMCID: PMC8932285 DOI: 10.1136/bmjopen-2021-054424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Investigate predictors of adverse outcome in children with and without attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) at 6 years of age. DESIGN Prospective population-based cohort study. SETTING Western Sweden. PARTICIPANTS From a screening-based population cohort of 589 individuals, 62 (11 female) diagnosed with ADHD+DCD at mean age 6.6 years, and a comparison group of 51 population-matched (10 female) children were followed prospectively. OUTCOME MEASURES Drawn from a clinical reassessment at age 9 years of 110 of the 113 individuals, neuropsychiatric symptoms, continuous performance test results and measures of motor function were used as predictors of outcome in linear regression models. Participants were followed in national registers up to 30-31 years of age for outcomes in adulthood. Predictors were regressed onto an adverse outcome score (range 0-7) comprising seven binary endpoints, and when applicable onto each continuous outcome separately (low educational attainment, low occupation level, psychiatric disorder, psychotropic medication prescription, sick pension, high dependence on social benefits and criminal conviction). RESULTS Of the 110 individuals, 3 had died. In univariable regression onto the adverse outcome score, the strongest predictors at age 9 years were symptoms of conduct disorder, oppositional defiant disorder, ADHD and motor dysfunction, with an R2 around 25%, followed by autistic traits (R2=15%) and depressive symptoms (R2=8%). Combining these six strongest predictors in a multivariable model yielded an adjusted R2=38%. Subgroup analyses were similar, except for a strong association of autistic traits with the adverse outcome score in females (n=20, R2=50%). CONCLUSION Several neurodevelopmental symptoms, including ADHD severity at age 9 years, accounted for a considerable amount of the variance in terms of adulthood adverse outcome. Broad neurodevelopmental profiling irrespective of diagnostic thresholds should inform research and clinical practice. The study highlights the importance of considering associated comorbidities and problems in ADHD.
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Affiliation(s)
- Valdemar Landgren
- Psychiatry, Skaraborg Hospital Skövde, Skövde, Sweden
- Gillberg Neuropsychiatry Centre, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
| | - Magnus Landgren
- Gillberg Neuropsychiatry Centre, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
- Pediatrics, Skaraborg Hospital Mariestad, Mariestad, Sweden
| | - Mats Johnson
- Gillberg Neuropsychiatry Centre, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden
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21
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Armour JA, Joussemet M, Mageau GA, Varin R. Perceived Parenting and Borderline Personality Features during Adolescence. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01295-3. [PMID: 35013846 DOI: 10.1007/s10578-021-01295-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/27/2022]
Abstract
This study investigates the associations between perceived parenting and borderline personality disorder (BPD) in adolescents. The relations between components of parenting and BPD features were explored. Participants (N = 270; mean age = 15.3) assessed their own BPD features (Personality Assessment Inventory) and both of their parents' parenting practices (Parents as Social Context Questionnaire; Perceived Parental Autonomy Support Scale). SEM results suggest that controlling, rejecting and chaotic parenting all predicted global BPD, and all these parenting components were significantly associated with at least one BPD feature. Chaotic parenting, a relatively neglected construct in the BPD literature, seems to play an important role in early BPD.
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Affiliation(s)
- Jessie-Ann Armour
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Mireille Joussemet
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.
| | - Geneviève A Mageau
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Rose Varin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
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22
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Shippen N, Horn SR, Triece P, Chronis-Tuscano A, Meinzer MC. Understanding ADHD in Black Adolescents in Urban Schools: A Qualitative Examination of Factors that Influence ADHD Presentation, Coping Strategies, and Access to Care. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:213-229. [PMID: 35602172 PMCID: PMC9122271 DOI: 10.1080/23794925.2021.2013140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The high school years are a challenging developmental period for adolescents with attention-deficit/hyperactivity disorder (ADHD), their families, and those who work with them in the school system. Moreover, racially minoritized families and schools in low-resource, urban settings often experience additional adverse experiences that can make access to evidence-based mental health care particularly difficult. This qualitative investigation into the experiences of Black high school students with ADHD, their caregivers, teachers, and school mental health providers (SMHPs) aimed to understand this community's experiences with ADHD across development and to explore the barriers/facilitators to adequate services. Through focus group interviews with stakeholders (i.e., 6 adolescents with a diagnosis of ADHD, 5 caregivers of adolescents with ADHD, 6 teachers, 5 school mental health providers), themes emerged related to (1) developmental changes observed in ADHD presentation in high school students and (2) contextual factors (including barriers/facilitators to optimal school and home functioning). These themes led to the development of an ecological model that show various contextual factors influencing the experiences of Black adolescents with ADHD in under-resourced urban public high schools (e.g., adolescents' coping strategies, caregiver involvement, teacher burden or lack of ADHD-knowledge, socioeconomic status, access to care). This qualitative study represents the first step of a treatment development project assessing the implementation of a depression prevention intervention for Black adolescents with ADHD in urban public-school settings. Clinical implications (e.g., coordination of care between home and schools, increasing attention to social determinants of health, ensuring culturally competent discussion of ADHD and its treatment) are discussed.
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Affiliation(s)
| | | | | | | | - Michael C. Meinzer
- University of Illinois at Chicago, Chicago, IL,University of Maryland, College Park, MD
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23
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Vos M, Rommelse NNJ, Franke B, Oosterlaan J, Heslenfeld DJ, Hoekstra PJ, Klein M, Faraone SV, Buitelaar JK, Hartman CA. Characterizing the heterogeneous course of inattention and hyperactivity-impulsivity from childhood to young adulthood. Eur Child Adolesc Psychiatry 2022; 31:1-11. [PMID: 33813662 PMCID: PMC9343304 DOI: 10.1007/s00787-021-01764-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
To advance understanding of the heterogeneity in the course of ADHD, joint symptom trajectories of inattention and hyperactivity-impulsivity from childhood to young adulthood were modelled and associated with genetic, demographic, and clinical characteristics. Data were obtained from the NeuroIMAGE cohort which includes 485 individuals with ADHD, their 665 siblings, and 399 typically developing children. Trajectories were based on scores of the Conners Parent Rating Scale Revised and estimated over seven homogeneous age bins (from 5 to 28 years) using parallel process latent class growth analysis on data collected across 2-4 time points. Multilevel multinomial logistic regression was used to identify characteristics that differentiated between the derived classes. A seven-class solution revealed "severe combined stable" (4.8%), "severe combined decreasing" (13%), "severe inattentive stable" (4.8%), "moderate combined increasing" (7.5%), "moderate combined decreasing" (12.7%), "stable mild" (12.9%), and "stable low" (44.3%) classes. Polygenic risk for depression, ADHD diagnosis, ADHD medication use, IQ, comorbid symptom levels (foremost oppositional behaviour), and functional impairment levels differentiated classes with similar ADHD symptom levels in childhood but a diverging course thereafter. The course of ADHD is highly heterogeneous, with stable, decreasing, and increasing trajectories. Overall, severe symptom levels in childhood are associated with elevated-to-severe symptom levels in adolescence and young adulthood, despite substantial symptom reductions. Beyond symptom severity in childhood, genetic, demographic, and clinical characteristics distinguish the heterogeneous course.
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Affiliation(s)
- Melissa Vos
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Nanda N. J. Rommelse
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Barbara Franke
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jaap Oosterlaan
- grid.12380.380000 0004 1754 9227Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of Pediatrics, Emma Children’s Hospital, Amsterdam Medical Center and Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - Dirk J. Heslenfeld
- grid.12380.380000 0004 1754 9227Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pieter J. Hoekstra
- grid.4494.d0000 0000 9558 4598Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke Klein
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.7692.a0000000090126352Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stephen V. Faraone
- grid.411023.50000 0000 9159 4457Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY USA ,grid.411023.50000 0000 9159 4457Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, NY USA ,grid.7914.b0000 0004 1936 7443Department of Biomedicine, K.G. Jebsen Center for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Jan K. Buitelaar
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catharina A. Hartman
- grid.4494.d0000 0000 9558 4598Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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24
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Viering T, Hoekstra PJ, Philipsen A, Naaijen J, Dietrich A, Hartman CA, Franke B, Buitelaar JK, Hildebrandt A, Thiel CM, Gießing C. Emotion dysregulation and integration of emotion-related brain networks affect intraindividual change in ADHD severity throughout late adolescence. Neuroimage 2021; 245:118729. [PMID: 34813971 DOI: 10.1016/j.neuroimage.2021.118729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/18/2022] Open
Abstract
The course of attention deficit hyperactivity disorder (ADHD) from adolescence into adulthood shows large variations between individuals; nonetheless determinants of interindividual differences in the course are not well understood. A frequent problem in ADHD, associated with worse outcomes, is emotion dysregulation. We investigated whether emotion dysregulation and integration of emotion-related functional brain networks affect interindividual differences in ADHD severity change. ADHD severity and resting state neuroimaging data were measured in ADHD and unaffected individuals at two points during adolescence and young adulthood. Bivariate latent change score models were applied to investigate whether emotion dysregulation and network integration affect ADHD severity changes. Emotion dysregulation was gauged from questionnaire subscales for conduct problems, emotional problems and emotional lability. Better emotion regulation was associated with a better course of ADHD (104 participants, 44 females, age range: 12-27). Using graph analysis, we determined network integration of emotion-related functional brain networks. Network integration was measured by nodal efficiency, i.e., the average inverse path distance from one node to all other nodes. A pattern of low nodal efficiency of cortical regions associated with emotion processing and high nodal efficiency in subcortical areas and cortical areas involved in implicit emotion regulation predicted a better ADHD course. Larger nodal efficiency of the right orbitofrontal cortex was related to a better course of ADHD (99 participants, 42 females, age range: 10-29). We demonstrated that neural and behavioral covariates associated with emotion regulation affect the course of ADHD severity throughout adolescence and early adulthood beyond baseline effects of ADHD severity.
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Affiliation(s)
- Tammo Viering
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Postfach 2503, Oldenburg 26111, Germany; University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, Netherlands.
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, Netherlands
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Jilly Naaijen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands
| | - Andrea Dietrich
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, Netherlands
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Human Genetics, Nijmegen, Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Nijmegen, Netherlands
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Andrea Hildebrandt
- Psychological Methods and Statistics, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Christiane M Thiel
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Postfach 2503, Oldenburg 26111, Germany; Research Center Neurosensory Science, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany; Cluster of Excellence "Hearing4all", Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Carsten Gießing
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Postfach 2503, Oldenburg 26111, Germany
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Suresh P, Ray B, Duan K, Chen J, Schoenmacker G, Franke B, Buitelaar JK, Sprooten E, Arias-Vasquez A, Turner JA, Liu J. Evaluating the Neuroimaging-Genetic Prediction of Symptom Changes in Individuals with ADHD. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:1950-1956. [PMID: 34891669 DOI: 10.1109/embc46164.2021.9630229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that could persist into adulthood with known abnormalities in brain structure. Genetics also play an important role in the etiology of the disorder and could affect the disorder trajectory. In this study, we investigated the prediction power of brain image and genomic features for symptom change in 77 individuals with ADHD as part of NeuroIMAGE cohort. Gray matter components and working memory assessments at baseline, as well as gene scores of interest, were used to predict the changes in the two symptom domains: inattentive and hyperactive/impulsive, an average of 4 years. A linear regression model coupled with various feature selection approaches, including leave-one-out-cross-validation (LOOCV), stability selection with resampling, and permutation tests, was implemented to mitigate the overtraining potential caused by small sample sizes. Results showed that traditional LOOCV overestimated the prediction power. We proposed a novel stability selection with the threshold set by permutation tests, which provided more objective assessment. Using our proposed procedure, we identified a statistical promising prediction model for inattention symptom change; the consistent correlation between predicted values and measured values during model training, validating and hold out testing (r=0.64, 0.53, 0.46, respectively), but the p value is not significant in the holdout test. The selected features include age, gray matter in the insula, genes OSBPL1A, CTNNB1, PRPSAP2, ACADM, and polygenic risk score of education attainment, which have been previously reported to be associated with ADHD. We speculate that significant associations may be observed with a large sample size.
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Krieger V, Amador-Campos JA. Clinical presentations of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents: comparison of neurocognitive performance. Child Neuropsychol 2021; 27:1024-1053. [PMID: 33928840 DOI: 10.1080/09297049.2021.1917530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to compare performance in working memory (WM), processing speed (PRS), and attention measures in children and adolescents with typical development (TD) and with Attention deficit hyperactivity disorder (inattentive [ADHD-I] or combined [ADHD-C]) presentations, and to determine the predictive ability of the measures mentioned to discriminate between ADHD presentations and TD. 260 children and adolescents, 138 with ADHD (70 ADHD-I and 68 ADHD-C) and 122 TD in two age cohorts (8-12 years; 13-16 years), were assessed with WM and PRS indexes of Wechsler Intelligence Scale for Children (WISC-IV) and the d2 attention test. Significant differences between ADHD and TD groups in the WISC-IV GAI scores were found in children but not in adolescents. Children and adolescents with both ADHD presentations performed poorly on the PRS index, while on the WM index only children exhibited difficulties. In the attention test, children with ADHD-C showed more impulsivity and more difficulties for processing speed, concentration and accuracy than ADHD-I and TD. In addition, both ADHD presentations had higher inattention scores than TD. ADHD adolescents performed worse than TD in processing speed, concentration and accuracy. ADHD groups showed more impulsivity and inattention than TD. Digit Span and Symbol Search (WISC-IV) and processing speed and accuracy (d2) successfully classified ADHD and TD in children, but in adolescents, only coding (WISC-IV) and accuracy (d2) successfully classified ADHD presentations and TD. The WISC-IV and d2 yield neuropsychological profiles which reflect age-related cognitive changes and may allow the adaptation of more tailored early interventions for ADHD.
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Affiliation(s)
- Virginia Krieger
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Juan Antonio Amador-Campos
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neuroscience, University of Barcelona (UBneuro), Barcelona, Spain
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Murray AL, Hall HA, Speyer LG, Carter L, Mirman D, Caye A, Rohde L. Developmental trajectories of ADHD symptoms in a large population-representative longitudinal study. Psychol Med 2021; 52:1-7. [PMID: 33769236 DOI: 10.1017/s0033291721000349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous research has suggested that there is substantial heterogeneity in the developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms. Sometimes, qualitative distinctions between trajectories with different ages of onset and/or patterns of remission are made; however, little is known about the predictors and broader clinical meaningfulness of these candidate 'developmental subtypes' of ADHD symptoms. METHODS We applied latent class growth analysis to data from the UK Millennium Cohort Study (MCS; N = 11 316; ages 3, 5, 7, 11 and 14) to evaluate whether developmental trajectories of ADHD symptoms differing in early life predictors could be identified. Our optimal model included six trajectory groups, labelled unaffected (34.9% of the sample), mildly affected (24.1%), subclinical remitting (12.8%), pre-school onset partially remitting (14.1%), developmentally increasing (7.6%) and pre-school onset persistent (6.4%). RESULTS Factors such as gender, conduct problems, cognitive ability, maternal education, premature birth, peer problems and school readiness scores differentiated between specific ADHD symptom trajectories. CONCLUSIONS Taken together, our findings provide preliminary evidence that distinguishing different trajectories of ADHD symptoms could be clinically informative.
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Affiliation(s)
| | | | | | - Lara Carter
- Department of Psychology, University of Edinburgh, UK
| | - Daniel Mirman
- Department of Psychology, University of Edinburgh, UK
| | - Arthur Caye
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - Luis Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
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Jaekel J, Kim HM, Lee SJ, Schwartz A, Henderson JMT, Woodward LJ. Emotional and Behavioral Trajectories of 2 to 9 Years Old Children Born to Opioid-Dependent Mothers. Res Child Adolesc Psychopathol 2021; 49:443-457. [PMID: 33433780 PMCID: PMC7943531 DOI: 10.1007/s10802-020-00766-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2020] [Indexed: 12/20/2022]
Abstract
Maternal opioid use in pregnancy has increased dramatically. Knowledge about children's longer-term emotional and behavioral development after prenatal opioid exposure is scarce. A regional sample of 89 opioid-exposed and 104 non-exposed comparison children were studied prospectively at ages 2, 4.5, and 9 years using the Strengths and Difficulties Questionnaire (SDQ) completed by primary caregivers. Across all childhood assessments, opioid-exposed children obtained significantly higher total difficulties scores than non-exposed comparison children. Growth curve modeling revealed that, relative to their same age peers, opioid-exposed children's emotional and behavioral difficulties significantly worsened over time. Moreover, fixed effects estimates showed that total difficulties trajectories were poorer for children subject to higher prenatal risk (Est = 1.78, 95% CI = [0.46, 3.09]) who were born to mothers with high levels of social adversity (1.11 [0.51, 1.71]), and were then raised in families characterized by high levels of psychosocial risk (1.94 [0.90, 2.98]) and unstable caregiving (1.91 [0.33, 3.48]). A complex set of pre- and postnatal processes contribute to opioid-exposed children's emotional and behavioral development. Efforts to mitigate the long-term consequences of opioid use in pregnancy need to consider both children's and their caregivers' biopsychosocial risks.
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Affiliation(s)
- Julia Jaekel
- Department of Child & Family Studies, University of Tennessee Knoxville, Knoxville, USA. .,Department of Psychology, University of Tennessee Knoxville, Knoxville, USA. .,Department of Psychology, University of Warwick, Coventry, UK.
| | - Hyun M Kim
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Samantha J Lee
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Ashlyn Schwartz
- Department of Public Health, University of Tennessee Knoxville, Knoxville, USA
| | | | - Lianne J Woodward
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
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Gümüs F, Ergün G, Dikeç G. Effect of Psychoeducation on Stress in Parents of Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Study. J Psychosoc Nurs Ment Health Serv 2020; 58:34-41. [PMID: 32396205 DOI: 10.3928/02793695-20200506-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/14/2020] [Indexed: 11/20/2022]
Abstract
The current experimental pre-/posttest study sought to determine the effect of psychoeducation on the stress levels of parents of children with attention-deficit/hyperactivity disorder (ADHD). A total of 172 parents participated and were randomly assigned to experimental (n = 86) and control (n = 86) groups. There was no significant difference between mean pretest scores of parents in the experimental and control groups on the Caregiver Stress Scale (p > 0.005); however, significant differences were found between pre- and posttest scores in the experimental group after psychoeducation and at 6-month follow up (p < 0.001). There were also significant differences between pre- and posttest scores and pretest scores and 6-month follow-up scores in the experimental group (p < 0.05). In the light of the findings, psychiatric nurses can use psychoeducation programs to support families of children with ADHD to reduce their stress levels. [Journal of Psychosocial Nursing and Mental Health Services, 58(7), 34-41.].
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The Transition of Youth with ADHD into the Workforce: Review and Future Directions. Clin Child Fam Psychol Rev 2020; 22:316-347. [PMID: 30725305 DOI: 10.1007/s10567-019-00274-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Previous research suggests that a majority of children with attention-deficit/hyperactivity disorder (ADHD) continue to experience increased impairment across multiple life domains into adulthood. A systematic review of the occupational impairments, and associated educational and financial difficulties, faced by individuals with childhood ADHD was conducted. Systematic searches from PsycINFO and PubMed databases and other sources (i.e., books and consultants with experts) yielded 35 relevant articles that described 19 longitudinal studies on adults with a history of ADHD or related symptoms. Multiple studies indicated that those with a history of ADHD had more educational impairment and were less likely to graduate from high school and college than their peers without a history of ADHD. Subsequently, they faced lower occupational attainment, had more job instability, and demonstrated more impaired job performance, and these outcomes were largely consistent regardless of sex, medication history, or symptom persistence. Similar results were found in clinical and representative national studies in both U.S. and abroad, although older studies tended to indicate less occupational impairment. In addition, ADHD was associated with a number of financial challenges, including lower annual income, more reliance on public aid, and increased risk for homelessness. Future research should use more varied informant sources and utilize innovative measures of occupational impairment at both a macro- and micro-level of analyses. In addition, studies of effective supports and interventions in occupational settings for individuals with ADHD are needed.
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Goble P, Nauman C, Fife K, Blalock SM. Development of executive function skills: Examining the role of teachers and externalizing behaviour problems. INFANT AND CHILD DEVELOPMENT 2019. [DOI: 10.1002/icd.2160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Priscilla Goble
- School of Family and Consumer SciencesTexas State University San Marcos Texas
| | - Cambrian Nauman
- School of Family and Consumer SciencesTexas State University San Marcos Texas
| | - Katelyn Fife
- School of Family and Consumer SciencesTexas State University San Marcos Texas
| | - Sarah M. Blalock
- School of Family and Consumer SciencesTexas State University San Marcos Texas
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Gross TJ, Duncan J, Kim SY, Mason WA, Haggerty KP. Predicting School Suspension Risk from Eighth through Tenth Grade Using the Strengths and Difficulties Questionnaire. CONTEMPORARY SCHOOL PSYCHOLOGY 2019; 23:270-289. [PMID: 32775014 PMCID: PMC7406192 DOI: 10.1007/s40688-018-00215-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The current study examined (1) if the Strengths and Difficulties Questionnaire (SDQ) would yield alternative factor structures related to either symptoms or strengths with early adolescent students when an exploratory factor analysis (EFA) is used; (2) which scales best predicted suspensions of typically developing early adolescents; and (3) what cut-off scores were useful for identifying youth at risk for suspensions. The current study included 321 parent-student dyads, who were followed from the middle of eighth grade until the end of tenth grade. A symptoms-based EFA yielded three factors: Misbehavior, Isolation, and Agitation. A strength-based EFA yielded three factors, as, well: Emotional, Social, and Moral competence. Logistic regression path analyses were used to predict risk of any suspension at the end of eighth, ninth, and tenth grades. The predictor variables were the original SDQ Conduct Problems and Hyperactivity scales in one model, the Misbehavior and Agitation scales in a second model, and the Emotional and Moral competence scales in the third model. Only the Misbehavior scale consistently predicted suspensions across each grade (b = .27, OR = 1.32, p < .001; b = .15, OR = 1.18, p = .029; b = .17, OR = 1.18, p = .029, respectively). For the Misbehavior scale, cut-off scores were established that reflected the 75th and 90th percentile; however, each cut-off demonstrated strengths and weaknesses for identifying at-risk students. The expectation of screening to identify youth at-risk for suspensions, a complex school discipline decision, is discussed.
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Affiliation(s)
- Thomas J Gross
- Western Kentucky University, Psychology Department, 3045 Gary A. Ransdell Hall, 1906 College Heights Blvd., #21030, Bowling Green, KY 42101-1030
| | - Jenna Duncan
- Lipscomb University, College of Education, One University Park Drive, Nashville, TN 37204
| | - Samuel Y Kim
- Texas Woman's University, Department of Psychology and Philosophy, CFO 807B, P.O. Box 425470, Denton, TX 76204-5470
| | - W Alex Mason
- National Research Institute for Child and Family Studies, Boys Town, NE, 14100 Crawford Street, Boys Town, NE 68010
| | - Kevin P Haggerty
- Social Development Research Group, University of Washington, Seattle, UW Box #358734, 9725 Third Ave NE, Suite #401, Seattle WA 98115
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Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood. Dev Psychopathol 2019; 32:791-802. [PMID: 31439070 DOI: 10.1017/s0954579419001135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study used repeated measures data to identify developmental profiles of elevated risk for ADHD (i.e., six or more inattentive and/or hyperactive-impulsive symptoms), with an interest in the age at which ADHD risk first emerged. Risk factors that were measured across the first 3 years of life were used to predict profile membership. Participants included 1,173 children who were drawn from the Family Life Project, an ongoing longitudinal study of children's development in low-income, nonmetropolitan communities. Four heuristic profiles of ADHD risk were identified. Approximately two thirds of children never exhibited elevated risk for ADHD. The remaining children were characterized by early childhood onset and persistent risk (5%), early childhood limited risk (10%), and middle childhood onset risk (19%). Pregnancy and delivery complications and harsh-intrusive caregiving behaviors operated as general risk for all ADHD profiles. Parental history of ADHD was uniquely predictive of early onset and persistent ADHD risk, and low primary caregiver education was uniquely predictive of early childhood limited ADHD risk. Results are discussed with respect to how changes to the age of onset criterion for ADHD in DSM5 may affect etiological research and the need for developmental models of ADHD that inform ADHD symptom persistence and desistance.
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Moderation of parenting by inhibitory control in the prediction of the common and unique variance of hyperactivity-impulsivity and inattention. Dev Psychopathol 2019; 32:909-921. [DOI: 10.1017/s0954579419000774] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AbstractThis study examined whether the interaction between parenting and inhibitory control predicts hyperactivity-impulsivity and inattention in 195 children. Observation data of positive parenting were collected at 4 years, and mother reports of coercive parenting at 5 years, inhibitory control at 6 years, and hyperactivity-impulsivity/inattention at 7 years were obtained. The common and unique variance of hyperactivity-impulsivity and inattention symptoms were examined as outcomes using a bifactor model. Results indicated that positive parenting practices predicted lower levels of hyperactivity-impulsivity/inattention behaviors at age 7 only when children's inhibitory control was high. These results support the vantage sensitivity model, which posits that some individuals show an increased sensitivity to positive experiences exclusively, and support the appropriateness of a targeted prevention approach in early childhood.
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Digital Attention-Related Augmented-Reality Game: Significant Correlation between Student Game Performance and Validated Clinical Measures of Attention-Deficit/Hyperactivity Disorder (ADHD). CHILDREN-BASEL 2019; 6:children6060072. [PMID: 31142022 PMCID: PMC6617061 DOI: 10.3390/children6060072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/01/2019] [Accepted: 05/14/2019] [Indexed: 11/17/2022]
Abstract
As many as half of school children with autism spectrum disorder (ASD) exhibit symptoms of attention-deficit/hyperactivity disorder (ADHD), resulting in marked negative academic, social, and behavioral outcomes. The focus of the US Food and Drug Administration (FDA) on real-world data from novel digital sources, and the emergence of Current Procedural Terminology (CPT) codes to reimburse for digital monitoring and neurobehavioral testing suggest an increasing acceptance of the role of technology in augmenting clinical care and research. Empowered Brain is an augmented reality and artificial intelligence-based social-emotional communication aid for students with ASD. In this study, student performance on Empowered Brain is correlated to validated clinical measures of ADHD. Seven high school students with a diagnosis of ASD were recruited from a public high school. All students were assessed for severity of ADHD-related symptoms via three clinical gold-standard assessments, namely the Aberrant Behavioral Checklist (ABC), Social Responsiveness Scale 2 (SRS-2), and Teacher Report Form (TRF). Students used Empowered Brain over a one-week period. We measured the correlation of student in-game performance (as measured by point- and star-based rewards) relative to the hyperactivity subscale of the ABC (ABC-H), and the ADHD-subscale of the TRF. All seven students completed the study and managed to successfully use Empowered Brain. Students received a culminative total of 32 sessions, an average of 4.6 sessions per student (range 2–8). Student in-game performance demonstrated highly significant correlation relative to ABC-H (points: p = 0.0013; stars: p = 0.0013), and significant correlation to TRF ADHD scores (points: p = 0.012; stars: p = 0.012). No adverse effects were noted among students who used Empowered Brain. New technologies may herald novel ways of identifying and characterizing symptoms of ADHD in student populations. This study provides evidence that Empowered Brain in-game performance correlates with ADHD symptom severity in students with ASD. Larger samples are required to validate these findings, with more diverse participants that can also widen the generalizability of these findings to a broader range of brain conditions that manifest with inattention, impulsivity, and hyperactivity. Through further research, we may find that such technologies can help us to identify and longitudinally monitor such symptoms, and potentially aid in severity stratification and digital phenotyping.
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Lin YJ, Gau SSF. Developmental changes of neuropsychological functioning in individuals with and without childhood ADHD from early adolescence to young adulthood: a 7-year follow-up study. Psychol Med 2019; 49:940-951. [PMID: 29941053 DOI: 10.1017/s0033291718001599] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Our knowledge about the developmental change of neuropsychological functioning in attention-deficit/hyperactivity disorder (ADHD) is limited. This prospective longitudinal study examined the changes in neuropsychological functions and their associations with the changes of ADHD symptoms across the developmental stages from early adolescence to young adulthood. METHODS We followed up 53 individuals diagnosed with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) ADHD during childhood (mean age 12.77 years at time 1, 19.81 years at time 2) and 50 non-ADHD controls (mean age 12.80 years at time 1, 19.36 years at time 2) with repeated psychiatric interviews at two time points to confirm ADHD and other psychiatric diagnoses. Neuropsychological functions with high- and low-executive demands, measured by the Cambridge Neuropsychological Testing Automated Battery (CANTAB) at two time points, were compared. RESULTS Both groups showed improvements in all neuropsychological tasks except reaction time in the ADHD group. Despite having a greater improvement in spatial working memory (SWM) than controls, individuals with ADHD still performed worse in various neuropsychological tasks than controls at follow-up. Better baseline intra-dimension/extra-dimension shift and parental occupation predicted fewer ADHD symptoms at follow-up independent of baseline ADHD symptoms. The degree of ADHD symptom reduction was not significantly linearly correlated to the magnitude of neuropsychological function improvement. CONCLUSION Individuals with ADHD and controls had parallel developments in neuropsychological functioning, except a catch-up in SWM in ADHD. Almost all neuropsychological functions herein were still impaired in ADHD at late adolescence/young adulthood. There may be a threshold (i.e. non-linear) relationship between neuropsychological functioning and ADHD symptoms.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry,National Taiwan University and College of Medicine,Taipei,Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry,National Taiwan University and College of Medicine,Taipei,Taiwan
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Babinski DE, Welkie J. Feasibility of Ecological Momentary Assessment of Negative Emotion in Girls With ADHD: A Pilot Study. Psychol Rep 2019; 123:1027-1043. [PMID: 30917744 DOI: 10.1177/0033294119838757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study explores the feasibility of using mobile phone ecological momentary assessment to evaluate negative emotion in adolescent girls with attention-deficit/hyperactivity disorder (ADHD). A total of 13 girls with ADHD, ages 12-16 years old (38.5% with comorbid depression), and their mothers completed several daily surveys assessing the intensity and variability of youth negative emotion using mobile phone-based ecological momentary assessment for approximately one week. The rate of response to survey prompts by youth and maternal reports was examined. In addition, associations between girls' and mothers' ratings of negative emotion were calculated. Finally, the severity and fluctuation in negative emotion were compared between girls with and without depression. Girls and their mothers demonstrated a high level of compliance with assessment procedures, and maternal and youth ratings were significantly correlated. In addition, girls with comorbid depression and their mothers endorsed significantly more intense and variable negative emotion compared to girls with ADHD alone. These preliminary findings show that ecological momentary assessment is a feasible and valid method for collecting information on emotion regulation among girls with ADHD and their mothers that can be applied to future work aimed at collecting ecologically valid assessments of functioning in girls with ADHD.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Janelle Welkie
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
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Attention deficit/hyperactivity disorder and future expectations in Russian adolescents. ACTA ACUST UNITED AC 2019; 11:279-287. [PMID: 30852726 DOI: 10.1007/s12402-019-00292-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Abstract
In recent years, there has been an increasing focus on the role of future expectations-the extent to which a future outcome is deemed likely-in the health and well-being of adolescents, with research linking future expectations to outcomes such as an increased likelihood of engaging in risky health behaviors. As yet, however, there has been no research on future expectations and attention deficit/hyperactivity disorder (ADHD) in adolescence. To address this research gap, the current study examined the association between ADHD symptoms/possible ADHD status and future expectations in a school-based sample of adolescents. Data were analyzed from 537 Russian adolescents (aged 12-17) with teacher-reported ADHD symptoms and self-reported future expectations. Logistic regression analysis was used to examine associations. In fully adjusted analyses, inattention symptoms/possible ADHD inattentive status was associated with lower future educational expectations, while a possible ADHD hyperactivity status was associated with increased odds for negative future expectations relating to work, family and succeeding in what is most important. The findings of this study suggest that greater ADHD symptoms/possible ADHD status in adolescence may be linked to an increased risk for negative future expectations across a variety of different life domains.
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Abstract
PURPOSE OF REVIEW Emotional symptoms are common and persistent in youth and adults with attention-deficit/hyperactivity disorder (ADHD) and cause clinically significant impairments. We review recent neuropsychological, neurophysiological, and peripheral psychophysiological evidence for emotion and emotion regulation deficits in ADHD across youth and adults. RECENT FINDINGS Central and autonomous nervous system correlates argue in favor of more general self-regulation deficits and also specific emotional deficits in ADHD. These include general performance deficits in executive functions, and structural as well as functional impairments in neuronal networks associated with top-down self-regulation. Specific deficits with bottom-up emotional activation in the amygdala and emotion evaluation associated with the orbitofrontal cortex have also been described. Furthermore, vagally mediated, high-frequency heart rate variability is associated with emotional self-regulation deficits throughout the life span. The current evidence is based on multilevel studies that assess associations of emotion regulation. However, further studies that adequately consider the processual recursive character of emotion generation and regulation may give important new insights into emotional regulation of ADHD. Emotion regulation deficits in ADHD are associated with specific as well as general self-regulation deficits traceable on the level of neuropsychological, neurophysiological, and psychophysiological assessments. The temporal dynamics of the interplay of those different systems need further study in order to optimize and personalize treatment of emotion regulation difficulties, including emotional reactivity, in patients with ADHD.
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Valero S, Bosch R, Corominas M, Barrau V, Ramos-Quiroga JA, Casas M. Remittance or persistence of attention deficit-hyperactivity disorder (ADHD) and its impact on recidivism in risky driving behaviors. TRAFFIC INJURY PREVENTION 2018; 19:701-707. [PMID: 30485128 DOI: 10.1080/15389588.2018.1505043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Recent data regarding the persistence or remittance of attention deficit-hyperactivity disorder (ADHD) diagnosis into adulthood raise the question of its possible role in crucial public health issues, including road safety, especially when neurocognitive capacities are challenged. METHODS The study included 611 participants with serious traffic violations. The Spanish version of the Mini International Neuropsychiatric Interview (M.I.N.I.) was used to assess psychopathology. They were grouped into 3 diagnostic conditions: non-ADHD, persistent ADHD (ADHD-P), and remittent ADHD (ADHD-R). Several risky driving behaviors were analyzed. RESULTS Although participants with ADHD have more driving violations relative to non-ADHD, ADHD-R, and ADHD-P drivers have similar profiles. ADHD-R and ADHD-P drivers are more prone to perform risky and recidivistic behaviors relative to non-ADHD counterparts (P = .044 and P = .047, respectively); ADHD-R and ADHD-P participants are statistically comparable in this proneness (P = .772). CONCLUSION These results suggest that the underlying core deficits of ADHD-attention and other executive disabilities-persist despite the fact that some people no longer reach the threshold for clinical diagnosis.
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Affiliation(s)
- S Valero
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - R Bosch
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Corominas
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - V Barrau
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - J A Ramos-Quiroga
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Casas
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
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Bilgin A, Baumann N, Jaekel J, Breeman LD, Bartmann P, Bäuml JG, Avram M, Sorg C, Wolke D. Early Crying, Sleeping, and Feeding Problems and Trajectories of Attention Problems From Childhood to Adulthood. Child Dev 2018; 91:e77-e91. [DOI: 10.1111/cdev.13155] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ayten Bilgin
- University of Warwick
- Istanbul Medeniyet University
| | | | - Julia Jaekel
- University of Warwick
- University of Tennessee Knoxville
| | | | | | - Josef G. Bäuml
- Technical University Munich
- TUM-NIC Neuroimaging Center, Technical University Munich
| | - Mihai Avram
- Technical University Munich
- TUM-NIC Neuroimaging Center, Technical University Munich
| | - Christian Sorg
- Technical University Munich
- TUM-NIC Neuroimaging Center, Technical University Munich
| | - Dieter Wolke
- Department of Psychology
- Warwick Medical School, University of Warwick
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42
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Wilens TE, Isenberg BM, Kaminski TA, Lyons RM, Quintero J. Attention-Deficit/Hyperactivity Disorder and Transitional Aged Youth. Curr Psychiatry Rep 2018; 20:100. [PMID: 30221318 DOI: 10.1007/s11920-018-0968-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Extensive research has been conducted on attention-deficit/hyperactivity disorder (ADHD) in children and adults; however, less is known about ADHD during the transition from childhood to adulthood. Transitional aged youth (TAY) with ADHD represents a particularly vulnerable population as their newfound independence and responsibility often coincides with the development of comorbid disorders. The purpose of this review is to provide an update on the evaluation, diagnosis, and treatment of TAY-ADHD. RECENT FINDINGS Recent studies discovering ADHD symptoms emerging in TAY call the classification of ADHD as a disorder necessarily developing in childhood into question. TAY-ADHD are also shown to be vulnerable to academic and social impairments, increased risky behavior, and comorbid psychiatric disorders. Due to the risk of stimulant diversion in TAY, providers are advised to take precaution when prescribing medication to this population. Recent studies demonstrating the efficacy of psychotherapy in conjunction with non-stimulant or extended release stimulant medication provide a feasible alternative. This review highlights research on the course and evaluation of ADHD, impairments and comorbidities specific to TAY, and treatments tailored to address the unique challenges associated with TAY-ADHD.
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Affiliation(s)
- Timothy E Wilens
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.
| | - Benjamin M Isenberg
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Tamar A Kaminski
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Rachael M Lyons
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Javier Quintero
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Medical School, Complutense University of Madrid, Madrid, Spain
- PSIKIDS, Madrid, Spain
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43
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Wichstrøm L, Penelo E, Rensvik Viddal K, de la Osa N, Ezpeleta L. Explaining the relationship between temperament and symptoms of psychiatric disorders from preschool to middle childhood: hybrid fixed and random effects models of Norwegian and Spanish children. J Child Psychol Psychiatry 2018; 59:285-295. [PMID: 28671298 DOI: 10.1111/jcpp.12772] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain. METHODS Screen-stratified community samples of 4-year olds in Trondheim, Norway (n = 1,042), and 3-year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention-deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer-based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time-invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap). RESULTS In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD-symptoms, and surgency predisposed children to increased ADHD-symptoms. Complication effects were observed in the Spanish children for ADHD-symptoms, which increased surgency and diminished effortful control, and for ODD-symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported. CONCLUSIONS The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children.
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Affiliation(s)
- Lars Wichstrøm
- Department of Psychology, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,NTNU Social Research, Trondheim, Norway
| | - Eva Penelo
- Unitat d'Epidemiologia i Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Kristine Rensvik Viddal
- Department of Psychology, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Nuria de la Osa
- Unitat d'Epidemiologia i Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lourdes Ezpeleta
- Unitat d'Epidemiologia i Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
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ADHD Symptoms in Middle Adolescence Predict Exposure to Person-Related Life Stressors in Late Adolescence in 5-HTTLPR S-allele Homozygotes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:1427-1437. [DOI: 10.1007/s10802-017-0377-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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45
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Atherton OE, Ferrer E, Robins RW. The development of externalizing symptoms from late childhood through adolescence: A longitudinal study of Mexican-origin youth. Dev Psychol 2017; 54:1135-1147. [PMID: 29251969 DOI: 10.1037/dev0000489] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Youth who exhibit externalizing problems during childhood and adolescence are at an increased risk for a wide range of detrimental life outcomes. Despite the profound consequences of externalizing problems for children, their families, and their communities, we know less about the precise trajectory of externalizing symptoms across late childhood and adolescence, because of the paucity of fine-grained longitudinal research. The present study examined the development of externalizing symptoms in a large sample (N = 674) of Mexican-origin youth, assessed annually from age 10 to 17. Specifically, we conducted analyses to better understand the trajectories of attention-deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms (and their codevelopment), as well as how gender and cultural factors influence symptom trajectories. On average, ADHD symptoms slowly declined from age 10 to 17; ODD symptoms increased until age 13 and then declined thereafter; and, CD symptoms slowly increased until age 15 and then leveled off. ADHD, ODD, and CD symptoms predicted change in each other, indicating youth may accumulate multiple forms of externalizing problems over time. Boys reported fewer externalizing problems than girls, contrary to expectations. Consistent with the Immigrant Paradox, we found that 2nd + generation youth, youth who endorsed fewer traditional Mexican cultural values (traditional gender roles, traditional family values, and religiosity), and youth who engaged in less Spanish/more English language use were at increased risk for exhibiting ADHD, ODD, and CD symptoms from childhood through adolescence. We discuss the theoretical and practical implications of these developmental patterns among Mexican-origin youth. (PsycINFO Database Record
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46
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Pauli-Pott U, Schloß S, Heinzel-Gutenbrunner M, Becker K. Multiple causal pathways in attention-deficit/hyperactivity disorder – Do emerging executive and motivational deviations precede symptom development? Child Neuropsychol 2017; 25:179-197. [DOI: 10.1080/09297049.2017.1380177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ursula Pauli-Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Susan Schloß
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Monika Heinzel-Gutenbrunner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
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47
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Gumustas F, Yilmaz I, Yulaf Y, Gokce S, Sabuncuoglu O. Empathy and Facial Expression Recognition in Children With and Without Attention-Deficit/Hyperactivity Disorder: Effects of Stimulant Medication on Empathic Skills in Children with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2017; 27:433-439. [PMID: 28332851 DOI: 10.1089/cap.2016.0052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study was to compare children and adolescents with attention-deficit/hyperactivity disorder (ADHD) to healthy children and adolescents in terms of state and trait empathy and emotion expression recognition skills. The goal was also to determine whether there are changes in emotion recognition and empathy measures in children with ADHD after methylphenidate (MPH) treatment. METHODS The research sample consisted of outpatient drug-naive children and adolescents between the age of 8 and 14 years (n = 65) with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria, and healthy children and adolescents of the same age (n = 61). Scores of the oppositional problems (OPs) and conduct problems (CPs) were obtained to evaluate their impact on children's empathy skills with the Child Behavior Checklist. Self-reported (Bryant Index of Empathy, BEI) and parent-reported (Griffith Empathy Measurement-Parent Rating, GEM-PR) scales were used to evaluate trait empathy. The Empathy Response Task (ERT) was used to evaluate state empathy, and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA-2) was used to evaluate facial expression recognition skills. The scales and tests were repeated after 12 weeks of MPH treatment in the ADHD group. RESULTS There were no significant statistical differences in trait empathy skills evaluated by parent-reported and self-reported measures, ERT, and DANVA-2 scores. In self-reported measures, the girls had higher scores than boys. From the results of the regression analysis, it was concluded that OPs were not associated with the measures. However, CPs were associated with the scores of the BEI, GEM-PR, and the match scores of the ERT. The average dosage of MPH in the group with ADHD was 0.83 ± 0.21 mg/(kg·d). While there was no change in the BEI and GEM-PR scores after 12 weeks of treatment, there was a significant increase in the ERT interpretation subscore and a significant decrease in the recognition error of anger and sadness expressions in the DANVA-2. CONCLUSIONS The findings of our study suggest that children with ADHD have similar levels of trait and state empathy skills and facial expressions as healthy controls and CPs negatively affect their empathy skills. MPH treatment does not change trait empathy skills, yet there are some improvements in state empathy skills.
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Affiliation(s)
- Funda Gumustas
- 1 Department of Child Psychiatry, Republic of Turkey Ministry of Health, Marmara University Research and Training Hospital , Istanbul, Turkey
| | - Ibrahim Yilmaz
- 2 Department of Medical Pharmacology, Istanbul Medipol University School of Medicine , Istanbul, Turkey
| | - Yasemin Yulaf
- 3 Special Clinic of Child and Adolescent Psychiatry , Tekirdag, Turkey
| | - Sebla Gokce
- 4 Department of Child Psychiatry, Republic of Turkey Ministry of Health, Erenkoy Mental Health and Neurological Diseases Training and Research Hospital , Istanbul, Turkey
| | - Osman Sabuncuoglu
- 5 Department of Child Psychiatry, School of Medicine, Marmara University , Istanbul, Turkey
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48
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Borschuk AP, Rodweller C, Salorio CF. The influence of comorbid asthma on the severity of symptoms in children with attention-deficit hyperactivity disorder. J Asthma 2017; 55:66-72. [PMID: 28459608 DOI: 10.1080/02770903.2017.1306549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The current study examined the association between asthma and attention-deficit hyperactivity disorder (ADHD) symptoms in a clinical pediatric sample. METHODS Demographic and neuropsychological data for children with a billing diagnosis of ADHD were extracted from a clinical database. Families completed standard rating scales. Seventy-one patients with a co-morbid asthma diagnosis were identified and matched by age to a group of 71 patients with only ADHD. RESULTS Children with asthma and ADHD were more likely to display clinically elevated levels of hyperactivity, externalizing behaviors, anxiety, and hyperactive/impulsive behaviors compared to children with ADHD alone. Boys with asthma and ADHD had more symptoms than boys with only ADHD of somatization and emotional internalizing, while girls with asthma and ADHD had more symptoms of hyperactivity/impulsivity, conduct problems, anxiety, and emotional internalizing compared to girls with only ADHD. CONCLUSIONS Findings suggest that in children with ADHD, co-morbid asthma is associated with increased behavioral and internalizing symptoms, with distinct gender differences present. Increased behavioral and internalizing symptoms seen in children with both asthma and ADHD may be due to the burden of their medical condition. No difference was found on cognitive variables, suggesting chronic hypoxia may be less influential in explaining these differences. Future research should determine the specific mechanisms of these differences.
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Affiliation(s)
- Adrienne P Borschuk
- a Departments of Behavioral Psychology, Neuropsychology, and Pediatric Rehabilitation , Kennedy Krieger Institute , Baltimore , MD , USA
| | - Casey Rodweller
- a Departments of Behavioral Psychology, Neuropsychology, and Pediatric Rehabilitation , Kennedy Krieger Institute , Baltimore , MD , USA
| | - Cynthia F Salorio
- a Departments of Behavioral Psychology, Neuropsychology, and Pediatric Rehabilitation , Kennedy Krieger Institute , Baltimore , MD , USA.,b Departments of Psychiatry and Behavioral Sciences and Physical Medicine and Rehabilitation , Johns Hopkins University School of Medicine , Baltimore , MD , USA
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49
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Abstract
This article reviews evidence that trait impulsivity-expressed early in life as the hyperactive-impulsive and combined presentations of attention-deficit/hyperactivity disorder (ADHD)-is a bottom-up, subcortically mediated vulnerability to all externalizing disorders. This vulnerability arises from deficient mesolimbic dopamine responding, which imbues psychological states (irritability, discontentment) that motivate excessive approach behavior (hyperactivity, impulsivity). Through complex interactions with (a) aversive motivational states that arise from largely independent subcortical systems, (b) emotion regulatory mechanisms that arise from top-down, cortical modulation of subcortical neural function, and (c) environmental risk factors that shape and maintain emotion dysregulation, trait impulsivity confers vulnerability to increasingly severe externalizing behaviors across development. This perspective highlights the importance of identifying transdiagnostic neural vulnerabilities to psychopathology; dovetails with the hierarchical, latent structure of psychopathology; and suggests that progression along the externalizing spectrum is an ontogenic process whereby a common, multifactorially inherited trait interacts with endogenous and exogenous influences to yield increasingly intractable externalizing behaviors across development.
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Affiliation(s)
| | - Aimee R Zisner
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210; ,
| | - Colin L Sauder
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas 78229;
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50
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Schulz KP, Li X, Clerkin SM, Fan J, Berwid OG, Newcorn JH, Halperin JM. Prefrontal and parietal correlates of cognitive control related to the adult outcome of attention-deficit/hyperactivity disorder diagnosed in childhood. Cortex 2017; 90:1-11. [PMID: 28292705 DOI: 10.1016/j.cortex.2017.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/07/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
The protracted and highly variable development of prefrontal cortex regions that support cognitive control has been purported to shape the adult outcome of attention-deficit/hyperactivity disorder (ADHD). This neurodevelopmental model was tested in a prospectively followed sample of 27 adult probands who were diagnosed with ADHD in childhood and 28 carefully matched comparison subjects aged 21-28 years. Probands were classified with persistent ADHD or remitted ADHD. Behavioral and neural responses to the Stimulus and Response Conflict Task (SRCT) performed during functional magnetic resonance imaging (fMRI) were compared in probands and comparison subjects and in probands with persistent and remitted ADHD. Response speed and accuracy for stimulus, response, and combined conflicts did not differ across groups. Orbitofrontal, inferior frontal and parietal activation was lower in probands than comparison subjects, but only for combined conflicts, when demand for cognitive control was highest. Reduced activation for combined conflicts in probands was almost wholly attributable to the persistence of ADHD; orbitofrontal, inferior frontal, anterior cingulate and parietal activation was lower in probands with persistent ADHD than both probands with remitted ADHD and comparison subjects, but did not differ between probands with remitted ADHD and comparison subjects. These data provide the first evidence that prefrontal and parietal activation during cognitive control parallels the adult outcome of ADHD diagnosed in childhood, with persistence of symptoms linked to reduced activation and symptom recovery associated with activation indistinguishable from adults with no history of ADHD.
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Affiliation(s)
- Kurt P Schulz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Xiaobo Li
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Suzanne M Clerkin
- Department of Psychology, Purchase College of the State University of New York, Purchase, NY, USA
| | - Jin Fan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychology, Queens College of the City University of New York, Flushing, NY, USA
| | - Olga G Berwid
- Department of Behavioral Sciences, York College of the City University of New York, Jamaica, NY, USA
| | - Jeffrey H Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey M Halperin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychology, Queens College of the City University of New York, Flushing, NY, USA
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