This study involves a prospective, naturalistic study of the psychiatric outcomes of adolescent and young adults with reading disabilities. The investigators note that previous cross-sectional studies support the notion that reading and reading-related disabilities are associated with increased psychiatric morbidity during childhood. There are three specific aims, each tied to a series of thoughtful hypotheses, which guide this study:
Specific Aim 1 : Estimate the degree to which adolescents and young adults with reading disabilities are at higher risk (compared to individuals without reading disabilities) for (A) psychiatric disorder; (B) greater severity of psychiatric symptomatology; (C)significant life outcomes; and (D) poor quality of life and greater functional impairment. Related to this specific aim are four hypotheses: Hypothesis 1A: Adolescents with reading disabilities will evidence higher rates of both externalizing and internalizing disorders than adolescents without reading disabilities; Hypothesis 1B: Adolescents with reading disabilities will evidence more aggressive and delinquent behaviors, more severe depressive symptoms, and more trait anxiety over time than adolescents without reading disabilities; Hypothesis 1C: Adolescents with reading disabilities will evidence a greater likelihood over time of incarceration and school dropout and will report a greater number of undesirable objective life events than adolescents without reading disabilities; Hypothesis 1D: Adolescents with reading disabilities will report a poorer quality of life and more functional impairment over time than adolescents without reading disabilities.
Specific Aim 2 : Examine the degree to which the relationships between reading disabilities and various outcomes of interest (psychiatric disorders, severity of symptomatology, significant life outcome, and quality of life) are mediated by co-occurring attention deficit hyperactivity disorder. The investigators predict that the poor outcomes will not be solely mediated by the presence of attention deficit disorder. The following specific hypotheses will be tested: Hypothesis 2A: Adolescents with reading disabilities will evidence higher rates of both externalizing and internalizing disorders than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2B: Adolescents with reading disabilities will evidence more aggressive and delinquent behaviors, more severe depressive symptoms, and more trait anxiety over time than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2C: Adolescents with reading disabilities will evidence a greater likelihood over time of incarceration and school dropout, and will report a greater number of undesirable objective life events than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2D: Adolescents with reading disabilities will report a poorer quality of life and more functional impairment over time than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder.
Specific Aim 3 : Test hypotheses regarding the associated of three reading-related phenotypes with differing behavioral manifestations. The investigators point to their previous research that suggests that one phenotype of reading disability is marked by difficulties with phonemic awareness and is involved with linkage to chromosome 6. A second reading-related phenotype is defined by phonological decoding difficulties and appears to be associated with chromosome 1. A third reading-related phenotype is marked by difficulties with single word identification and is associated with chromosome 15. The preliminary data indicate that these three reading-related phenotypes are also associated with specific genetic linkages and brain morphology, and may be associated with specific psychiatric and behavioral manifestations. There are three related hypotheses: Hypothesis 3A: Adolescents with the phonemic awareness phenotype will evidence higher rates of attention deficit hyperactivity disorder, inattentive type, than all other adolescents except those with the single word reading phenotype; Hypothesis 3B: Adolescents with phonological decoding deficits will show higher levels of social withdrawal than adolescents without this phenotype; Hypothesis 3C: Adolescents with difficulties with single word reading will evidence more severe aggressive and delinquent behaviors, a higher rate of conduct and oppositional disorder, and a higher rate of substance-use disorders than all other adolescents. Adolescents with single word reading deficits will also exhibit a higher rate of attention deficit hyperactivity disorder, inattentive type, than all other youths, except those with the phonemic awareness phenotype. Thus, the two groups that are related to attention deficit hyperactivity disorder are the phonemic awareness phenotype (chromosome 6) and the single word reading phenotype (chromosome 15).
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