ADHD is defined by behavioral symptoms that are not well defined in relation to underlying neurobiology or mechanism. Using mechanisms to define its nosology and predict outcome is expected to be more powerful than the current approach, but this hope has not been realized. The current proposal seeks to break this impasse. It combines cognitive and emotion measures in a longitudinal design to establish (a) what mechanisms predict different outcomes, (b) whether novel, mechanism based types can be validated that will be useful to nosology and clinical practice, and (c) creation and cross validation of a clinical risk index that can directly translate mechanism knowledge into clinical practice. Although the rationale involves neurobiology to some extent, the measures are deliberately restricted to relatively low cost and easily disseminated measures that would readily be usable in clinical practice in a range of setting. A cohort of 486 children of which ove 300 had well characterized ADHD at baseline will now be followed into adolescence in an accelerated longitudinal design. Over 2500 observations will be made across multiple waves and these will be used to characterize risk, recovery, and mechanisms. The project rationale and hypotheses derive from a detailed theoretical conception that the PI has developed over several years. The significance of the proposal derives from the potential to move ADHD mechanisms from theory to application both in nosology and clinical prediction. The innovation lies heavily in the proposal that mechanism based typology of ADHD is tractable and can be developed in a formal way. The approach will validate mechanism effects using a detailed longitudinal design that will enable strong evaluation of age and time invariance/dependence of both typing models and effect sizes of their predictive utility. The age range studied (childhood to middle adolescence) is ideal for examining persistence/desistance of ADHD as well as initiation of serious outcomes like drug use, health problems, and comorbid psychiatric disorders.
Aim 1 will use a standard analytic strategy to evaluate mechanisms from a variable centered perspective.
Aim 2 will use clustering validation approaches to explore the taxonomic possibilities of mechanism-based types and validate them over time.
Aim 3 will introduce the risk score index to ADHD based on combining mechanisms and clinical features at different levels of analysis, with built in cross validation.
The Aims directly match key priorities of the NIMH strategic plan. If successful, the project hopes to break the impasse facing the field with regard to utilizing mechanism-based concepts of ADHD in relation to taxonomy and clinical assessment.

Public Health Relevance

New treatments for ADHD require better understanding of how to predict course of illness and of what aspects of the disease are risk factors for future outcome. This research will develop new tools to predict ADHD illness course.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
5R37MH059105-16
Application #
9410953
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Pacheco, Jenni
Project Start
1999-09-20
Project End
2019-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
16
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Oregon Health and Science University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Holton, Kathleen F; Johnstone, Jeanette M; Brandley, Elizabeth T et al. (2018) Evaluation of dietary intake in children and college students with and without attention-deficit/hyperactivity disorder. Nutr Neurosci :1-14
Karalunas, Sarah L; Gustafsson, Hanna C; Fair, Damien et al. (2018) Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychol Assess :
Gustafsson, Hanna C; Sullivan, Elinor L; Nousen, Elizabeth K et al. (2018) Maternal prenatal depression predicts infant negative affect via maternal inflammatory cytokine levels. Brain Behav Immun 73:470-481
Karalunas, Sarah L; Hawkey, Elizabeth; Gustafsson, Hanna et al. (2018) Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability. J Abnorm Child Psychol 46:1705-1716
Miller, Lindsay L; Gustafsson, Hanna C; Tipsord, Jessica et al. (2018) Is the Association of ADHD with Socio-Economic Disadvantage Explained by Child Comorbid Externalizing Problems or Parent ADHD? J Abnorm Child Psychol 46:951-963
Bauer, Brian W; Gustafsson, Hanna C; Nigg, Joel et al. (2018) Working memory mediates increased negative affect and suicidal ideation in childhood attention-deficit/hyperactivity disorder. J Psychopathol Behav Assess 40:180-193
Dotterer, Hailey L; Waller, Rebecca; Cope, Lora M et al. (2017) Concurrent and developmental correlates of psychopathic traits using a triarchic psychopathy model approach. J Abnorm Psychol 126:859-876
Nigg, Joel T (2017) Annual Research Review: On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology. J Child Psychol Psychiatry 58:361-383
Momany, Allison M; Kamradt, Jaclyn M; Ullsperger, Josie M et al. (2017) Sex moderates the impact of birth weight on child externalizing psychopathology. J Abnorm Psychol 126:244-256
Musser, Erica D; Willoughby, Michael T; Wright, Suzanne et al. (2017) Maternal prepregnancy body mass index and offspring attention-deficit/hyperactivity disorder: a quasi-experimental sibling-comparison, population-based design. J Child Psychol Psychiatry 58:240-247

Showing the most recent 10 out of 49 publications