Functional Outcomes of Young Adults with Childhood ADHD: A Latent Profile Analysis

Abstract

Objective.-Adults with childhood Attention-Deficit Hyperactivity Disorder (ADHD) experience impairment in core functional domains (e.g., educational attainment, occupational status, social relationships, substance abuse, and criminal behavior), but it is currently unclear which impairments co-occur and whether subgroups experience differentiable patterns, none, or all aforementioned functional domains. Latent profile analysis (LPA) was used to characterize patterns of impairment. Method.-Data from the Pittsburgh ADHD Longitudinal Study were used. Participants were 317 25 year-olds with childhood ADHD. LPA characterized the variability across substance use (alcohol consumption, cigarette smoking, marijuana use), criminal behavior, peer impairment, educational attainment, maternal relationship, financial dependence, and sexual activity among young adults with childhood ADHD. Childhood predictors of profiles were examined, and ADHD profiles were compared to a matched comparison group without ADHD also followed longitudinally (n = 217). Results.-Five profiles were found: prototypic impairment group (54%), high binge drinking group (17%), high marijuana use group (10%), high criminal activity group (3%), and high crossdomain impairment group (17%). All profiles were impaired compared to non-ADHD young adults. Childhood variables rarely significantly predicted profiles. Conclusions.-Young adults with childhood ADHD have differentiable impairment patterns that vary based on substance use, criminal behavior, and number of clinically impaired domains. Nearly all young adult ADHD profiles were impaired in peer, educational, and financial domains, and there was not a non-impaired ADHD profile. Use of specific substances was elevated among subgroups of, but not all, young adults with ADHD histories. Finally, the high cross-domain impairment profile was impaired in all domains.

Children With ADHD Are at Risk for a Broad Array of Adverse Adult Outcomes That Cross Functional Domains: Results From a Population-Based Birth Cohort Study

“…This approach grouped outcomes together to find patterns, as opposed to examining outcomes at the level of individual subjects in order to identify patterns. Another recently published study, by Merrill et al (2020) took a different approach by grouping individuals together using latent profile analyses from the Pittsburgh ADHD Longitudinal Study. In this study, investigators estimated latent profiles of functional outcomes among young adults with childhood ADHD.…”

“…In this study, investigators estimated latent profiles of functional outcomes among young adults with childhood ADHD. The findings revealed five distinct profiles of impairment that varied based on substance use, criminal behavior, and number of clinically impaired domains (Merrill et al, 2020). Notably, controls were not included in the latent profile analysis but were included as a reference, and it is possible that only including individuals with childhood ADHD in the latent profile analysis limited the ability to detect a group with positive functional outcomes.…”

Beers with Peers: Childhood ADHD and Risk for Correlated Change in Perceived Peer and Personal Alcohol Use Across Young Adulthood

“…Notably, regardless of how much peers actually drink, young adults’ perceptions of alcohol use among their peers predict their own alcohol consumption (Schulte, Monreal, Kia‐Keating, and Brown, 2010). Given that young people with ADHD are more likely than their typically developing peers to be impulsive, to have social difficulties, and to be prone to poor decision‐making in high‐risk settings (Molina et al, 2012), they may be especially vulnerable to the influence of alcohol‐using peers on their own heavy drinking (Merrill et al, 2020). In addition to yielding to peer influences (socialization), young adults may also curate their friend groups by drifting toward peers who engage in similar drinking habits to their own (selection; Becker, Marceau, Hernandez, and Spirito, 2019; Curran, Stice, and Chassin, 1997).…”

Network analysis of narrative discourse and attention-deficit hyperactivity symptoms in adults

“…Adults with the disorder may present clinically significant impairments in tasks demanding working memory, memory span, processing speed, decision making, delay aversion to rewards, time perception, executive function, and general communication abilities [ 3 ]. As a result, an array of occupational, academic, social and domestic difficulties may arise from different sets of those deficiencies [ 4 ].…”