The Temperament in Middle Childhood Questionnaire (TMCQ) is one of a family of instruments representing one of the major conceptual models of child temperament. The present study reports new ...psychometric information on the TMCQ using a larger sample than in prior factor-analytic studies of this instrument. Data from parent ratings of 1,418 children were utilized. The sample of community volunteers included 697 typically developing youth and 721 defined by research diagnostic procedures as having attention-deficit/hyperactivity disorder. Results failed to support the original proposed structure of the TMCQ, but found support for a structure with 12 subscales that confirmed a substantial portion of the lower order factor structure. However, the intended three-factor higher order structure was not able to be fully recovered. Two-group invariance was supported in the final model, supporting use in studies of typical and atypical development. In conclusion, with some modifications the TMCQ remains a useful research measure at the lower order factor level. The validity of the higher order structure is less clear, likely due to measure-specific limitations, and suggests a need for some refinement to the measure.
Public Significance Statement
This study provides evidence for the reliability and validity of a modified version of the Temperament in Middle Childhood Questionnaire, a commonly used instrument in developmental and psychopathology research.
Attention-deficit/hyperactivity disorder (ADHD) is among the many syndromes in the psychiatric nosology for which etiological signal and clinical prediction are weak. Reducing phenotypic and ...mechanistic heterogeneity should be useful to arrive at stronger etiological and clinical prediction signals. We discuss key conceptual and methodological issues, highlighting the role of dimensional features aligned with Research Domain Criteria and cognitive, personality, and temperament theory as well as neurobiology. We describe several avenues of work in this area, utilizing different statistical, computational, and machine learning approaches to resolve heterogeneity in ADHD. We offer methodological and conceptual recommendations. Methodologically, we propose that an integrated approach utilizing theory and advanced computational logic to address targeted questions, with consideration of developmental context, can render the heterogeneity problem tractable for ADHD. Conceptually, we conclude that the field is on the cusp of justifying an emotionally dysregulated subprofile in ADHD that may be useful for clinical prediction and treatment testing. Cognitive profiles, while more nascent, may be useful for clinical prediction and treatment assignment in different ways depending on developmental stage. Targeting these psychological profiles for neurobiological and etiological study to capture different pathophysiological routes remains a near-term opportunity. Subtypes are likely to be multifactorial, cut across multiple dimensions, and depend on the research or clinical outcomes of interest for their ultimate selection. In this context parallel profiles based on cognition, emotion, and specific neural signatures appear to be on the horizon, each with somewhat different utilities. Efforts to integrate such cross-cutting profiles within a conceptual dysregulation framework are well underway.
Head motion systematically distorts clinical and research MRI data. Motion artifacts have biased findings from many structural and functional brain MRI studies. An effective way to remove motion ...artifacts is to exclude MRI data frames affected by head motion. However, such post-hoc frame censoring can lead to data loss rates of 50% or more in our pediatric patient cohorts. Hence, many scanner operators collect additional ‘buffer data’, an expensive practice that, by itself, does not guarantee sufficient high-quality MRI data for a given participant. Therefore, we developed an easy-to-setup, easy-to-use Framewise Integrated Real-time MRI Monitoring (FIRMM) software suite that provides scanner operators with head motion analytics in real-time, allowing them to scan each subject until the desired amount of low-movement data has been collected. Our analyses show that using FIRMM to identify the ideal scan time for each person can reduce total brain MRI scan times and associated costs by 50% or more.
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The improving survival rates of extremely low, very low, and low birth weight and premature infants are good news. Scientifically, they raise complex questions about trends in the incidence of ...neurodevelopmental conditions, from severe injuries like cerebral palsy, now declining after earlier increases in incidence, to subtler yet also disabling and costly conditions like attention-deficit/hyperactivity disorder, whose true incidence likewise may not have increased in the past 15 years.
Objective: Characterization of clinical heterogeneity in attention-deficit hyperactivity disorder (ADHD) remains controversial. Neuropsychological and cognitive studies provide one type of validation ...data, but too often have considered only a narrow range of functional domains. Method: The current study examined ADHD subtype and presentation differences across a broad range of neurocognitive domains in a large clinically characterized, community-recruited sample of 498 youth (213 control, 107 ADHD-primarily inattentive ADHD-PI, 137 ADHD-combined ADHD-C), ages 6-17 years. Domains assessed included inhibition, working memory, arousal, processing speed, response variability, and temporal information processing. Results: Youth with ADHD-C performed worse than youth with ADHD-PI in all domains, consistent with a severity model. Performance among a subgroup with a "restrictive inattentive" presentation indicated potential deficits in processing speed relative to other ADHD-PI youth, but no other effects. When all measures were included in the same model, cognitive control (executive functions, working memory, and memory span), arousal, and response variability each provided uniquely incremental statistical prediction of specific symptom dimensions and of subtype/presentation, but temporal information processing and processing speed did not. Conclusion: Results suggest the potential to consolidate multiple neurocognitive theories of ADHD, and that such consolidation will apply across putative clinical subtypes or presentations.
Objective: Children with ADHD have heterogeneous behavioral and neuropsychological profiles. The aim of this study was to examine the possible utility of executive function (EF) subtypes within ADHD. ...Method: Participants were 357 children aged 6 through 13 with a diagnosis of ADHD. Children completed a brief laboratory battery measuring EF, including response inhibition, response variability, speed, and set-shifting. Children also completed standardized intelligence and achievement testing. Results: Two-way cluster analysis of EF profiles of children with ADHD produced a three-cluster solution, labeled poor inhibitory control, poor set-shifting/speed, and intact task performance. Clusters significantly differed in measures of intelligence, academic achievement, and other disruptive behavior and anxiety/mood symptoms. Conclusion: These findings further support the idea that children with ADHD have heterogeneous EF profiles and suggest that the theory of ADHD should consider these individual differences in EF profiles within the ADHD diagnostic category.
Poor metabolic health during pregnancy is associated with health concerns for pregnant individuals and their offspring. Lower socioeconomic status (SES) is one risk factor for poor metabolic health, ...and may be related to limited access to healthful and affordable foods (e.g., living in a food desert). This study evaluates the respective contributions of SES and food desert severity on metabolic health during pregnancy. The food desert severity of 302 pregnant individuals was determined using the United States Department of Agriculture Food Access Research Atlas. SES was measured using total household income adjusted for household size, years of education, and amount of reserve savings. Information about participants' glucose concentrations one hour following an oral glucose tolerance test during the second trimester was extracted from medical records and percent adiposity during the second trimester was assessed using air displacement plethysmography. Information about participants' nutritional intake during the second trimester was obtained by trained nutritionists via three unannounced 24-h dietary recalls. Structural equation models showed that lower SES predicted higher food desert severity (β = - 0.20, p = 0.008) and higher adiposity (β = - 0.27, p = 0.016) and consumption of a more pro-inflammatory diet (β = - 0.25, p = 0.003) during the second trimester of pregnancy. Higher food desert severity also predicted higher percent adiposity during the second trimester (β = 0.17, p = 0.013). Food desert severity significantly mediated the relationship between lower SES and higher percent adiposity during the second trimester (β
= - 0.03, 95% CI - 0.079, - 0.004). These findings indicate that access to healthful and affordable foods is a mechanism by which SES contributes to adiposity during pregnancy and may inform interventions intended to improve metabolic health during pregnancy.
Attention-deficit/hyperactivity disorder (ADHD) is a complex behavioral disorder, often difficult and time consuming to diagnose. Laboratory assessment of ADHD-related constructs of attention and ...motor activity may be helpful in elucidating neurobiology; however, neuroimaging studies evaluating laboratory measures of ADHD are lacking. In this preliminary study, we assessed the association between fractional anisotropy (FA), a measure of white matter microstructure, and laboratory measures of attention and motor behavior using the QbTest, a widely used measure thought to improve clinician diagnostic confidence. This is the first look at neural correlates of this widely used measure. The sample included adolescents and young adults (ages 12–20, 35% female) with ADHD (n = 31) and without (n = 52). As expected, ADHD status was associated with motor activity, and cognitive inattention and impulsivity in the laboratory. With regard to MRI findings, laboratory observed motor activity and inattention were associated with greater FA in white matter regions of the primary motor cortex. All three laboratory observations were associated with lower FA in regions subserving fronto-striatal-thalamic and frontoparietal (i.e. superior longitudinal fasciculus) circuitry. Further, FA in white matter regions of the prefrontal cortex appeared to mediate the relationship between ADHD status and motor activity on the QbTest. These findings, while preliminary, suggest that performance on certain laboratory tasks is informative with regard to neurobiological correlates of subdomains of the complex ADHD phenotype. In particular, we provide novel evidence for a relationship between an objective measure of motor hyperactivity and white matter microstructure in motor and attentional networks.
The Diagnostic and Statistical Manual of Mental Disorder-Fifth Edition explicitly requires that attention-deficit/hyperactivity disorder (ADHD) symptoms should be apparent across settings, taking ...into account reports from multiple informants. Yet, it provides no guidelines how information from different raters should be combined in ADHD diagnosis. We examined the validity of different approaches using structural equation modeling (SEM) for multiple-informant data. Participants were 725 children, 6 to 17 years old, and their primary caregivers and teachers, recruited from the community and completing a thorough research-based diagnostic assessment, including a clinician-administered diagnostic interview, parent and teacher standardized rating scales, and cognitive testing. A best-estimate ADHD diagnosis was generated by a diagnostic team. An SEM model demonstrated convergent validity among raters. We found relatively weak symptom-specific agreement among raters, suggesting that a general average scoring algorithm is preferable to symptom-specific scoring algorithms such as the "or" and "and" algorithms. Finally, to illustrate the validity of this approach, we show that averaging makes it possible to reduce the number of items from 18 items to 8 items without a significant decrease in validity. In conclusion, information from multiple raters increases the validity of ADHD diagnosis, and averaging appears to be the optimal way to integrate information from multiple raters.
Children with attention deficit/hyperactivity disorder (ADHD) display alterations in both emotion reactivity and regulation. One mechanism underlying such alternations may be reduced coherence among ...emotion systems (i.e., autonomic, facial affect). The present study sought to examine this. One hundred children (50 with ADHD combined presentation), 7-11 years of age (62% male, 78% White), completed an emotion induction and suppression task. This task was coded for facial affect behavior across both negative and positive emotion eliciting task conditions. Electrocardiogram and impedance cardiography data were acquired throughout the task. Time-linked coherence of facial affect behavior and autonomic reactivity and regulation were examined during the induction conditions using hierarchical linear modeling. Although ADHD and typically developing children did not differ with respect to rates of facial affect behavior displayed (all Fs < 2.09, ps > .29), the ADHD group exhibited reduced coherence between facial affect behavior and an index of parasympathetic functioning (i.e., respiratory sinus arrhythmia), γ
= -0.03, SE = 0.02, t(138) = -1.96, p = .05. In contrast, children in the control group displayed a significant, positive, γ
= 0.06, SE = 0.01, t(138) = 4.07, p < .001, association between facial affect behavior and respiratory sinus arrhythmia. Children with ADHD may receive conflicting emotional signals at the levels of facial affective behavior and parasympathetic functioning when compared to typically developing youth. Weakened coherence among these emotion systems may be an underlying mechanism of emotion dysregulation in ADHD. Implications for etiology and treatment are discussed.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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