Predictors of Attention-Deficit/Hyperactivity Disorder Symptom Trajectories During Late Childhood and Early Adolescence Using the Adolescent Brain Cognitive Development (ABCD) Dataset

Attention-Deficit/Hyperactivity Disorder (ADHD) impacts 7% of children and is associated with serious impairment throughout the lifespan. Though considered a chronic, stable condition, symptoms fluctuate substantially during adolescence, and symptom trajectory is linked to adult outcomes. A small number of studies have examined symptom trajectory during adolescence, but these have predominately examined demographic predictors. As a neurodevelopmental disorder, ADHD is theorized to arise from deficits in executive functions (EFs). Extant literature identifies three major components of EF- working memory, behavioral inhibition, and set shifting- as interrelated constructs underlying ADHD symptom expression. This study aimed to 1.) identify trajectories of ADHD symptoms, 2.) examine demographic predictors of trajectories, and 3.) examine whether EF predicts symptom trajectory using five timepoints from the Adolescent Brain Cognitive Development study, a large-scale, representative, population-based sample from the United States. 1,605 participants meeting criteria for ADHD included in analyses. ADHD symptoms were measured by parent report on the widely used Achenbach Child Behavior Checklist. Growth Mixture Modeling was used to model trajectories of ADHD symptoms. However, poor entropy indicated trajectories were not clearly differentiated and predictors could not be examined. Therefore, exploratory regression was conducted to examine predictors of ADHD symptom change from baseline to 3-year follow-up. Male sex, medication use, greater than high school parental education, and better EF all predicted increasing ADHD symptoms. Findings must be interpreted with caution due to their exploratory nature and poor validity of the measure used for ADHD symptoms, which was found to have sensitivity of only 22.58%. Given the strong theoretical and empirical link between ADHD symptoms and EF, additional research on the connection between EF and disorder trajectory with more robust measures of EF is warranted.