Is an irritable ADHD profile traceable using personality dimensions? Replicability, stability, and predictive value over time of data-driven profiles

Abstract

Pediatric attention deficit/hyperactivity disorder (ADHD) is a heterogeneous condition. In particular, children with ADHD display varying profiles of dispositional traits, as assessed through temperament and personality questionnaires. Previous data-driven community detection analyses based on temperament dimensions identified an irritable profile of patients with ADHD, uniquely characterized by elevated emotional dysregulation symptoms. Belonging to this profile increased the risk of developing comorbid disorders. Here, we investigated whether we could replicate this profile in a sample of 178 children with ADHD, using community detection based on personality dimensions. Stability of the identified profiles, of individual classifications, and clinical prediction were longitudinally assessed over a 1-year interval. Three personality profiles were detected: The first two profiles had high levels of neuroticism, with the first displaying higher ADHD severity and lower openness to experience (profile 1; N = 38), and the second lower agreeableness (profile 2; N = 73). The third profile displayed scores closer to the normative range on all five factors (profile 3; N = 67). The identified profiles did only partially replicate the temperament-based profiles previously reported, as higher levels of neuroticism were found in two of the three detected profiles. Nonetheless, despite changes in individual classifications, the profiles themselves were highly stable over time and of clinical predictive value. Whereas children belonging to profiles 1 and 2 benefited from starting medication, children in profile 3 did not. Hence, belonging to an emotionally dysregulated profile at baseline predicted the effect of medication at follow-up over and above initial ADHD symptom severity. This finding suggests that personality profiles could play a role in predicting treatment response in ADHD.

Subgroups in Late Adulthood Are Associated With Cognition and Wellbeing Later in Life

“…Fourthly, the modularity index indicated weakly defined communities. This has also been reported in other studies using community detection with similar types of data ( Karalunas et al, 2014 ; Blanken et al, 2020 ). Since community detection and the modularity index are relatively new to psychological research, more methodological research is required into its properties with this type of data.…”

“…However, only 47-62% per subgroup retained their membership at T2. Instability in subgroup memberships over time alongside stable subgroup profiles has been indicated in previous studies using community detection (Karalunas et al, 2014;Blanken et al, 2020). Transitions between subgroups over time are also more likely when modifiable cluster factors are included, as in our study.…”

“…People with similar profiles on the input variables have a higher likelihood of being assigned to the same subgroup than people with dissimilar scores. Research so far suggests that the added value of this novel method compared to Latent Profile Analysis —which is commonly used to investigate heterogeneity— could be the identification of subgroups that are more stable over time with improved clinical predictive value ( Blanken et al, 2020 ).…”

Mental health in Canadian children and adolescents during COVID-19 pandemic: the role of personality and, coping and stress responses

“…Generally, individuals who score higher on Openness to Experience are more likely to experience higher psychological well-being ( Jacobsson et al, 2021 ). There are some studies in adults showing a negative relationship between Openness to Experience and Hyperactivity/Inattention ( Smith and Martel, 2019 ; Blanken et al, 2021 ), and some showing no associations ( Krieger et al, 2020 ; Nigg et al, 2020 ). We only found one study on 8–12-year-old children, showing that children with Hyperactivity/Inattention symptoms were consistently rated as having lower Openness to Experience ( Casher, 2016 ).…”

Clinical subtyping using community detection: Limited utility?

“…Community detection seems an attractive alternative, but its relative novelty also means that little guidance and knowledge is available. In the ADHD literature, there is a growing number of papers that have established the existence of three temperament subtypes using community detection (Blanken et al., 2021 ; Goh et al., 2020 ; Karalunas et al., 2014 , 2019 ; Nigg et al., 2020 ). In general, community detection is often used for subtyping analyses of ADHD and autism samples (Bathelt et al., 2018 ; Cordova et al., 2020 ; Deserno et al., 2022 ; Fair et al., 2014 ; Feczko et al., 2018 ; Groenman, et al., 2019 ; Mostert et al., 2018 ; Radhoe, Agelink van Rentergem, Torenvliet, et al., 2021 ), although there are also applications outside these disorders (e.g., Radhoe, Agelink van Rentergem, Kok, et al., 2021 ; Saliasi et al., 2015 ).…”