Pintos Lobo Rosario, Peraza Julio A, Salo Taylor, Meca Alan, Smith Donisha D, Feeney Kathleen E, Schmarder Katherine M, Sutherland Matthew T, Gonzalez Raul, Musser Erica D, Laird Angela R
Department of Psychology, Florida International University, Miami, FL, USA.
Department of Physics, Florida International University, Miami, FL, USA.
Dev Cogn Neurosci. 2025 Jul 3;75:101591. doi: 10.1016/j.dcn.2025.101591.
Social functioning difficulties among youth with attention-deficit/hyperactivity disorder (ADHD) have been examined behaviorally; however, limited research has investigated brain networks associated with social difficulties among youth with ADHD. A growing body of literature supports the utility of the NIMH's Research Domain Criteria (RDoC) framework, which emphasizes broad neurobiological based dimensions, allowing for the integration of models of both neural circuitry and behavior when examining externalizing behaviors in youth. We hypothesized that an ADHD classification system based on social functioning would better predict real-world psychosocial and academic outcomes compared to traditional Diagnostic and Statistical Manual of Mental Disorders (DSM-5) nosology of ADHD presentations. First, using data from the Adolescent Brain Cognitive Development (ABCD) Study, we identified four distinct profiles of youth with ADHD ranging from low social functioning to high social functioning. These social-data-derived profiles were linked to differential social challenges associated with caregiver income and mental health disorders. Next, our neuroimaging findings initially revealed differential patterns of functional connectivity across profiles involving attention-control, cingulo-opercular, sensorimotor networks. However, these connectivity differences were not consistently replicated, indicating that social functioning alone may not define neurobiologically distinct subgroups. Finally, in comparing our social functioning profiles to existing DSM-5 nosology with respect to real-world psychosocial outcomes, our social profiles demonstrated greater explanatory power for outcomes related to peer relationships, family conflict, and mental health. Overall, these findings emphasize the heterogeneity in social functioning among ADHD youth and suggest that while behavioral profiles are clinically meaningful, future work should integrate additional dimensions, such as executive functioning, to more precisely capture the neurobiological underpinnings of ADHD.
针对患有注意力缺陷多动障碍（ADHD）的青少年的社交功能困难，已有行为学方面的研究；然而，针对与患有ADHD的青少年社交困难相关的脑网络的研究却很有限。越来越多的文献支持美国国立精神卫生研究所（NIMH）的研究领域标准（RDoC）框架的实用性，该框架强调基于广泛神经生物学的维度，在研究青少年的外化行为时允许整合神经回路和行为模型。我们假设，与传统的《精神疾病诊断与统计手册》（DSM-5）中ADHD表现的分类法相比，基于社交功能的ADHD分类系统能更好地预测现实世界中的心理社会和学业成果。首先，利用青少年大脑认知发展（ABCD）研究的数据，我们确定了患有ADHD的青少年的四种不同类型，从社交功能低到社交功能高。这些从社交数据得出的类型与与照顾者收入和精神健康障碍相关的不同社交挑战有关。接下来，我们的神经影像学研究结果最初揭示了不同类型之间功能连接的差异模式，涉及注意力控制、扣带回-脑岛网络、感觉运动网络。然而，这些连接差异并未得到一致的重复验证，这表明仅社交功能可能无法定义神经生物学上不同的亚组。最后，在将我们的社交功能类型与现有的DSM-5分类法在现实世界的心理社会结果方面进行比较时，我们的社交类型对与同伴关系、家庭冲突和心理健康相关的结果显示出更大的解释力。总体而言，这些发现强调了ADHD青少年社交功能的异质性，并表明虽然行为类型在临床上有意义，但未来的工作应整合其他维度，如执行功能，以更精确地捕捉ADHD的神经生物学基础。
