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Wiker T, Pedersen ML, Ferschmann L, Beck D, Norbom LB, Dahl A, von Soest T, Agartz I, Andreassen OA, Moberget T, Westlye LT, Huster RJ, Tamnes CK. Assessing the Longitudinal Associations Between Decision-Making Processes and Attention Problems in Early Adolescence. Res Child Adolesc Psychopathol 2024; 52:803-817. [PMID: 38103132 PMCID: PMC11063004 DOI: 10.1007/s10802-023-01148-8] [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] [Accepted: 10/25/2023] [Indexed: 12/17/2023]
Abstract
Cognitive functions and psychopathology develop in parallel in childhood and adolescence, but the temporal dynamics of their associations are poorly understood. The present study sought to elucidate the intertwined development of decision-making processes and attention problems using longitudinal data from late childhood (9-10 years) to mid-adolescence (11-13 years) from the Adolescent Brain Cognitive Development (ABCD) Study (n = 8918). We utilised hierarchical drift-diffusion modelling of behavioural data from the stop-signal task, parent-reported attention problems from the Child Behavior Checklist (CBCL), and multigroup univariate and bivariate latent change score models. The results showed faster drift rate was associated with lower levels of inattention at baseline, as well as a greater reduction of inattention over time. Moreover, baseline drift rate negatively predicted change in attention problems in females, and baseline attention problems negatively predicted change in drift rate. Neither response caution (decision threshold) nor encoding- and responding processes (non-decision time) were significantly associated with attention problems. There were no significant sex differences in the associations between decision-making processes and attention problems. The study supports previous findings of reduced evidence accumulation in attention problems and additionally shows that development of this aspect of decision-making plays a role in developmental changes in attention problems in youth.
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Affiliation(s)
- Thea Wiker
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
- Division of Mental health and Substance Abuse, Diakonhjemmet Hospital, PoBox 23 Vinderen, Oslo, 0319, Norway.
| | - Mads L Pedersen
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Lia Ferschmann
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Dani Beck
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental health and Substance Abuse, Diakonhjemmet Hospital, PoBox 23 Vinderen, Oslo, 0319, Norway
| | - Linn B Norbom
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Andreas Dahl
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental health and Substance Abuse, Diakonhjemmet Hospital, PoBox 23 Vinderen, Oslo, 0319, Norway
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Sweden
| | - Ole A Andreassen
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Torgeir Moberget
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Rene J Huster
- Department of Psychology, University of Oslo, Oslo, Norway
- Multimodal Imaging and Cognitive Control Lab, Department of Psychology, University of Oslo, Oslo, Norway
- Cognitive and Translational Neuroscience Cluster, Department of Psychology, University of Oslo, Oslo, Norway
| | - Christian K Tamnes
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental health and Substance Abuse, Diakonhjemmet Hospital, PoBox 23 Vinderen, Oslo, 0319, Norway
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Peisch V, Li V, Arnett AB. Effortful Control Protects Against Familial Liability for ADHD: Longitudinal Results from the ABCD Study in the United States. Res Child Adolesc Psychopathol 2024; 52:595-604. [PMID: 37750998 DOI: 10.1007/s10802-023-01131-3] [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] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Effortful control, the ability to regulate complex and goal-directed behavior, may protect individuals from developing mental health symptoms. This study tested the potential for child effortful control and executive functioning to buffer the effects of familial liability for attention deficit hyperactivity disorder (ADHD) problems across a one-year timeframe. Data from the prospectively-collected Adolescent Brain Cognitive Development (ABCD)® study were used to examine whether caregiver-rated child effortful control and executive functioning moderated the association between familial ADHD risk and later ADHD symptoms in a sample of children (N = 6,133; ages 9-10 years at baseline). Two independent variables were considered to compare the predictive powers of specific (family ADHD) and broad (family psychopathology) risk factors. Two additional moderating variables (surgency, negative affect) were tested to examine specificity of effortful control and executive functioning as moderators. All variables of interest were measured on a continuum and via caregiver report. At high levels of effortful control and executive functioning, there was no association between familial liability for ADHD or broad psychopathology and later child ADHD problems. The moderator effects were specific to effortful control and executive functioning domains. Etiological models of heritable psychiatric disorders, such as ADHD, should consider the risk and protective contributions of individual traits, such as effortful control and executive functioning. Clinical prevention and intervention efforts may target self-regulation skills in children to buffer against familial liability for ADHD problems.
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Affiliation(s)
- Virginia Peisch
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
| | - Vivian Li
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Anne B Arnett
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Kaminski A, Xie H, Hawkins B, Vaidya CJ. Change in Striatal Functional Connectivity Networks Across Two Years Due to Stimulant Exposure in Childhood ADHD: Results from the ABCD Sample. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.18.24304470. [PMID: 38562872 PMCID: PMC10984058 DOI: 10.1101/2024.03.18.24304470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Widely prescribed as the first choice of treatment for Attention-Deficit/Hyperactivity Disorder (ADHD), stimulants (methylphenidate and amphetamines) have been studied for their long-term effects on the brain in prospective designs that carefully control dosage and adherence. It is unknown whether those findings generalize to real-world conditions such as community-based treatment, which is marked by intermittent exposure and polypharmacy. To fill this gap, we capitalized on the observational design of the Adolescent Brain Cognitive Development (ABCD) study to examine effects of stimulant exposure on modulation of large-scale bilateral cortical networks' resting-state functional connectivity (rs-FC) with 6 striatal regions (left and right caudate, putamen, and nucleus accumbens) across two years in children with ADHD. Out of 11,878 children, 179 met criteria for an ADHD diagnosis at baseline and high-quality imaging data at baseline and the two-year timepoint. Bayesian hierarchical logistic regressions revealed that change in rs-FC over the two-year period of multiple striatal-cortical networks associated with executive functions and a visuo-motor network predicted stimulant exposure. These networks did not overlap with those that predicted non-stimulant exposure. Of these networks, change selective to stimulant exposure was limited to rs-FC with the putamen, specifically frontoparietal and visual networks, implicating motor control. 23% of stimulant-exposed children did not meet criterion for ADHD at the two-year timepoint, and they were distinguished by change in rs-FC between left putamen and frontoparietal network. Thus, while stimulant exposure for a two-year period under real-world conditions modulated striatal-cortical functional networks broadly, therapeutic effects of that exposure were limited in scale, to network connections relevant to motor control in a small subset of children.
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Affiliation(s)
- Adam Kaminski
- Department of Psychology, Georgetown University, Washington, DC
| | - Hua Xie
- Children’s Research Institute, Children’s National Medical Center, Washington, DC
| | - Brylee Hawkins
- Department of Psychology, Georgetown University, Washington, DC
| | - Chandan J. Vaidya
- Department of Psychology, Georgetown University, Washington, DC
- Children’s Research Institute, Children’s National Medical Center, Washington, DC
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Mooney MA, Hermosillo RJM, Feczko E, Miranda-Dominguez O, Moore LA, Perrone A, Byington N, Grimsrud G, Rueter A, Nousen E, Antovich D, Feldstein Ewing SW, Nagel BJ, Nigg JT, Fair DA. Cumulative Effects of Resting-State Connectivity Across All Brain Networks Significantly Correlate with Attention-Deficit Hyperactivity Disorder Symptoms. J Neurosci 2024; 44:e1202232023. [PMID: 38286629 PMCID: PMC10919250 DOI: 10.1523/jneurosci.1202-23.2023] [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: 04/19/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024] Open
Abstract
Identification of replicable neuroimaging correlates of attention-deficit hyperactivity disorder (ADHD) has been hindered by small sample sizes, small effects, and heterogeneity of methods. Given evidence that ADHD is associated with alterations in widely distributed brain networks and the small effects of individual brain features, a whole-brain perspective focusing on cumulative effects is warranted. The use of large, multisite samples is crucial for improving reproducibility and clinical utility of brain-wide MRI association studies. To address this, a polyneuro risk score (PNRS) representing cumulative, brain-wide, ADHD-associated resting-state functional connectivity was constructed and validated using data from the Adolescent Brain Cognitive Development (ABCD, N = 5,543, 51.5% female) study, and was further tested in the independent Oregon-ADHD-1000 case-control cohort (N = 553, 37.4% female). The ADHD PNRS was significantly associated with ADHD symptoms in both cohorts after accounting for relevant covariates (p < 0.001). The most predictive PNRS involved all brain networks, though the strongest effects were concentrated among the default mode and cingulo-opercular networks. In the longitudinal Oregon-ADHD-1000, non-ADHD youth had significantly lower PNRS (Cohen's d = -0.318, robust p = 5.5 × 10-4) than those with persistent ADHD (age 7-19). The PNRS, however, did not mediate polygenic risk for ADHD. Brain-wide connectivity was robustly associated with ADHD symptoms in two independent cohorts, providing further evidence of widespread dysconnectivity in ADHD. Evaluation in enriched samples demonstrates the promise of the PNRS approach for improving reproducibility in neuroimaging studies and unraveling the complex relationships between brain connectivity and behavioral disorders.
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Affiliation(s)
- Michael A Mooney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon 97239
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon 97239
- Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon 97239
| | - Robert J M Hermosillo
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55454
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Eric Feczko
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55454
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Oscar Miranda-Dominguez
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55454
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, Minnesota 55455
| | - Lucille A Moore
- Department of Neurology, Oregon Health & Science University, Portland, Oregon 97239
| | - Anders Perrone
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Nora Byington
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Gracie Grimsrud
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Amanda Rueter
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
| | - Elizabeth Nousen
- Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon 97239
- Division of Psychology, Department of Psychiatry, Oregon Health & Science University, Portland, Oregon 97239
| | - Dylan Antovich
- Division of Psychology, Department of Psychiatry, Oregon Health & Science University, Portland, Oregon 97239
| | | | - Bonnie J Nagel
- Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon 97239
- Division of Psychology, Department of Psychiatry, Oregon Health & Science University, Portland, Oregon 97239
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon 97239
| | - Joel T Nigg
- Center for Mental Health Innovation, Oregon Health & Science University, Portland, Oregon 97239
- Division of Psychology, Department of Psychiatry, Oregon Health & Science University, Portland, Oregon 97239
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon 97239
| | - Damien A Fair
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55454
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, Minnesota 55414
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota 55455
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Nigg JT, Bruton A, Kozlowski MB, Johnstone JM, Karalunas SL. Systematic Review and Meta-Analysis: Do White Noise or Pink Noise Help With Task Performance in Youth With Attention-Deficit/Hyperactivity Disorder or With Elevated Attention Problems? J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00074-1. [PMID: 38428577 DOI: 10.1016/j.jaac.2023.12.014] [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: 06/01/2023] [Revised: 11/22/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Public interest in the potential benefits of white, pink, and brown noise for attention-deficit/hyperactivity disorder (ADHD) has recently mushroomed. White noise contains all frequencies of noise and sounds like static; pink or brown noise has more power in the lower frequencies and may sound, respectively, like rain or a waterfall. This meta-analysis evaluated effects on laboratory tasks in individuals with ADHD or elevated ADHD symptoms. METHOD Eligible studies reported on participants with diagnosis of ADHD or elevated symptoms of ADHD who were assessed in a randomized trial using laboratory tasks intended to measure aspects of attention or academic work involving attention or executive function while exposed to white, pink, and brown noise and compared with a low/no noise condition. Two authors independently reviewed and screened studies for eligibility. A random-effects meta-analysis was conducted with preplanned moderator analyses of age, diagnostic status, and task type. Publication bias was evaluated. The GRADE tool was used to assess certainty of the evidence. Sensitivity analyses were conducted to evaluate robustness. RESULTS Studies of children and college-age young adults with ADHD or ADHD symptoms (k = 13, N = 335) yielded a small but statistically significant benefit of white and pink noise on task performance (g = 0.249, 95% CI [0.135, 0.363], p < .0001). No studies of brown noise were identified. Heterogeneity was minimal, and moderators were nonsignificant; results survived sensitivity tests, and no publication bias was identified. In non-ADHD comparison groups (k = 11, N = 335), white and pink noise had a negative effect (g = -0.212, 95% CI [-0.355, -0.069], p = .0036). CONCLUSION White and pink noise provide a small benefit on laboratory attention tasks for individuals with ADHD or high ADHD symptoms, but not for non-ADHD individuals. This article addresses theoretical implications, cautions, risks, and limitations. STUDY PREREGISTRATION INFORMATION White Noise for ADHD: A Systematic Review And Meta-analysis; https://www.crd.york.ac.uk/prospero; CRD42023393992.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland, Oregon.
| | - Alisha Bruton
- Oregon Health & Science University, Portland, Oregon
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McKay CC, De Jesus AV, Peterson O, Leibenluft E, Kircanski K. Cross-Sectional and Longitudinal Relations Among Irritability, Attention-Deficit/Hyperactivity Disorder Symptoms, and Inhibitory Control. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00003-0. [PMID: 38272350 DOI: 10.1016/j.jaac.2023.10.015] [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: 03/21/2023] [Revised: 09/29/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Irritability and attention-deficit/hyperactivity disorder (ADHD) symptoms frequently co-occur in youth. Although ADHD has been associated with inhibitory control deficits, the literature on irritability and inhibitory control is mixed. Examining how irritability, ADHD symptoms, and inhibitory control interrelate both cross-sectionally and longitudinally across development could shed light on common and distinct mechanisms of youth psychopathology. METHOD We utilized a cross-lagged panel model with data from 2 time points (at ages 10 and 12 years) of the Adolescent Brain and Cognitive Development (ABCD) Study (N = 7,444, or ∼63% of the baseline sample with full data at each time point) to test cross-sectional and longitudinal associations among parent-reported irritability and ADHD symptoms and behaviorally assessed inhibitory control. This was performed separately across discovery and replication subsamples, each n = 3,722. RESULTS As expected, irritability and ADHD symptoms exhibited strong cross-sectional and reciprocal cross-lagged associations. Higher ADHD symptoms at age 10 years were associated concurrently with poorer inhibitory control and predicted poorer inhibitory control at age 12. Contrary to predictions, inhibitory control was not significantly associated with irritability cross-sectionally, nor was it predictive of later irritability or ADHD symptoms. CONCLUSION These findings highlight strong links between irritability and ADHD. Although inhibitory control deficits were linked to ADHD and predictive of its symptom course, inhibitory control had no significant associations with irritability. Future research should investigate other candidate mechanisms of the co-occurrence of irritability and ADHD symptoms and predictors of their developmental trajectories.
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Affiliation(s)
- Cameron C McKay
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Alethea Vittali De Jesus
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Olivia Peterson
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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Weigard A, McCurry KL, Shapiro Z, Martz ME, Angstadt M, Heitzeg MM, Dinov ID, Sripada C. Generalizable prediction of childhood ADHD symptoms from neurocognitive testing and youth characteristics. Transl Psychiatry 2023; 13:225. [PMID: 37355620 PMCID: PMC10290685 DOI: 10.1038/s41398-023-02502-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/26/2023] Open
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are believed to result from disrupted neurocognitive development. However, evidence for the clinical and predictive value of neurocognitive assessments in this context has been mixed, and there have been no large-scale efforts to quantify their potential for use in generalizable models that predict individuals' ADHD symptoms in new data. Using data drawn from the Adolescent Brain Cognitive Development Study (ABCD), a consortium that recruited a diverse sample of over 10,000 youth (ages 9-10 at baseline) across 21 U.S. sites, we develop and test cross-validated machine learning models for predicting youths' ADHD symptoms using neurocognitive abilities, demographics, and child and family characteristics. Models used baseline demographic and biometric measures, geocoded neighborhood data, youth reports of child and family characteristics, and neurocognitive tests to predict parent- and teacher-reported ADHD symptoms at the 1-year and 2-year follow-up time points. Predictive models explained 15-20% of the variance in 1-year ADHD symptoms for ABCD Study sites that were left out of the model-fitting process and 12-13% of the variance in 2-year ADHD symptoms. Models displayed high generalizability across study sites and trivial loss of predictive power when transferred from training data to left-out data. Features from multiple domains contributed meaningfully to prediction, including neurocognition, sex, self-reported impulsivity, parental monitoring, and screen time. This work quantifies the information value of neurocognitive abilities and other child characteristics for predicting ADHD symptoms and provides a foundational method for predicting individual youths' symptoms in new data across contexts.
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Affiliation(s)
| | | | - Zvi Shapiro
- Department of Psychology, Emory University, Atlanta, USA
| | - Meghan E Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Ivo D Dinov
- Departments of Computational Medicine and Bioinformatics, and Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, USA
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
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Duffy KA, Gandhi R, Falke C, Wiglesworth A, Mueller BA, Fiecas MB, Klimes-Dougan B, Luciana M, Cullen KR. Psychiatric Diagnoses and Treatment in Nine- to Ten-Year-Old Participants in the ABCD Study. JAACAP OPEN 2023; 1:36-47. [PMID: 38405128 PMCID: PMC10890826 DOI: 10.1016/j.jaacop.2023.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective Psychiatric disorders commonly emerge prior to adulthood. Identification and intervention may vary significantly across populations. We leveraged a large population-based study to estimate the prevalence of psychiatric disorders and treatments, and evaluate predictors of treatment, in children ages 9-10 in the United States. Method We analyzed cross-sectional data from the Adolescent Brain Cognitive Developmental (ABCD) Study. The Computerized Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP) was used to estimate clinical diagnoses, and the Child Behavior Checklist (CBCL) was used to assess internalizing and externalizing psychopathology. Parents reported on prescription medications and other mental health interventions. Prevalence rates of KSADS diagnoses and treatments were calculated. Logistic regression analyses estimated associations between clinical and sociodemographic predictors (sex at birth, race, ethnicity, income, education, urbanicity) and treatments. Results The most common KSADS diagnoses were anxiety disorders, followed by attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder. ADHD and depression diagnoses predicted stimulant and antidepressant medication use, respectively. Bipolar and ADHD diagnoses also predicted antidepressant medications, outpatient treatment and psychotherapy. The odds of reporting specific treatments varied by sex, ethnic and racial identities, urbanicity, and income. Conclusion Expected rates of KSADS-based psychiatric symptoms are present in the ABCD sample at ages 9-10, with treatment patterns broadly mapping onto psychopathology in expected ways. However, we observed important variations in reported treatment utilization across sociodemographic groups, likely reflecting societal and cultural influences. Findings are considered in the context of potential mental health disparities in U.S. children.
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Affiliation(s)
- Kelly A. Duffy
- University of Minnesota, Minneapolis, Minnesota, 55455, USA
| | - Raghu Gandhi
- University of Minnesota, Minneapolis, Minnesota, 55455, USA
| | - Chloe Falke
- University of Minnesota, Minneapolis, Minnesota, 55455, USA
| | | | | | - Mark B. Fiecas
- University of Minnesota, Minneapolis, Minnesota, 55455, USA
| | | | - Monica Luciana
- University of Minnesota, Minneapolis, Minnesota, 55455, USA
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Mooney MA, Ryabinin P, Morton H, Selah K, Gonoud R, Kozlowski M, Nousen E, Tipsord J, Antovich D, Schwartz J, Herting MM, Faraone SV, Nigg JT. Joint polygenic and environmental risks for childhood attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom dimensions. JCPP ADVANCES 2023; 3:e12152. [PMID: 37753156 PMCID: PMC10519744 DOI: 10.1002/jcv2.12152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/10/2023] [Indexed: 03/18/2023] Open
Abstract
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.
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Affiliation(s)
- Michael A. Mooney
- Division of Bioinformatics and Computational BiologyDepartment of Medical Informatics and Clinical EpidemiologyOregon Health & Science UniversityPortlandOregonUSA
- Knight Cancer InstituteOregon Health & Science UniversityPortlandOregonUSA
| | - Peter Ryabinin
- Knight Cancer InstituteOregon Health & Science UniversityPortlandOregonUSA
| | - Hannah Morton
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Katharine Selah
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Rose Gonoud
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Michael Kozlowski
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Elizabeth Nousen
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Jessica Tipsord
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Dylan Antovich
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
| | - Joel Schwartz
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Megan M. Herting
- Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of PediatricsChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Stephen V. Faraone
- Department of PsychiatrySUNY Upstate Medical UniversitySyracuseNew YorkUSA
| | - Joel T. Nigg
- Department of PsychiatryCenter for ADHD ResearchOregon Health & Science UniversityPortlandOregonUSA
- Department of Behavioral NeuroscienceOregon Health & Science UniversityPortlandOregonUSA
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Hartman CA, Chen Q, Solberg BS, Du Rietz E, Klungsøyr K, Cortese S, Dalsgaard S, Haavik J, Ribasés M, Mostert JC, Libutzki B, Kittel-Schneider S, Cormand B, Vos M, Larsson H, Reif A, Faraone SV, Bellato A. Anxiety, mood, and substance use disorders in adult men and women with and without Attention-Deficit/Hyperactivity Disorder: a substantive and methodological overview. Neurosci Biobehav Rev 2023; 151:105209. [PMID: 37149075 DOI: 10.1016/j.neubiorev.2023.105209] [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: 07/25/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
Knowledge on psychiatric comorbidity in adult ADHD is essential for prevention, detection, and treatment of these conditions. This review (1) focuses on large studies (n> 10,000; surveys, claims data, population registries) to identify (a) overall, (b) sex- and (c) age-specific patterns of comorbidity of anxiety disorders (ADs), major depressive disorder (MDD), bipolar disorder (BD) and substance use disorders (SUDs) in adults with ADHD relative to adults without ADHD; and (2) describes methodological challenges relating to establishing comorbidity in ADHD in adults as well as priorities for future research. Meta-analyses (ADHD: n=550,748; no ADHD n=14,546,814) yielded pooled odds ratios of 5.0(CI:3.29-7.46) for AD, 4.5(CI:2.44-8.34) for MDD, 8.7(CI:5.47-13.89) for BD and 4.6(CI:2.72-7.80) for SUDs, indicating strong differences in adults with compared to adults without ADHD. Moderation by sex was not found: high comorbidity held for both men and women with sex-specific patterns as in the general population: higher prevalences of ADs, MDD and BD in women and a higher prevalence of SUDs in men. Insufficient data on different phases of the adult lifespan prevented conclusions on developmental changes in comorbidity. We discuss methodological challenges, knowledge gaps, and future research priorities.
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Affiliation(s)
- Catharina A Hartman
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands.
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Berit Skretting Solberg
- Child- and adolescent psychiatric outpatient unit, Hospital Betanien, Bergen, Norway; Department of Biomedicine, University of Bergen, Norway
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Norway; Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Marta Ribasés
- Department of Psychiatry, Mental Health and Addictions, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain
| | - Jeanette C Mostert
- Department of Psychiatry, Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Center Nijmegen, the Netherlands; Department of Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Berit Libutzki
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic, University Hospital Würzburg, Würzburg, Germany
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Melissa Vos
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessio Bellato
- School of Psychology, University of Nottingham, Semenyih, Malaysia
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11
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Olfson M, Wall M, Wang S, Blanco C. Prevalence and Correlates of Mental Disorders in Children Aged 9 and 10 Years: Results From the ABCD Study. J Am Acad Child Adolesc Psychiatry 2023:S0890-8567(23)00178-8. [PMID: 37062398 DOI: 10.1016/j.jaac.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/21/2022] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE To estimate the prevalence of current DSM-5 disorders in children, ages 9 to 10 years, and their associations with sociodemographic and physical characteristics. METHOD In this analysis of the Adolescent Brain Cognitive Development (ABCD) first wave study data, current child mental disorders were based on the computerized parent version of the Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5 (N=11,874) supplemented with the child version for mood and selected anxiety disorders and with teacher Brief Problem Monitor ratings for the attention and externalizing scales. Child sociodemographic (race/ethnicity, nativity, parental marital status, parental education, family income) and physical characteristics (sex, pubertal stage, weight status, maternal age) were derived from parent report and anthropometric measurement. Odds ratios (OR) with 95% Confidence Intervals (95%CI) assessed associations with child mental disorders. RESULTS The prevalence of any current mental disorder was 10.11% including 11.48% among boys and 8.68% among girls. After controlling for several sociodemographic and physical characteristics, boys (OR=1.53; 95%CI=1.17-1.99), children from families with incomes below $25,000 (OR=2.05; 95%CI=1.31-3.22), incomes of $25,000-$49,000 (OR=1.90; 95%CI=1.20-3.00) ($75,000, reference) and obese children (OR=1.45, 95%CI=1.16-1.81) (healthy weight, reference) were at increased risk for any current child mental disorder. Children from the lowest family income group were at particularly high risk for ADHD (OR=3.86, 95%CI=1.69-8.79) and disruptive behavior behaviors (OR=4.13; 95%CI=1.86-9.15). CONCLUSION These patterns underscore the importance of strengthening service planning, preventive interventions, and etiological research focused on children from low income families.
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Affiliation(s)
- Mark Olfson
- College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York.
| | - Melanie Wall
- College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York
| | - Shuai Wang
- National Institute on Drug Abuse, Rockville, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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12
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Nigg JT, Karalunas SL, Mooney MA, Wilmot B, Nikolas MA, Martel MM, Tipsord J, Nousen EK, Schmitt C, Ryabinin P, Musser ED, Nagel BJ, Fair DA. The Oregon ADHD-1000: A new longitudinal data resource enriched for clinical cases and multiple levels of analysis. Dev Cogn Neurosci 2023; 60:101222. [PMID: 36848718 PMCID: PMC9984785 DOI: 10.1016/j.dcn.2023.101222] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
The fields of developmental psychopathology, developmental neuroscience, and behavioral genetics are increasingly moving toward a data sharing model to improve reproducibility, robustness, and generalizability of findings. This approach is particularly critical for understanding attention-deficit/hyperactivity disorder (ADHD), which has unique public health importance given its early onset, high prevalence, individual variability, and causal association with co-occurring and later developing problems. A further priority concerns multi-disciplinary/multi-method datasets that can span different units of analysis. Here, we describe a public dataset using a case-control design for ADHD that includes: multi-method, multi-measure, multi-informant, multi-trait data, and multi-clinician evaluation and phenotyping. It spans > 12 years of annual follow-up with a lag longitudinal design allowing age-based analyses spanning age 7-19 + years with a full age range from 7 to 21. Measures span genetic and epigenetic (DNA methylation) array data; EEG, functional and structural MRI neuroimaging; and psychophysiological, psychosocial, clinical and functional outcomes data. The resource also benefits from an autism spectrum disorder add-on cohort and a cross sectional case-control ADHD cohort from a different geographical region for replication and generalizability. Datasets allowing for integration from genes to nervous system to behavior represent the "next generation" of researchable cohorts for ADHD and developmental psychopathology.
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Affiliation(s)
- Joel T Nigg
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA.
| | | | - Michael A Mooney
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, USA
| | - Beth Wilmot
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, USA
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa, USA
| | | | - Jessica Tipsord
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Elizabeth K Nousen
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Colleen Schmitt
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Peter Ryabinin
- Knight Cancer Institute, Oregon Health & Science University, USA
| | - Erica D Musser
- Department of Psychology, Florida International University, USA
| | - Bonnie J Nagel
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Damien A Fair
- Department of Pediatrics, Masonic Institute for the Developing Brain, Institute of Child Development, College of Education and Human Development, University of Minnesota, USA.
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13
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Jones SA, Nagel BJ, Nigg JT, Karalunas SL. Attention-deficit/hyperactivity disorder and white matter microstructure: the importance of dimensional analyses and sex differences. JCPP ADVANCES 2022; 2:e12109. [PMID: 36817187 PMCID: PMC9937645 DOI: 10.1002/jcv2.12109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Attention-deficit/hyperactive disorder (ADHD) has substantial heterogeneity in clinical presentation. A potentially important clue may be variation in brain microstructure. Using fractional anisotropy (FA), previous studies have produced equivocal results in relation to ADHD. This may be due to insufficient consideration of possible sex differences and ADHD's multi-componential nature. Methods Using whole-brain analyses, we investigated the association between FA and both ADHD diagnosis and ADHD symptom domains in a well-characterized, ADHD (n = 234; 32% female youth) and non-ADHD (n = 177; 52% female youth), case-control cohort (ages 7-12). Sex-specific effects were tested. Results No ADHD group differences were found using categorical assessment of ADHD without consideration of moderators. However, dimensional analyses found total symptoms were associated with higher FA in the superior corona radiata. Further, inattention symptoms were associated with higher FA in the corpus callosum and ansa lenticularis, and lower FA in the superior longitudinal fasciculus, after control for overlap with hyperactivity-impulsivity. Hyperactivity-impulsivity symptoms were associated with higher FA in the superior longitudinal fasciculus, and lower FA in the superior cerebellar peduncles, after control for overlap with inattention. Meanwhile, both categorical and dimensional analyses revealed ADHD-by-sex interactions (voxel-wise p < 0.01). Girls with ADHD had higher FA, but boys with ADHD had lower FA (or no effect), compared to their same-sex peers, in the bilateral anterior corona radiata. Further, higher ADHD symptom severity was associated with higher FA in girls, but lower FA in boys, in the anterior and posterior corona radiata and cerebral peduncles. Conclusions ADHD symptom domains appear to be differentially related to white matter microstructure, highlighting the multi-componential nature of the disorder. Further, sex differences will be crucial to consider in future studies characterizing ADHD-related differences in white matter microstructure.
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Affiliation(s)
- Scott A. Jones
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Bonnie J. Nagel
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Joel T. Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
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14
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Cecil CAM, Nigg JT. Epigenetics and ADHD: Reflections on Current Knowledge, Research Priorities and Translational Potential. Mol Diagn Ther 2022; 26:581-606. [PMID: 35933504 PMCID: PMC7613776 DOI: 10.1007/s40291-022-00609-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 12/30/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and debilitating neurodevelopmental disorder influenced by both genetic and environmental factors, typically identified in the school-age years but hypothesized to have developmental origins beginning in utero. To improve current strategies for prediction, prevention and treatment, a central challenge is to delineate how, at a molecular level, genetic and environmental influences jointly shape ADHD risk, phenotypic presentation, and developmental course. Epigenetic processes that regulate gene expression, such as DNA methylation, have emerged as a promising molecular system in the search for both biomarkers and mechanisms to address this challenge. In this Current Opinion, we discuss the relevance of epigenetics (specifically DNA methylation) for ADHD research and clinical practice, starting with the current state of knowledge, what challenges we have yet to overcome, and what the future may hold in terms of methylation-based applications for personalized medicine in ADHD. We conclude that the field of epigenetics and ADHD is promising but is still in its infancy, and the potential for transformative translational applications remains a distant goal. Nevertheless, rapid methodological advances, together with the rise of collaborative science and increased availability of high-quality, longitudinal data make this a thriving research area that in future may contribute to the development of new tools for improved prediction, management, and treatment of ADHD.
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Affiliation(s)
- Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Rotterdam, The Netherlands.
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
| | - Joel T Nigg
- Division of Psychology, Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
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15
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Park J, Lee DY, Kim C, Lee YH, Yang SJ, Lee S, Kim SJ, Lee J, Park RW, Shin Y. Long-term methylphenidate use for children and adolescents with attention deficit hyperactivity disorder and risk for depression, conduct disorder, and psychotic disorder: a nationwide longitudinal cohort study in South Korea. Child Adolesc Psychiatry Ment Health 2022; 16:80. [PMID: 36221129 PMCID: PMC9554986 DOI: 10.1186/s13034-022-00515-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Methylphenidate (MPH) is the most frequently prescribed medication for the treatment of attention deficit hyperactivity disorder (ADHD). However, the safety of its long-term use remain unclear. In particular, real-world evidence of long-term MPH treatment regarding the risk of depression, conduct disorders, and psychotic disorders in children and adolescents is needed. This study aimed to compare the risks of depression, conduct disorder, and psychotic disorder between long- and short-term MPH treatments in children and adolescents. METHODS This population-based cohort study used a nationwide claims database of all patients with ADHD in South Korea. Patients aged less than 18 years who were prescribed MPH were included in the study. Long- and short-term MPH were defined as > 1 year, and < 1 year, respectively. Overall, the risk of developing depressive disorder, conduct disorder and oppositional defiant disorder (ODD), and psychotic disorder were investigated. A 1:2 propensity score matching was used to balance the cohorts, and the Cox proportional hazards model was used to evaluate the safety of MPH. RESULTS We identified 1309 long-term and 2199 short-term MPH users. Long-term MPH use was associated with a significantly lower risk of depressive (hazard ratio [HR], 0.70 [95% confidence interval [CI] 0.55-0.88]) and conduct disorders and ODD (HR, 0.52 [95% CI 0.38-0.73]) than short-term MPH use. Psychotic disorder was not significantly associated with long-term MPH use (hazard ratio [HR], 0.83 [95% confidence interval [CI] 0.52-1.32]). CONCLUSIONS Our findings suggest that long-term MPH use may be associated with a decreased risk of depression, conduct disorders and ODD. Moreover, the long-term use of MPH does not increase the risk of psychotic disorders. Long-term MPH administration may be considered as a favourable treatment strategy for children and adolescents with ADHD regarding depressive, conduct, and psychotic disorders.
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Affiliation(s)
- Jimyung Park
- grid.251916.80000 0004 0532 3933Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
| | - Dong Yun Lee
- grid.251916.80000 0004 0532 3933Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Chungsoo Kim
- grid.251916.80000 0004 0532 3933Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
| | - Yo Han Lee
- grid.222754.40000 0001 0840 2678Department of Preventive Medicine, Korea University School of Medicine, Seoul, South Korea
| | - Su-Jin Yang
- Gwangju Smile Center for Crime Victims, Gwangju, South Korea
| | - Sangha Lee
- grid.251916.80000 0004 0532 3933Department of Psychiatry, Ajou University School of Medicine, 206, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do 16499 Republic of Korea
| | - Seong-Ju Kim
- grid.251916.80000 0004 0532 3933Department of Psychiatry, Ajou University School of Medicine, 206, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do 16499 Republic of Korea
| | - Jeewon Lee
- grid.412678.e0000 0004 0634 1623Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Rae Woong Park
- grid.251916.80000 0004 0532 3933Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea ,grid.251916.80000 0004 0532 3933Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Yunmi Shin
- Department of Psychiatry, Ajou University School of Medicine, 206, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
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16
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Aloi J, Hulvershorn L. Editorial: The Epidemiology and Cognitive Characteristics of Attention-Deficit/Hyperactivity Disorder Depend on How Strictly the Disorder Is Defined. J Am Acad Child Adolesc Psychiatry 2022; 61:1221-1223. [PMID: 35803444 DOI: 10.1016/j.jaac.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
In this month's issue of the Journal, Cordova et al.1 advance knowledge in our field by leveraging the Adolescent Brain Cognitive Development (ABCD) Study dataset to characterize the prevalence and comorbidities of attention-deficit/hyperactivity disorder (ADHD) in a large community sample. The ABCD dataset2 is useful because it is one of the largest samples of its kind (N = 11,878) and includes data from multiple measures and from multiple informants. This allows for sophisticated latent variable approaches to define ADHD from both a categorical and a dimensional perspective. Latent variables are variables that are not directly observed but are detected via measurement of other directly observed variables and statistical modeling.3.
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Affiliation(s)
- Joseph Aloi
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis
| | - Leslie Hulvershorn
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis.
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