Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
Psychopathology and Neuropsychology Lab, Paris 8 University, Rue de la Liberté 2, 93526, Saint-Denis, France.
Eur Child Adolesc Psychiatry. 2021 Apr;30(4):633-645. doi: 10.1007/s00787-020-01546-z. Epub 2020 May 12.
Pediatric attention deficit/hyperactivity disorder (ADHD) is a heterogeneous condition. In particular, children with ADHD display varying profiles of dispositional traits, as assessed through temperament and personality questionnaires. Previous data-driven community detection analyses based on temperament dimensions identified an irritable profile of patients with ADHD, uniquely characterized by elevated emotional dysregulation symptoms. Belonging to this profile increased the risk of developing comorbid disorders. Here, we investigated whether we could replicate this profile in a sample of 178 children with ADHD, using community detection based on personality dimensions. Stability of the identified profiles, of individual classifications, and clinical prediction were longitudinally assessed over a 1-year interval. Three personality profiles were detected: The first two profiles had high levels of neuroticism, with the first displaying higher ADHD severity and lower openness to experience (profile 1; N = 38), and the second lower agreeableness (profile 2; N = 73). The third profile displayed scores closer to the normative range on all five factors (profile 3; N = 67). The identified profiles did only partially replicate the temperament-based profiles previously reported, as higher levels of neuroticism were found in two of the three detected profiles. Nonetheless, despite changes in individual classifications, the profiles themselves were highly stable over time and of clinical predictive value. Whereas children belonging to profiles 1 and 2 benefited from starting medication, children in profile 3 did not. Hence, belonging to an emotionally dysregulated profile at baseline predicted the effect of medication at follow-up over and above initial ADHD symptom severity. This finding suggests that personality profiles could play a role in predicting treatment response in ADHD.
儿童注意缺陷多动障碍（ADHD）是一种异质性疾病。特别是，通过气质和人格问卷评估，ADHD 患儿表现出不同的性格特征。先前基于气质维度的数据分析社区检测，确定了 ADHD 患者的易激惹特征谱，其特点是情绪调节障碍症状升高。属于该特征谱的患者患共病障碍的风险增加。在这里，我们使用基于人格维度的社区检测，在 178 名 ADHD 儿童样本中调查了是否可以复制这种特征谱。识别的特征谱、个体分类的稳定性以及临床预测在 1 年的时间间隔内进行了纵向评估。检测到三个人格特征谱：前两个特征谱具有较高的神经质水平，第一个特征谱表现出较高的 ADHD 严重程度和较低的开放性（特征谱 1；N = 38），第二个特征谱具有较低的宜人性（特征谱 2；N = 73）。第三个特征谱显示所有五个因素的得分接近常模（特征谱 3；N = 67）。识别的特征谱仅部分复制了先前报道的基于气质的特征谱，因为在三个检测到的特征谱中的两个中发现了更高水平的神经质。尽管个体分类发生了变化，但特征谱本身在时间上具有高度稳定性，并且具有临床预测价值。尽管属于特征谱 1 和 2 的儿童受益于开始药物治疗，但属于特征谱 3 的儿童则没有。因此，在基线时属于情绪失调特征谱可预测药物治疗在随访时的效果，超过了初始 ADHD 症状严重程度的影响。这一发现表明，人格特征谱可能在预测 ADHD 治疗反应中发挥作用。
