Patterns of Homotypic and Heterotypic Continuity Between ADHD Symptoms, Externalising and Internalising Problems from Age 7 to 15

Abstract

ADHD presents a serious community-health problem through its links to a wide range of negative outcomes. These outcomes are exacerbated when ADHD symptoms co-occur with other mental health problems. Research evidence suggests high rates of cocomorbidity with a range of problems. However, there is a paucity of longitudinal research that examines the predictive links between ADHD symptoms and symptoms of other mental health problems. We examined a cross-lagged autoregressive model in order to assess homotypic and heterotypic continuity between ADHD symptoms, aggressive behavior, non-aggressive behavior problems and anxiety/depression in a community-based sample of 1571 youth (761 female, 810 male) assessed annually from age 7 to 13 and again at age 15. Consistently significant correlations between each pair of problem behaviors provided support for concurrent comorbidity. Furthermore, significant autoregressive pathways provided support for homotypic continuity. Support for heterotypic continuity was limited to ADHD symptoms predicting both aggressive behavior and non-aggressive behavior problems, but not vice versa. Our study highlights the importance of focusing on ADHD symptoms to identify children at risk not only for continued ADHD symptomatology but also a range of externalizing behavior problems including different types of aggression and non-aggressive behavior problems, such as rule-breaking. Identifying these patterns in a community-based sample provides support for the possibility of early identification of risk for a range of problem behaviors.

Analyzing dynamic change in children’s socioemotional development using the strengths and difficulties questionnaire in a large United Kingdom longitudinal study.

“…In particular, cross-lagged panel models (CLPMs) have often been the method of choice (e.g. Obsuth et al, 2020;van Lier et al, 2012). However, CLPMs suffer from a major limitation in that they conflate within-and between-person effects (Berry & Willoughby, 2017).…”

“…However, previous research suggests that almost all common socio-emotional issues, that is conduct problems, hyperactivity/inattention, emotional problems, peer problems and prosociality, are connected to all others (e.g. Andrade & Tannock, 2013;Obsuth et al, 2015Obsuth et al, , 2020Patalay et al, 2017). This implies that simultaneously examining all their relations and their development over time is critical to get a complete picture of mental health development An alternative conceptualisation of comorbidities comes from the network approach to psychopathology (Borsboom, 2008).…”

Cohort Profile: The Zurich Project on the Social Development From Childhood to Adulthood (Z-Proso)

“…Subsequent research examined developmental cascades across domains of poor psychosocial functioning and found evidence of heterotypic continuity insofar as ADHD symptoms tended to predict both aggressive and non-aggressive symptoms later in life (Obsuth et al, 2020). Moreover, z-proso contributed the first within-person analyses of developmental cascades between internalising problems and externalising problems and found evidence of externalising-to-internalising cascades until adolescence .…”

Developmental Relations Between Internalising Problems and ADHD in Childhood: a Symptom Level Perspective

“…Most longitudinal studies investigating the links between ADHD and internalising problems (e.g. Obsuth et al, 2020) have used modelling techniques such as cross-lagged panel models (CLPM), which conflate between-and within-person effects and thus provide ambiguous results regarding the development of co-occurring mental health issues (Berry & Willoughby, 2017). An alternative to traditionally used statistical techniques such as CLPMs are graphical vector autoregression (GVAR) models (Epskamp, 2020).…”