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衰老和青春期发育对儿童和青少年 ADHD、抑郁和损伤症状的预测作用不同:一项为期八年的纵向研究。

Aging and Pubertal Development Differentially Predict Symptoms of ADHD, Depression, and Impairment in Children and Adolescents: An Eight-Year Longitudinal Study.

机构信息

Department of Psychology, University of Kentucky, 171 Funkhouser Drive, 40506-0044, Lexington, KY,, USA.

Children's National Hospital, Center for Autism Spectrum Disorders, Center for Neuroscience Research, Washington, D.C., USA.

出版信息

Res Child Adolesc Psychopathol. 2023 Jun;51(6):819-832. doi: 10.1007/s10802-023-01030-7. Epub 2023 Jan 31.

Abstract

Activational effects of the reproductive neuroendocrine system may explain why some youths with ADHD are at greater risk for exacerbated ADHD symptoms (hyperactivity, inattention, impulsivity) during adolescence. For youths diagnosed with ADHD, first signs of ADHD symptoms become noticeable by multiple reporters (e.g., teachers, parents) when children enter schools, typically around kindergarten. The current study examined possible sex differences in ADHD, impairment, and comorbidity due to pubertal effects, as the role of pubertal development in ADHD is understudied. ADHD symptoms, depressive symptoms, impairment, and pubertal stage were assessed annually by multiple reporters in a well-characterized community sample of 849 children over-recruited for ADHD over eight years. Ages ranged from 7 to 13 years (38.16% female) at wave 1. Multilevel models indicated that males had higher levels of hyperactivity, impulsivity, and inattention than females, but that females had higher levels of impairment than males. Inattention symptoms did not show marked maturation changes. Hyperactivity and impulsivity declined as youth aged and impairment increased as youth aged. Lastly, depressive symptoms largely increased as youth aged and were higher amongst youth at later pubertal stages. Put together, aging and pubertal development are associated with improved ADHD symptoms but not for youth with high impairment. Findings from this study contributes to understanding the role that aging, pubertal status, and pubertal development plays in ADHD, impairment, and comorbidity in children and adolescents.

摘要

生殖神经内分泌系统的激活作用可能解释了为什么一些患有 ADHD 的年轻人在青春期时更有可能出现 ADHD 症状(多动、注意力不集中、冲动)加剧。对于被诊断患有 ADHD 的年轻人来说,当孩子进入学校时(通常是在幼儿园),就会由多个报告人(如教师、家长)注意到 ADHD 症状的最初迹象。本研究旨在探讨青春期对 ADHD、障碍和合并症的可能性别差异,因为青春期发育在 ADHD 中的作用研究不足。在一项针对 ADHD 的特征明确的社区样本中,通过多位报告人对 ADHD 进行了八年多的超额招募,每年评估 ADHD 症状、抑郁症状、障碍和青春期阶段。年龄范围为 7 至 13 岁(38.16%为女性),第一波研究年龄为 7 岁。多层次模型表明,男性的多动、冲动和注意力不集中水平高于女性,但女性的障碍水平高于男性。注意力不集中症状没有明显的成熟变化。随着年龄的增长,多动和冲动减少,随着年龄的增长,障碍增加。最后,抑郁症状随着年龄的增长而大大增加,且在青春期后期的青少年中更高。综上所述,随着年龄的增长和青春期的发展,ADHD 症状有所改善,但对于高障碍的青少年来说并非如此。这项研究的结果有助于了解衰老、青春期状态和青春期发育在儿童和青少年 ADHD、障碍和合并症中的作用。

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