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Research on Child and Adolescent Psychopathology

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05-08-2023

An Individualized, Data-Driven Biological Approach to Attention-Deficit/Hyperactivity Disorder (ADHD) Heterogeneity

Auteurs: Stephanie S. J. Morris, Adela Timmons, Erica D. Musser

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 11/2023

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed mental health disorder in childhood, however, there is well-established heterogeneity in both the presentation of ADHD symptoms and secondary characteristics across the literature. Existing Diagnostic and Statistical Manual of Mental Disorders (DSM-5) nosology has been ineffective in explaining such heterogeneity in terms of both pathophysiology and clinical trajectories. The current study investigated ADHD heterogeneity via a biologically-based, data-driven approach (k-Means algorithm). Specifically, unique biological profiles (derived from patterns of parasympathetic and sympathetic functioning) were identified and utilized as predictors of clinical presentations. Two hundred eighty-nine participants (167 youth with ADHD), ages 5 to 13 years, completed an emotion-based task while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., electrodermal activity [EDA]) activity were obtained. Overall, results suggest that three distinct biological profiles among youth with ADHD are evident, with biological profiles differing in regulation and arousal levels during emotionally evocative contexts: (Profile 1) underregulated, hyperaroused (negative contexts only), (Profile 2) typically regulated, underaroused, and (Profile 3) overregulated (positive contexts only), hyperaroused. Results are supported by several dopaminergic- and reward-based theories, integrating differing concepts across the literature, and adds biological support for existing models. Behaviorally, results may translate into differing clinical presentations, however, further work is needed. In general, youth with ADHD are heterogenous in autonomic functioning, which could have implications for synthesizing across differing theories within the literature, predicting clinical presentations, and developing targeted treatments.

vorige artikel Asian Indian American Parental Help-Seeking Intentions for ADHD

volgende artikel Treatment Outcomes of Children with Primary Versus Secondary Callous-Unemotional Traits

American Academy of Pediatrics. (2019). Clinical practice Guideline for the diagnosis, evaluation, and treatment of ADHD in children and adolescents. Developmental Pediatrics, 144(4), 54–54. https://doi.org/10.5005/jp/books/12480_13.CrossRef

American Psychiatric Association (1994). Diagnostic And Statistical Manual of Mental Disorders: DSM-IV.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Beauchaine, T. P. (2001). Vagal tone, development, and Gray’s motivational theory: Toward an integrated model of autonomic nervous system functioning in psychopathology. Development and Psychopathology, 38(2), 183–214. https://doi.org/10.1017/S0954579401002012.CrossRef

Berntson, G. G., Bigger, J. T., Eckberg, D. L., Grossman, P., Kaufmann, P. G., & Malik, M. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34(6), 623–648. https://doi.org/10.1111/j.1469-8986.1997.tb02140.x.CrossRefPubMed

Berntson, G. G., Cacioppo, J. T., & Quigley, K. S. (1993). Respiratory sinus arrhythmia: Autonomic origins, physiological mechanisms, and psychophysiological implications. Psychophysiology, 30(2), 183–196. https://doi.org/10.1111/j.1469-8986.1993.tb01731.x.CrossRefPubMed

Berntson, G. G., Cacioppo, J. T., Quigley, K. S., & Fabro, V. T. (1994). Autonomic space and psychophysiological response. Psychophysiology, 31(1), 44–61. https://doi.org/10.1111/J.1469-8986.1994.TB01024.X.CrossRefPubMed

Berntson, G. G., Norman, G. J., Hawkley, L. C., & Cacioppo, J. T. (2008). Cardiac autonomic balance vs. Cardiac Regulatory Capacity Psychophysiology, 45(4), 643. https://doi.org/10.1111/J.1469-8986.2008.00652.X.CrossRefPubMed

Bied, A., Biederman, J., & Faraone, S. (2017). Parent-based diagnosis of ADHD is as accurate as a teacher-based diagnosis of ADHD. Postgraduate Medicine, 129(3), 375–381. https://doi.org/10.1080/00325481.2017.1288064.CrossRefPubMedPubMedCentral

Bradley, M. M., Cuthbert, B. N., & Lang, P. J. (1990). Startle reflex modification: Emotion or attention? Psychophysiology, 27(5), 519–522. https://doi.org/10.1111/j.1469-8986.1990.tb01966.x.CrossRef

Bunford, N., Evans, S. W., & Wymbs, F. (2015). ADHD and emotion dysregulation among children and adolescents. Clinical Child And Family Psychology Review, 18, 185–217. https://doi.org/10.1007/s10567-015-0187-5.CrossRefPubMed

Bunford, N., Kujawa, A., Dyson, M., Olino, T., & Klein, D. N. (2021). Examination of developmental pathways from preschool temperament to early adolescent ADHD symptoms through initial responsiveness to reward. Development and Psychopathology, 1–13. https://doi.org/10.1017/S0954579420002199.

Cacioppo, J. T., Tassinary, L. G., & Berntson, G. (2007). Handbook of psychophysiology. Cambridge University Press.

Chalmers, J. A., Quintana, D. S., Abbott, M. J. A., & Kemp, A. H. (2014). Anxiety disorders are associated with reduced heart rate variability: A meta-analysis. Frontiers in Psychiatry, 5(JUL), 80. https://doi.org/10.3389/FPSYT.2014.00080/ABSTRACT.CrossRefPubMedPubMedCentral

Chhabildas, N., Pennington, B. F., & Willcutt, E. G. (2001). A comparison of the neuropsychological profiles of the DSM-IV subtypes of ADHD. Journal of Abnormal Child Psychology, 29(6), 529–540. https://doi.org/10.1023/A:1012281226028.CrossRefPubMed

Conzelmann, A., Gerdes, A. B. M., Mucha, R. F., Weyers, P., Lesch, K. P., Bähne, C. G., Fallgatter, A. J., Renner, T. J., Warnke, A., Romanos, M., & Pauli, P. (2014). Autonomic hypoactivity in boys with attention-deficit/hyperactivity disorder and the influence of methylphenidate. World Journal of Biological Psychiatry, 15(1), 56–65. https://doi.org/10.3109/15622975.2013.829584.CrossRef

De Wied, M., Van Boxtel, A., Matthys, W., & Meeus, W. (2012). Verbal, facial and autonomic responses to Empathy-Eliciting Film clips by disruptive male adolescents with high Versus Low callous-unemotional traits. Journal of Abnormal Child Psychology, 40(2), 211. https://doi.org/10.1007/S10802-011-9557-8.CrossRefPubMed

Eppinger, H., & Hess, L. (1915). Vagotonia Ment Nerv Dis Monogr No 20. Nervous & Mental Disease Publishing Company.

Fabiano, G. A., Pelham, W. E. Jr., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., et al. (2006). A practical measure of impairment: Psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 34, 369–385. https://doi.org/10.1207/s15374424jccp3503_3.CrossRef

Fowles, D. C. (1986). The eccrine system and electrodermal activity. Psychophysiology: Systems Processes and Applications, 1, 51–96.

Fowles, D. C. (2000). Electrodermal hyporeactivity and antisocial behavior: Does anxiety mediate the relationship? Journal of Affective Disorders, 61(3), 177–189. https://doi.org/10.1016/S0165-0327(00)00336-0.CrossRefPubMed

Graziano, P. A., Reavis, R. D., Keane, S. P., & Calkins, S. D. (2007). The role of emotion regulation in children’s early academic success. Journal of School Psychology, 45(1), 3–19. https://doi.org/10.1016/j.jsp.2006.09.002.CrossRefPubMedPubMedCentral

Hinnant, J. B., Elmore-Staton, L., & El-Sheikh, M. (2011). Developmental trajectories of respiratory sinus arrhythmia and preejection period in middle childhood. Developmental Psychobiology, 53(1), 59–68. https://doi.org/10.1002/DEV.20487.CrossRefPubMedPubMedCentral

Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang, P. (2010). Research Domain Criteria (RDoC): Toward a new classification Framework for Research on Mental Disorders. Https://DoiOrg, 167(7), 748–751. https://doi.org/10.1176/APPI.AJP.2010.09091379.CrossRef

Karalunas, S. L., Fair, D., Musser, E. D., Aykes, K., Iyer, S. P., & Nigg, J. T. (2014). Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: Toward biologically based nosologic criteria. JAMA Psychiatry, 71(9), 1015–1024. https://doi.org/10.1001/jamapsychiatry.2014.763.CrossRefPubMedPubMedCentral

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of. Arch Gen Psychiatry, 62(June), 593–602. http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593.

Lahey, B. B., Pelham, W. E., Loney, J., Lee, S. S., & Willcutt, E. (2005). Instability of the DSM-IV subtypes of ADHD from Preschool through elementary school. Archives of General Psychiatry, 62(8), 896–902. https://doi.org/10.2106/00004623-197153080-00008.

Lorber, M. (2004). Psychophysiology of aggression, psychopathy, and Conduct problems: A Meta-analysis. Psychological Bulletin, 130(4), 531–552. https://content.apa.org/record/2004-15935-001.CrossRefPubMed

Martel, M. M., & Nigg, J. T. (2006). Child ADHD and personality/temperament traits of reactive and effortful control, resiliency, and emotionality. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47(11), 1175–1183. https://doi.org/10.1111/j.1469-7610.2006.01629.x.CrossRefPubMed

Morris, S. S. J., Musser, E. D., Tenenbaum, R. B., Ward, A. R., Martinez, J., Raiker, J. S., Coles, E. K., & Riopelle, C. (2019). Emotion regulation via the autonomic nervous system in children with Attention-Deficit/Hyperactivity disorder (ADHD): Replication and extension. Journal of Abnormal Child Psychology, 48(3), 361–373. https://doi.org/10.1007/s10802-019-00593-8.CrossRef

Morris, S. S. J., Musser, E. D., Tenenbaum, R. B., Ward, A. R., Raiker, J. S., & Coles, E. K. (2021). Methylphenidate Improves Autonomic Functioning among Youth with Attention-Deficit/Hyperactivity Disorder. Research on Child and Adolescent Psychopathology. https://doi.org/10.1007/s10802-021-00870-5.

Musser, E. D., Backs, R. W., Schmitt, C. F., Ablow, J. C., Measelle, J. R., & Nigg, J. T. (2011). Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Child Psychology, 39(6), 841–852. https://doi.org/10.1007/s10802-011-9499-1.CrossRefPubMedPubMedCentral

Musser, E. D., & Nigg, J. T. (2017). Emotion dysregulation across emotion Systems in attention Deficit/Hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 48(1), 153–165. https://doi.org/10.1080/15374416.2016.1270828/SUPPL_FILE/HCAP_A_1270828_SM5136.DOCX.CrossRefPubMedPubMedCentral

Nigg, J. T. (2006). Temperament and developmental psychopathology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47(3–4), 395–422. https://doi.org/10.1111/j.1469-7610.2006.01612.x.CrossRefPubMed

Nigg, J. T., Goldsmith, H. H., & Sachek, J. (2004). Temperament and Attention Deficit Hyperactivity Disorder: The Development of a Multiple Pathway Model. In Journal of Clinical Child and Adolescent Psychology (Vol. 33, Issue 1, pp. 42–53). https://doi.org/10.1207/S15374424JCCP3301_5.

Overbeek, T. J. M., Van Boxtel, A., & Westerink, J. H. D. M. (2014). Respiratory sinus arrhythmia responses to cognitive tasks: Effects of task factors and RSA indices. Biological Psychology, 99(1), 1–14. https://doi.org/10.1016/j.biopsycho.2014.02.006.CrossRefPubMed

Pang, K. C., & Beauchaine, T. P. (2013). Longitudinal patterns of autonomic nervous system responding to emotion evocation among children with Conduct problems and/or depression. Developmental Psychobiology, 55(7), 698. https://doi.org/10.1002/DEV.21065.CrossRefPubMed

Pelham, W. E., Burrows-MacLean, L., Gnagy, E. M., Fabiano, G. A., Coles, E. K., Tresco, K. E., et al. (2005a). Transdermal methylphenidate, behavioral and combined treatment for children with ADHD. Experimental and Clinical Psychopharmacology, 13, 111–126. https://doi.org/10.1037/1064-1297.13.2.111.CrossRefPubMed

Pelham, W. E., Fabiano, G. A., & Massetti, G. M. (2005b). Evidence-based assessment of attention-deficit/hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449–476. https://doi.org/10.1207/s15374424jccp3403_5.CrossRefPubMed

Pelham, W. E. Jr., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 31(2), 210–218. https://doi.org/10.1097/00004583-199203000-00006.CrossRef

Pelham, W. E., Foster, E. M., & Robb, J. A. (2007). The economic impact of attention-deficit/hyperactivity disorder in children and adolescents. Journal of Pediatric Psychology, 32(6), 711–727. https://doi.org/10.1093/jpepsy/jsm022.CrossRefPubMed

Perlstein, S., Waller, R., Wagner, N., Byrd, A., Vine, V., Jennings, J. R., & Stepp, S. (2021). Autonomic nervous system inflexibility during parent-child interactions is related to callous-unemotional traits in Youth aged 10–14 years old. Research on Child and Adolescent Psychopathology, 49(12), 1581–1592. https://doi.org/10.1007/S10802-021-00849-2.CrossRefPubMedPubMedCentral

Polanczyk, G. V., Willcutt, E. G., Salum, G. A., Kieling, C., & Rohde, L. A. (2014). ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis. International Journal of Epidemiology, 43(2), 434–442. https://doi.org/10.1093/ije/dyt261.CrossRefPubMedPubMedCentral

Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. https://doi.org/10.1016/J.BIOPSYCHO.2006.06.009.CrossRefPubMed

Robb, J. A., Sibley, M. H., Pelham, W. E., Foster, E. M., Molina, B. S. G., Gnagy, E. M., & Kuriyan, A. B. (2011). The estimated Annual cost of ADHD to the US Education System. School Mental Health, 3(3), 169–177. https://doi.org/10.1007/s12310-011-9057-6.CrossRefPubMedPubMedCentral

Salminen, M., Ravaja, N., Kallinen, K., & Saari, T. (2013). Mediated cues of group emotion during knowledge-work tasks: Effects on subjective and physiological responses. Interacting with Computers, 25(1), 60–73. https://doi.org/10.1093/iwc/iws006.CrossRef

Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic interview schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. American Academy of Child & Adolescent Psychiatry, 39(1), 28–38.CrossRef

Shields, S. A., MacDowell, K. A., Fairchild, S. B., & Campbell, M. L. (1987). Is mediation of sweating cholinergic, adrenergic, or both? A comment on the literature. Psychophysiology, 24(3), 312–319. https://doi.org/10.1111/j.1469-8986.1987.tb00301.x.CrossRefPubMed

Sikström, S., & Söderlund, G. (2007). Stimulus-dependent dopamine release in Attention-Deficit/Hyperactivity disorder. Psychological Review, 114(4), 1047–1075. https://doi.org/10.1037/0033-295X.114.4.1047.CrossRefPubMed

Sonuga-Barke, E. J. S. (2002). Psychological heterogeneity in AD/HD - A dual pathway model of behaviour and cognition. Behavioural Brain Research, 130(1–2), 29–36. https://doi.org/10.1016/S0166-4328(01)00432-6.CrossRefPubMed

Stone, L. B., McCormack, C. C., & Bylsma, L. M. (2020). Cross system autonomic balance and regulation: Associations with depression and anxiety symptoms. Psychophysiology, 57(10), 1–17. https://doi.org/10.1111/psyp.13636.CrossRef

Suess, P. E., Porges, S. W., & Plude, D. J. (1994). Cardiac vagal tone and sustained attention in school-age children. Psychophysiology, 31(1), 17–22. https://doi.org/10.1111/j.1469-8986.1994.tb01020.x.CrossRefPubMed

Uno, H. (1977). Sympathetic innervation of the sweat glands and piloarrector muscles of macaques and human beings. The Journal of Investigative Dermatology, 69, 112–120. https://doi.org/10.1111/1523-1747.ep12497915.CrossRefPubMed

Wallin, B. G. (1981). Sympathetic nerve activity underlying electrodermal and cardiovascular reactions in man. Psychophysiology, 18(4), 470–4767. https://doi.org/10.1111/j.1469-8986.1981.tb02483.x.CrossRefPubMed

Wechsler, D. (2011). Wechsler abbreviated scale of intelligence- second edition (WASI II). San Antonio: Psychological Corporation.

Wenger, M. A. (1966). Studies of autonomic balance: A Summary. Psychophysiology, 2(3), 173–186. https://doi.org/10.1111/j.1469-8986.1966.tb02641.x.CrossRefPubMed

Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., Loo, S. K., Carlson, C. L., McBurnett, K., & Lahey, B. B. (2012). Validity of DSM-IV attention–deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121(4), 991. https://doi.org/10.1037/A0027347.CrossRefPubMedPubMedCentral

Titel: An Individualized, Data-Driven Biological Approach to Attention-Deficit/Hyperactivity Disorder (ADHD) Heterogeneity
Auteurs: Stephanie S. J. Morris
Adela Timmons
Erica D. Musser
Publicatiedatum: 05-08-2023
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 11/2023
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-023-01104-6

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