Psychological Sciences, Purdue University, West Lafayette, Indiana.
Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon.
Dev Psychopathol. 2021 Dec;33(5):1803-1820. doi: 10.1017/s0954579421000900. Epub 2021 Dec 7.
Attention Deficit Hyperactivity Disorder (ADHD) is a common, chronic, and impairing disorder, yet presentations of ADHD and clinical course are highly heterogeneous. Despite substantial research efforts, both (a) the secondary co-occurrence of ADHD and complicating additional clinical problems and (b) the developmental pathways leading toward or away from recovery through adolescence remain poorly understood. Resolving these requires accounting for transactional influences of a large number of features across development. Here, we applied a longitudinal cross-lagged panel network model to a multimodal, multilevel dataset in a well-characterized sample of 488 children (nADHD=296) to test Research Domain Criteria initiative-inspired hypotheses about transdiagnostic risk. Network features included DSM symptoms, trait-based ratings of emotional functioning (temperament), and performance-based measures of cognition. Results confirmed that ADHD symptom domains, temperamental Irritability, and Working Memory are independent transdiagnostic risk factors for psychopathology based on their direct associations with other features across time. ADHD symptoms and working memory each had direct, independent associations with depression. Results also demonstrated tightly linked co-development of ADHD symptoms and temperamental Irritability, consistent with the possibility that this type of anger dysregulation is a core feature that is co-expressed as part of the ADHD phenotype for some children.
注意缺陷多动障碍(ADHD)是一种常见的、慢性的、会造成损害的障碍,但 ADHD 的表现和临床过程高度异质。尽管进行了大量的研究工作,但(a)ADHD 与其他复杂临床问题的继发共病,以及(b)导致青少年时期恢复或远离恢复的发展途径,仍未被充分理解。要解决这些问题,需要考虑到在整个发育过程中大量特征的交互影响。在这里,我们应用纵向交叉滞后面板网络模型,对一个特征良好的 488 名儿童(nADHD=296)的多模态、多层次数据集进行了分析,以检验关于跨诊断风险的研究领域标准倡议启发的假设。网络特征包括 DSM 症状、情绪功能的基于特质的评定(气质)和基于表现的认知测量。研究结果证实,ADHD 症状领域、气质的易激惹性和工作记忆是基于它们与其他特征在时间上的直接关联的跨诊断风险因素,是精神病理学的独立风险因素。ADHD 症状和工作记忆都与抑郁有直接的、独立的关联。研究结果还表明,ADHD 症状和气质易激惹性紧密相关,这与这种愤怒失调类型可能是某些儿童 ADHD 表型的核心特征之一,作为其共同表达的一部分的可能性一致。