Attention-deficit/hyperactivity disorder (ADHD) is well known to be a highly impairing and strongly persistent condition in boys and men, but knowledge about its long-term consequences in girls and women is severely limited. The core objective is to redress the major dearth of longitudinal data on females with ADHD via a rigorous, prospective, 15-year follow-up investigation, into the age span of the mid-20s, of a well-characterized, ethnically- and socioeconomically-diverse sample of girls with carefully diagnosed ADHD (n = 140), plus an age- and ethnicity/race-matched sample of comparison girls (n = 88). To the investigator's knowledge, this sample comprises the largest in existence of girls with this disorder, ascertained prior to adolescence. During earlier iterations of the curren grant, participants were recruited and investigated between the ages of 6 and 12 years (Wave 1) and followed systematically in early to mid- adolescence (Wave 2, ages 11-18 years;92% retention) and most recently in a 10-year follow-up in late adolescence/early adulthood (Wave 3, ages 17-24 years;95% retention).
Key aims for projected Wave 4 assessments, during the age span of 22-29 years, are to characterize outcomes of these women across multiple domains of functioning, including ADHD symptoms and subtypes, externalizing and internalizing behavior patterns (including antisocial behavior, mood disturbance, eating pathology, self-injurious and suicidal behavior), substance use/abuse, academic and vocational performance, neuropsychological skills, peer and family relations, health-related parameters, and service utilization. The overall goal is to understand trajectories of development, impairment, and (in some cases) positive adjustment, with the strongest focus on outcomes of major clinical and conceptual importance to female development: (a) educational attainment and employment status;(b) relationships/interpersonal functioning;(c) self-harm (i.e., suicidal behavior and sel-injury, which were present at strikingly high rates during the 10-year follow- up);(d) executive functioning;and (e) health-related behaviors. The project's established methods of ascertaining positive adjustment will be followed. A related aim is to characterize baseline predictors and moderators and adolescent mediators of adult functioning, via stringent and sophisticated statistical methods. The proposed Wave 4 assessments feature psychometrically rigorous, multi-method, and multi- informant measures, many of which are identical or parallel across all four waves, facilitating growth-curve and growth-mixture modeling. Because of (i) major gaps in knowledge surrounding adult adjustment of women with ADHD and (ii) the potential for unique findings to emerge during the age span of the mid-20s, examination of female developmental trajectories into adulthood is a key priority.
Such aims will be met in this innovative and rigorou investigation, with the potential to enhance both basic and clinical science.

Public Health Relevance

Attention-deficit hyperactivity disorder (ADHD) is a common and impairing neurodevelopmental disorder in males, but far less is known about female manifestations across development. This study will continue a prospective longitudinal investigation of a large, diverse, and well-characterized sample of girls with ADHD, ascertained in childhood, into a fourth wave of data collection during the age span of 22-29 years. Trajectories toward both impairment and adaptive functioning will be explored. This research has major relevance for basic science, clinical science, and public health, given the substantial impairments linked to ADHD in females.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Child Psychopathology and Developmental Disabilities Study Section (CPDD)
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Friedman-Hill, Stacia
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University of California Berkeley
Other Health Professions
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United States
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Ahmad, Shaikh I; Hinshaw, Stephen P (2017) Attention-Deficit/Hyperactivity Disorder, Trait Impulsivity, and Externalizing Behavior in a Longitudinal Sample. J Abnorm Child Psychol 45:1077-1089
Gordon, Chanelle T; Hinshaw, Stephen P (2017) Parenting Stress and Youth Symptoms among Girls with and without ADHD. Parent Sci Pract 17:11-29
Gordon, Chanelle T; Hinshaw, Stephen P (2017) Parenting Stress as a Mediator Between Childhood ADHD and Early Adult Female Outcomes. J Clin Child Adolesc Psychol 46:588-599
Owens, Elizabeth B; Zalecki, Christine; Gillette, Peter et al. (2017) Girls with childhood ADHD as adults: Cross-domain outcomes by diagnostic persistence. J Consult Clin Psychol 85:723-736
Lundervold, Astri J; Meza, Jocelyn I; Hysing, Mari et al. (2017) Parent Rated Symptoms of Inattention in Childhood Predict High School Academic Achievement Across Two Culturally and Diagnostically Diverse Samples. Front Psychol 8:1436
Guendelman, Maya D; Owens, Elizabeth B; Galán, Chardee et al. (2016) Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: Increased risk for internalizing symptoms and suicidality. Dev Psychopathol 28:1-14
Owens, Elizabeth B; Hinshaw, Stephen P (2016) Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD). J Abnorm Psychol 125:220-232
Guendelman, Maya D; Ahmad, Shaikh; Meza, Jocelyn I et al. (2016) Childhood Attention-Deficit/Hyperactivity Disorder Predicts Intimate Partner Victimization in Young Women. J Abnorm Child Psychol 44:155-66
Gard, Arianna M; Owens, Elizabeth B; Hinshaw, Stephen P (2016) Prenatal Smoke Exposure Predicts Hyperactive/Impulsive but Not Inattentive ADHD Symptoms in Adolescent and Young Adult Girls. Infant Child Dev 25:339-351
Meza, Jocelyn I; Owens, Elizabeth B; Hinshaw, Stephen P (2016) Response Inhibition, Peer Preference and Victimization, and Self-Harm: Longitudinal Associations in Young Adult Women with and without ADHD. J Abnorm Child Psychol 44:323-34

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