Lee Yu-Sheng, Sprong Matthew Evan, Shrestha Junu, Smeltzer Matthew P, Hollender Heaven
School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States.
School of Public Management and Policy, College of Public Affairs and Education, University of Illinois at Springfield, llinois, United States.
Clin Pract Epidemiol Ment Health. 2024 May 21;20:e17450179298863. doi: 10.2174/0117450179298863240516070510. eCollection 2024.
Attention Deficit Hyperactivity Disorder (ADHD) is a mental health disorder that affects attention and behavior. People with ADHD frequently encounter challenges in social interactions, facing issues, like social rejection and difficulties in interpersonal relationships, due to their inattention, impulsivity, and hyperactivity.
A National Longitudinal Survey of Youth (NLSY) database was employed to identify patterns of ADHD symptoms. The children who were born to women in the NLSY study between 1986 and 2014 were included. A total of 1,847 children in the NLSY 1979 cohort whose hyperactivity/inattention score was calculated when they were four years old were eligible for this study. A trajectory modeling method was used to evaluate the trajectory classes. Sex, baseline antisocial score, baseline anxiety score, and baseline depression score were adjusted to build the trajectory model. We used stepwise multivariate logistic regression models to select the risk factors for the identified trajectories.
The trajectory analysis identified six classes for ADHD, including (1) no sign class, (2) few signs since preschool being persistent class, (3) few signs in preschool but no signs later class, (4) few signs in preschool that magnified in elementary school class, (5) few signs in preschool that diminished later class, and (6) many signs since preschool being persistent class. The sensitivity analysis resulted in a similar trajectory pattern, except for the few signs since preschool that magnified later class. Children's race, breastfeeding status, headstrong score, immature dependent score, peer conflict score, educational level of the mother, baseline antisocial score, baseline anxious/depressed score, and smoking status 12 months prior to the birth of the child were found to be risk factors in the ADHD trajectory classes.
The trajectory classes findings obtained in the current study can (a) assist a researcher in evaluating an intervention (or combination of interventions) that best decreases the long-term impact of ADHD symptoms and (b) allow clinicians to better assess as to which class a child with ADHD belongs so that appropriate intervention can be employed.
注意力缺陷多动障碍(ADHD)是一种影响注意力和行为的心理健康障碍。患有ADHD的人在社交互动中经常遇到挑战,由于他们的注意力不集中、冲动和多动,会面临社交排斥和人际关系困难等问题。
使用全国青少年纵向调查(NLSY)数据库来识别ADHD症状模式。纳入了1986年至2014年期间参加NLSY研究的女性所生育的儿童。NLSY 1979队列中共有1847名儿童在4岁时计算了多动/注意力不集中得分,符合本研究条件。采用轨迹建模方法评估轨迹类别。对性别、基线反社会得分、基线焦虑得分和基线抑郁得分进行调整以建立轨迹模型。我们使用逐步多变量逻辑回归模型来选择已识别轨迹的风险因素。
轨迹分析确定了ADHD的六个类别,包括(1)无迹象类别,(2)自学前起症状轻微且持续存在类别,(3)学前症状轻微但后来无症状类别,(4)学前症状轻微但在小学阶段症状加重类别,(5)学前症状轻微但后来症状减轻类别,以及(6)自学前起症状严重且持续存在类别。敏感性分析得出了类似的轨迹模式,但自学前起症状轻微且后来症状加重类别除外。发现儿童的种族、母乳喂养状况、任性得分、不成熟依赖得分、同伴冲突得分、母亲的教育水平、基线反社会得分、基线焦虑/抑郁得分以及孩子出生前12个月的吸烟状况是ADHD轨迹类别的风险因素。
本研究中获得的轨迹类别结果能够(a)帮助研究人员评估最能降低ADHD症状长期影响的干预措施(或干预措施组合),以及(b)使临床医生能够更好地评估患有ADHD的儿童属于哪个类别,从而可以采用适当的干预措施。