Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA) - 26/07/17
, L. Eugene Arnold, MD c, James M. Swanson, PhD d, Brooke S.G. Molina, PhD e, Margaret H. Sibley, PhD f, Andrea L. Howard, PhD gfor the
MTA Cooperative Group
Abstract |
Objective |
Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functional outcomes are not adequately understood. The objective of the present study was to determine the effects of childhood demographic, clinical, and family factors on adult functional outcomes in individuals with and without childhood ADHD from the MTA cohort.
Method |
Regressions were used to determine associations of childhood factors (age range 7–10 years) of family income, IQ, comorbidity (internalizing, externalizing, and total number of non-ADHD diagnoses), parenting styles, parental education, number of household members, parental marital problems, parent–child relationships, and ADHD symptom severity with adult outcomes (mean age 25 years) of occupational functioning, educational attainment, emotional functioning, sexual behavior, and justice involvement in participants with (n = 579) and without (n = 258) ADHD.
Results |
Predictors of adult functional outcomes in ADHD included clinical factors such as baseline ADHD severity, IQ, and comorbidity; demographic factors such as family income, number of household members and parental education; and family factors such as parental monitoring and parental marital problems. Predictors of adult outcomes were generally comparable for children with and without ADHD.
Conclusion |
Childhood ADHD symptoms, IQ, and household income levels are important predictors of adult functional outcomes. Management of these areas early on, through timely treatments for ADHD symptoms, and providing additional support to children with lower IQ and from households with low incomes, could assist in improving adult functioning.
Le texte complet de cet article est disponible en PDF.Key words : attention-deficit/hyperactivity disorder, adult outcomes, functioning, Multimodal Treatment Study of ADHD study, childhood predictors
Plan
| Clinical guidance is available at the end of this article. |
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| The work reported was supported by cooperative agreement grants and contracts from the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) to the University of California–Berkeley: U01 MH50461, N01MH12009, and HHSN271200800005-C; DA-8-5550; Duke University: U01 MH50477, N01MH12012, and HHSN271200800009-C; DA-8-5554; University of California–Irvine: U01MH50440, N01MH12011, and HHSN271200800006- C; DA-8-5551; Research Foundation for Mental Hygiene (New York State Psychiatric Institute and Columbia University): U01 MH50467, N01 MH12007, and HHSN271200800007-C; DA-8-5552; Long Island–Jewish Medical Center: U01 MH50453; New York University: N01MH 12004, and HHSN271200800004-C; DA-8-5549; University of Pittsburgh: U01 MH50467, N01 MH 12010, and HHSN271200800008-C; DA-8-5553; DA 039881; and McGill University: N01MH12008, and HHSN271200800003-C; DA-8-5548. Dr. Roy was supported by the Ter Meulen grant from the Royal Netherlands Academy of Arts and Sciences (KNAW) to participate in this study. |
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| This study was presented as an abstract at the American Academy of Child and Adolescent Psychiatry’s 63rd Annual Meeting, October 24–29, 2016, New York, and at the 6th World Congress on ADHD, April 20-23, 2017, Vancouver. |
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| All authors were responsible for conception and design of the study, interpretation of the data, drafting and revision of the manuscript, and final approval. Drs. Hechtman, Arnold, Swanson, and Molina were responsible for data acquisition. Drs. Roy, Sibley, and Howard were responsible for data analysis. Drs. Hechtman, Swanson, and Molina obtained funding. |
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| The MTA was an NIMH cooperative agreement randomized clinical trial, continued under an NIMH contract as a follow-up study and under a National Institute on Drug Abuse (NIDA) contract. Collaborators from NIMH: Benedetto Vitiello, MD (Child and Adolescent Treatment and Preventive Interventions Research Branch), Joanne B. Severe, MS (Clinical Trials Operations and Biostatistics Unit, Division of Services and Intervention Research), Peter S. Jensen, MD (currently at REACH Institute and Mayo Clinic), L. Eugene Arnold, MD, MEd (currently at Ohio State University), Kimberly Hoagwood, PhD (currently at Columbia); previous contributors from the NIMH to the early phases: John Richters, PhD (currently at National Institute of Nursing Research); Donald Vereen, MD (currently at NIDA). Principal investigators and co-investigators from the sites: University of California, Berkeley/San Francisco: Stephen P. Hinshaw, PhD (Berkeley), Glen R. Elliott, PhD, MD (San Francisco); Duke University: Karen C. Wells, PhD, Jeffery N. Epstein, PhD (currently at Cincinnati Children’s Hospital Medical Center), Desiree W. Murray, PhD; previous Duke contributors to early phases: C. Keith Conners, PhD (former PI); John March, MD, MPH; University of California, Irvine: James Swanson, PhD, Timothy Wigal, PhD; previous contributor from UCLA to the early phases: Dennis P. Cantwell, MD (deceased); New York University School of Medicine: Howard B. Abikoff, PhD; Montreal Children’s Hospital/McGill University: Lily Hechtman, MD; New York State Psychiatric Institute, Columbia University, and Mount Sinai Medical Center: Laurence L. Greenhill, MD (Columbia), Jeffrey H. Newcorn, MD (Mount Sinai School of Medicine). University of Pittsburgh: Brooke Molina, PhD, Betsy Hoza, PhD (currently at University of Vermont), William E. Pelham, PhD (PI for early phases, currently at Florida International University). Follow-up phase statistical collaborators: Robert D. Gibbons, PhD (University of Illinois, Chicago); Sue Marcus, PhD (Mt. Sinai College of Medicine); Kwan Hur, PhD (University of Illinois, Chicago). Original study statistical and design consultant: Helena C. Kraemer, PhD (Stanford University). Collaborator from the Office of Special Education Programs, U.S. Department of Education: Thomas Hanley, EdD. Collaborator from Office of Juvenile Justice and Delinquency Prevention/Department of Justice: Karen Stern, PhD. |
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| Disclosure: Dr. Hechtman has received research support, served on advisory boards, and been a speaker for Eli Lilly and Co., GlaxoSmithKline, Ortho-Janssen, Purdue, Shire, and Ironshore. Dr. Arnold has received research funding from Forest, Eli Lilly and Co., Noven, Shire, Supernus, Roche, YoungLiving, the National Institutes of Health, and Autism Speaks; has consulted with Pfizer, Tris Pharma, and Waypoint; and has been on advisory boards for Arbor, Ironshore, Otsuka, Pfizer, Roche, Seaside Therapeutics, and Shire. Drs. Roy, Swanson, Molina, Sibley, and Howard report no biomedical financial interests or potential conflicts of interest. |
Vol 56 - N° 8
P. 687 - août 2017 Retour au numéro
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