Pathways from neurocognitive vulnerability to co-occurring internalizing and externalizing problems among women with and without attention-deficit/hyperactivity disorder followed prospectively for 16 years

Abstract

Using a sample of 228 females with and without childhood attention-deficit/hyperactivity disorder followed prospectively across 16 years, we measured childhood neurocognitive vulnerability via executive dysfunction using teacher-reported cognitive and learning problems. We then ascertained relations between dimensionally measured internalizing and externalizing psychopathology during adulthood and showed that childhood neurocognitive vulnerability reliably predicted such associated psychopathology. We identified six serial mediation pathways from childhood neurocognitive vulnerability to adult psychopathology through three early- and late-adolescent domains: individual (self-control and delay of gratification), peer (rejection/conflict and acceptance/friendship), and school (academic performance and school failure). The serial indirect effects occurred for the pathways from childhood neurocognitive vulnerability through early-adolescent academic performance, to late-adolescent school failure, to adult associated psychopathology, and from neurocognitive vulnerability through adolescent self-control and then the ability to delay gratification, to adult psychopathology. Furthermore, these indirect effects, plus two others, were moderated by parental distress during childhood and early adolescence, such that under conditions of high distress, the serial indirect effects were weaker than when parental distress was low. We discuss the potential importance of behavioral self-regulation and educational success for later psychological functioning, especially among girls, as well as implications for ontogenic process models of psychopathology.

Adolescent Mediators of Unplanned Pregnancy among Women with and without Childhood ADHD

“…Regardless, our key finding suggests that academic interventions intended to ensure that girls with ADHD succeed in school comprise one possible way to prevent later unwanted pregnancies. This result is consonant with our previous findings suggesting that interventions promoting educational success could be an important strategy for reducing the burden of adult psychopathology and global impairment in this population (Owens & Hinshaw, 2016a, 2016b.…”

Girls with childhood ADHD as adults: Cross-domain outcomes by diagnostic persistence.

“…Perhaps related to our all-female sample, many of whom initially presented with the inattentive type of ADHD, we found statistically significant and often very large associations between childhood ADHD and adult internalizing outcomes, but only when ADHD persisted beyond childhood. The mechanisms by which ADHD contributes to adult internalizing (and externalizing) problems among women are likely to be varied, but they appear to involve behavioral dysregulation and academic failure (Owens & Hinshaw, 2016). …”

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

“…N. Swanson et al, 2014). Thus, prospective identification of risk is now possible (Allely, 2014; CDC, 2014; Guendelman et al, 2016; Owens & Hinshaw, 2016). Although ADHD and maltreatment elevate risk, their combined effects are alarmingly potent (see Fig.…”

“…Although the literature is fractionated across subtypes of psychopathology (depression, borderline personality disorder [BPD]), ages of participants (adolescents, adults), biological vulnerabilities (genetic, neural, neurohormonal, peripheral), and environmental risk factors (abuse, trauma, invalidation), much is known about the etiology of NSSI and the more distal outcome of suicide. Recent research shows that highly impulsive preadolescent girls who also incur maltreatment, including physical and sexual abuse, are at 50% risk for developing NSSI and 33% risk for suicide attempts by late adolescence and early adulthood (Guendelman Owens, Galan, Gard, & Hinshaw, 2016; Hinshaw et al, 2012; Owens & Hinshaw, 2016; Stepp, Burke, Hipwell, & Loeber, 2012; E. N. Swanson, Owens, & Hinshaw, 2014).…”