Mechanism-based groups of children with ADHD are associated with distinct domains of impairment

• Type of Material: Article
• Authors: Cynthia Huang-Pollock, Emory University; Zvi Raphael Shapiro, Emory University; Bethany Bray, Emory University
• Language: English
• Date: 2022-12-19
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://www.sciencedirect.com/science/article/abs/pii/S0165178122006096?via%3Dihub
• Title of Journal or Parent Work: Psychiatry Research
• Volume: 319
• Grant/Funding Information: This work was supported in part by National Institute of Mental Health Grant R01 MH084947 to Cynthia Huang-Pollock.
• Keywords: Latent Profile Analysis (LPA); ADHD
• Research Categories: Psychology, Behavioral; Biology, Neuroscience

Abstract

Person-oriented analyses are commonly used to identify subgroups of children with mental health conditions in the hopes that they will meaningfully inform the taxonomy, assessment, and treatment of psychological disorder. However, whether these data-driven groups are demonstrably better at predicting important aspects of adaptive functioning than standard DSM taxonomy has not been established. Using Attention-Deficit-Hyperactivity-Disorder (ADHD) as a model condition, we utilized dimensions of personality and cognitive ability to identify person-centered profiles of school-aged children (N=246) and evaluated the association of these profiles with critical areas of adaptive functioning. A single profile (“Conscientious”) represented non-ADHD controls and was characterized by faster drift rate and higher executive functioning scores. Three profiles (“Disagreeable,” “Negative Emotionality,” and “Extraverted”) were identified for children with ADHD. Drift rate, but not executive functioning, distinguished among ADHD profiles, which were also distinctly associated with comorbid externalizing and internalizing psychopathology, social skills, and academic achievement. In contrast, the Diagnostic and Statistical Manual (DSM) presentations were not informative and showed similar patterns of impairment across domains. Person-centered profiles of children with ADHD are associated with distinct adaptive functioning deficits and may be useful in informing clinical practice.