The Oregon ADHD-1000: A new longitudinal data resource enriched for clinical cases and multiple levels of analysis

Examining for Associations between Motor Disturbances and ADHD Status in Young Adults

OBJECTIVE

Some studies show an association between ADHD and impaired balance/gait in children. However, it remains largely unexplored whether such an association exists in adults. We explore that association in this study.

METHOD

This cross-sectional study included 45 adults aged 17 to 21 (25 with, and 20 without ADHD), most obtained from a longitudinal cohort study beginning in childhood. We measured balance/gait using objective measures from inertial sensors during the Instrumented Stand and Walk Test. Demographics and severity of ADHD symptoms were measured via questionnaires.

RESULTS

Young adults with ADHD showed a tendency toward worse balance and impaired gait in a dual-task activity than adults without ADHD.

CONCLUSION

These findings suggest balance and gait impairments are associated with ADHD in young adults. Balance/gait measures may hold promise as markers for persistent neurodevelopmental disorders, and the novel task used here may hold promise for measuring these impairments in adults with ADHD.

Reproducible structure with measurement invariance for the Parent-Report Early Adolescent Temperament Questionnaire: Findings from three independent samples

Differences in adolescent temperament are associated with innumerable psychological outcomes in the developmental literature and can help link adult personality-based nosology to earlier development. The Early Adolescent Temperament Questionnaire-Revised is one important measure of adolescent temperament designed to capture constructs within the influential Rothbart temperament model. Yet conflicting factor structures and minimal evidence for measurement invariance across samples and clinical groups have limited its ability to further temperament-based understanding of psychopathology. The goal of the present study was to identify reproducible measurement structures for the parent-rated and self-rated Early Adolescent Temperament Questionnaire-Revised in multiple large independent samples and to evaluate how that structure corresponded to their proposed theoretical structure. We also tested measurement invariance and compared temperament characteristics in youth with and without attention-deficit/hyperactivity disorder. Findings support the lower order theoretical structure using a reduced set of items in the parent-rated form, including evidence for measurement invariance across samples and clinical groups. Findings confirm important patterns of temperament variation associated with attention-deficit/hyperactivity disorder diagnosis, including lower effortful control and differences in expression of negative affect and surgency. The self-rated form demonstrated poor structural validity and could not be reliably replicated in a confirmatory sample. Parent-reported temperament may help link personality-based models of psychopathology to earlier developmental periods where psychopathology often emerges. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Epigenetic age across development in children and adolescents with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition, though symptoms vary both within and between people in the population. We aimed to investigate trajectories of individual biological aging through the change in residuals of DNA methylation age estimates (EpiAge) regressed on chronological age (EpiAge Gap) in children and adolescents with and without ADHD.

METHODS

Three well-established epigenetic clocks (PedBE, Horvath, and Skin & blood) were used to estimate EpiAge in 293 saliva samples from 169 participants (91 with ADHD symptoms) from the Neuroimaging of the Children's Attention Project (NICAP). Participants attended single (cross-sectional sample, n = 75) or multiple (2-3) waves of assessment (longitudinal sample, n = 94). We compared EpiAge Gap between ADHD and control groups cross-sectionally and longitudinally, and replicated these findings in a second pediatric cohort from the Oregon ADHD-1000 cohort.

RESULTS

Across all three clocks, EpiAge Gap was comparable between ADHD and controls from the cross-sectional sample, and was a null finding for our longitudinal analysis of change in EpiAge Gap, after FDR correction (pFDR=0.24). Both cross-sectional and longitudinal findings were consistent in the replication cohort.

CONCLUSION

This study found no strong evidence of differential epigenetic aging in developing children and adolescents with or without ADHD. Larger cohort studies, which utilize estimates over a prolonged duration, crossing both early and later developmental periods, would further our understanding of biological age in ADHD.

Associations between Computationally Derived Parent Emotional Sentiment Scores and Child ADHD and ODD Over Time

Family emotional climate is often assessed as expressed emotion (EE) using the five-minute speech sample (FMSS). Parent EE is related to child externalizing behavior, but the relationship with ADHD apart from externalizing is unclear. We report the largest ADHD-non-ADHD study of EE to date, introduce computational scoring of the FMSS to assay parent negative sentiment, and use this to evaluate reciprocal parent-child effects over time in ADHD while considering comorbid ODD. Parents of 810 children (nADHD = 509), aged 7-13 years old, completed the FMSS at three points. The FMSS was expert-coded for EE-Criticism at Time 1 and Time 2, negative sentiment was scored at all three time points. Sentiment and EE-Criticism were moderately correlated (r =.39, p <.001, 95% CI [0.32, 0.46]), and each was similarly correlated with baseline ADHD symptoms (r's range 0.31-0.33, p <.001) and ODD symptoms (r(ODD-EE) = 0.35, p <.001; r(ODD-sentiment = 0.28, p <.001). A longitudinal, cross-lagged panel model revealed that increases over time in parental negative sentiment scores led to increased ODD symptoms. Parent sex (namely fathers, but not mothers) showed an interaction effect of sentiment with ADHD. ADHD and ODD are independently and jointly associated with parental EE-Criticism and negative sentiment assessed by the FMSS cross-sectionally. A recursive effects model is supported for ODD, but for ADHD effects depend on which parent is assessed. For fathers, ADHD was related to negative sentiment in complex manners but for mothers, negative sentiment was related primarily to ODD.

Subcortico-Cortical Dysconnectivity in ADHD: A Voxel-Wise Mega-Analysis Across Multiple Cohorts

OBJECTIVE

A large body of functional MRI research has examined a potential role for subcortico-cortical loops in the pathogenesis of attention deficit hyperactivity disorder (ADHD), but has produced inconsistent findings. The authors performed a mega-analysis of six neuroimaging data sets to examine associations between ADHD diagnosis and traits and subcortico-cortical connectivity.

METHODS

Group differences were examined in the functional connectivity of four subcortical seeds in 1,696 youths with ADHD diagnoses (66.39% males; mean age, 10.83 years [SD=2.17]) and 6,737 unaffected control subjects (47.05% males; mean age, 10.33 years [SD=1.30]). The authors examined associations between functional connectivity and ADHD traits (total N=9,890; 50.3% males; mean age, 10.77 years [SD=1.96]). Sensitivity analyses were used to examine specificity relative to commonly comorbid internalizing and non-ADHD externalizing problems. The authors further examined results within motion-matched subsamples, and after adjusting for estimated intelligence.

RESULTS

In the group comparison, youths with ADHD showed greater connectivity between striatal seeds and temporal, fronto-insular, and supplementary motor regions, as well as between the amygdala and dorsal anterior cingulate cortex, compared with control subjects. Similar findings emerged when ADHD traits were considered and when alternative seed definitions were adopted. Dominant associations centered on the connectivity of the caudate bilaterally. Findings were not driven by in-scanner motion and were not shared with commonly comorbid internalizing and externalizing problems. Effect sizes were small (largest peak d, 0.15).

CONCLUSIONS

The findings from this large-scale mega-analysis support established links with subcortico-cortical circuits, which were robust to potential confounders. However, effect sizes were small, and it seems likely that resting-state subcortico-cortical connectivity can capture only a fraction of the complex pathophysiology of ADHD.

The Relationship Between Emotion Dysregulation and Error Monitoring in Adolescents with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the limitations of existing diagnostic categories. One potential solution, consistent with the Research Domain Criteria (RDoC) initiative, is to interrogate psychological mechanisms at the behavioral and physiological level together to try and identify meaningful subgroups within existing categories. Such approaches provide a way to revise diagnostic boundaries and clarify individual variation in mechanisms. Here, we illustrate this approach to help resolve heterogeneity in ADHD using a combination of behaviorally-rated temperament measures from the Early Adolescent Temperament Questionnaire; cognitive performance on three difference conditions of an emotional go/no-go task; and electroencephalogram (EEG)-measured variation in multiple stages of error processing, including the error-related negativity (ERN) and positivity (Pe). In a large (N = 342), well-characterized sample of adolescents with ADHD, latent profile analysis identified two ADHD temperament subgroups: 1) emotionally regulated and 2) emotionally dysregulated (with high negative affect). Cognitive and EEG assessment in a subset of 272 adolescents (nADHD = 151) found that the emotionally dysregulated group showed distinct patterns of change in early neural response to errors (ERN) across emotional task conditions as compared to emotionally-regulated ADHD adolescents and typically-developing controls. Both ADHD groups showed blunted later response to errors (Pe) that was stable across emotional task conditions. Overall, neural response patterns identified important differences in how trait and state emotion interact to affect cognitive processing. Results highlight important temperament variation within ADHD that helps clarify its relationship to the ERN, one of the most prominent putative neural biomarkers for psychopathology.

Diffusion kurtosis imaging reveals abnormal gray matter and white matter development in some brain regions of children with attention-deficit/hyperactivity disorder

In this study, we explored the application of diffusion kurtosis imaging (DKI) technology in the brains of children with attention-deficit/hyperactivity disorder (ADHD). Seventy-two children with ADHD and 79 age- and sex-matched healthy controls were included in the study. All children were examined by means of 3D T1-weighted image, DKI, and conventional sequence scanning. The volume and DKI parameters of each brain region were obtained by software postprocessing (GE ADW 4.6 workstation) and compared between the two groups of children to determine the imaging characteristics of children with ADHD. The result showed the total brain volume was lower in children with ADHD than in healthy children (p < .05). The gray and white matter volumes in the frontal lobe, temporal lobe, hippocampus, caudate nucleus, putamen, globus pallidus, and other brain regions were lower in children with ADHD than in healthy children (p < .05). The axial kurtosis (Ka), mean kurtosis (MK), fractional anisotropy (FA), and radial kurtosis(Kr) values in the frontal lobe, temporal lobe, and caudate nucleus of children with ADHD were lower than those of healthy children, while the mean diffusivity(MD) and fractional anisotropy of kurtosis (FAK) values were higher than those of healthy children (p < .05). Additionally, the Ka, MK, FA, and Kr values in the frontal lobe, caudate nucleus, and temporal lobe could be used to distinguish children with ADHD (AUC > .05, p < .05). In conclusion, DKI showed abnormal gray matter and white matter development in some brain regions of children with ADHD.

Joint polygenic and environmental risks for childhood attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom dimensions

Background

attention-deficit/hyperactivity disorder (ADHD) is associated with both polygenic liability and environmental exposures, both intrinsic to the family, such as family conflict, and extrinsic, such as air pollution. However, much less is known about the interplay between environmental and genetic risks relevant to ADHD-a better understanding of which could inform both mechanistic models and clinical prediction algorithms.

Methods

Two independent data sets, the population-based Adolescent Brain Cognitive Development Study (ABCD) (N = 11,876) and the case-control Oregon-ADHD-1000 (N = 1449), were used to examine additive (G + E) and interactive (GxE) effects of selected polygenic risk scores (PRS) and environmental factors in a cross-sectional design. Genetic risk was measured using PRS for nine mental health disorders/traits. Exposures included family income, family conflict/negative sentiment, and geocoded measures of area deprivation, lead exposure risk, and air pollution exposure (nitrogen dioxide and fine particulate matter).

Results

ADHD PRS and family conflict jointly predicted concurrent ADHD symptoms in both cohorts. Additive-effects models, including both genetic and environmental factors, explained significantly more variation in symptoms than any individual factor alone (joint R 2 = .091 for total symptoms in ABCD; joint R 2 = .173 in Oregon-ADHD-1000; all delta-R 2 p-values <2e-7). Significant effect size heterogeneity across ancestry groups was observed for genetic and environmental factors (e.g., Q = 9.01, p = .011 for major depressive disorder PRS; Q = 13.34, p = .001 for area deprivation). GxE interactions observed in the full ABCD cohort suggested stronger environmental effects when genetic risk is low, though they did not replicate.

Conclusions

Reproducible additive effects of PRS and family environment on ADHD symptoms were found, but GxE interaction effects were not replicated and appeared confounded by ancestry. Results highlight the potential value of combining exposures and PRS in clinical prediction algorithms. The observed differences in risks across ancestry groups warrant further study to avoid health care disparities.