Dataset Information

Associations between neighborhood, family factors and symptom change in childhood attention deficit hyperactivity disorder.

ABSTRACT: Transactional theories view development as partly shaped by processes proximal to a child, which in turn interact with more distal neighborhood and societal contexts. Here we apply this theory to parse the interplay between neighborhood and familial factors on age-related change in symptoms of inattention and hyperactivity-impulsivity (ADHD). A cohort of 190 children (96 with ADHD) had a range of neighborhood and familial factors ascertained and had repeated clinical assessments over an average of 2.5?years at a U.S. research center. Using mixed model regression, we found an association between neighborhood wealth, but not the built environment, and the annual rate of change of inattentive but not hyperactive-impulsive symptoms. Following the transactional model, we asked if familial processes explain (mediate), modify (moderate), or act alongside this effect of neighborhood wealth on the change in a child's symptoms of inattention with age. We found evidence for moderation. Specifically, several family level variables - parental economic/education status and degree of family conflict and order moderated the effects of neighborhood wealth on the change in a child's inattentive symptoms. Children living in relatively affluent neighborhoods showed improvement with age in inattention, largely independent of variation in a wide range of familial factors. By contrast, children living in less affluent neighborhoods showed clinical deterioration only if the family had high levels of conflict or if the parents were of lower economic/educational status. Such work might help identify children whose familial and neighborhood contexts place them at risk of having ADHD symptoms persist or increase with age.

SUBMITTER: Sharp W

PROVIDER: S-EPMC6748875 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Associations between neighborhood, family factors and symptom change in childhood attention deficit hyperactivity disorder.

Sharp Wendy W Mangalmurti Aman A Hall Carlisha C Choudhury Saadia S Shaw Philip P

Social science & medicine (1982) 20190303

Transactional theories view development as partly shaped by processes proximal to a child, which in turn interact with more distal neighborhood and societal contexts. Here we apply this theory to parse the interplay between neighborhood and familial factors on age-related change in symptoms of inattention and hyperactivity-impulsivity (ADHD). A cohort of 190 children (96 with ADHD) had a range of neighborhood and familial factors ascertained and had repeated clinical assessments over an average ...[more]

PMID: 30857751

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Project description:PURPOSE:Disordered eating is more prevalent among adolescents with attention deficit/hyperactivity disorder. Both inattention and hyperactivity/impulsivity symptoms show strong associations with disordered eating, but few investigations of these associations have been longitudinal. Thus, we examined the effect of childhood to adolescent inattention and hyperactivity/impulsivity symptom trajectories on late adolescent disordered eating. METHODS:We used growth mixture modeling to identify distinct inattention and hyperactivity/impulsivity symptom trajectories (called "classes") across three time points (ages 8-9, 13-14, and 16-17 years) in the Swedish Twin study of CHild and Adolescent Development. The resulting classes were used to predict Eating Disorder Inventory-2 Bulimia, Drive for Thinness, and Body Dissatisfaction subscales at age 16-17 years, with adjustment for sex and body mass index at age 16-17 years. RESULTS:The combined inattention and hyperactivity/impulsivity symptom trajectory classes included: a "low symptom" class characterized by low inattention and hyperactivity/impulsivity throughout childhood/adolescence; a "predominantly inattention" class characterized by elevated inattention, but not hyperactivity/impulsivity, throughout childhood/adolescence; a "predominantly hyp/imp" class characterized by elevated hyperactivity/impulsivity, but not inattention, throughout childhood/adolescence; and a "both inattention and hyp/imp" class characterized by elevated inattention and hyperactivity/impulsivity throughout childhood/adolescence. After adjusting for sex and body mass index or sex and anxiety/depression symptoms, the "both inattention and hyp/imp" (vs. "low symptom") class predicted significantly higher Eating Disorder Inventory-2 subscale scores during late adolescence. CONCLUSIONS:Increased vigilance for disordered eating among children who have both inattention and hyperactivity/impulsivity symptoms throughout childhood and adolescence could aid in early identification of eating disorders.

Project description:Backgroundattention-deficit/hyperactivity disorder (ADHD) is associated with both polygenic liability and environmental exposures, both intrinsic to the family, such as family conflict, and extrinsic, such as air pollution. However, much less is known about the interplay between environmental and genetic risks relevant to ADHD-a better understanding of which could inform both mechanistic models and clinical prediction algorithms.MethodsTwo independent data sets, the population-based Adolescent Brain Cognitive Development Study (ABCD) (N = 11,876) and the case-control Oregon-ADHD-1000 (N = 1449), were used to examine additive (G + E) and interactive (GxE) effects of selected polygenic risk scores (PRS) and environmental factors in a cross-sectional design. Genetic risk was measured using PRS for nine mental health disorders/traits. Exposures included family income, family conflict/negative sentiment, and geocoded measures of area deprivation, lead exposure risk, and air pollution exposure (nitrogen dioxide and fine particulate matter).ResultsADHD PRS and family conflict jointly predicted concurrent ADHD symptoms in both cohorts. Additive-effects models, including both genetic and environmental factors, explained significantly more variation in symptoms than any individual factor alone (joint R 2 = .091 for total symptoms in ABCD; joint R 2 = .173 in Oregon-ADHD-1000; all delta-R 2 p-values <2e-7). Significant effect size heterogeneity across ancestry groups was observed for genetic and environmental factors (e.g., Q = 9.01, p = .011 for major depressive disorder PRS; Q = 13.34, p = .001 for area deprivation). GxE interactions observed in the full ABCD cohort suggested stronger environmental effects when genetic risk is low, though they did not replicate.ConclusionsReproducible additive effects of PRS and family environment on ADHD symptoms were found, but GxE interaction effects were not replicated and appeared confounded by ancestry. Results highlight the potential value of combining exposures and PRS in clinical prediction algorithms. The observed differences in risks across ancestry groups warrant further study to avoid health care disparities.

Dataset Information

Associations between neighborhood, family factors and symptom change in childhood attention deficit hyperactivity disorder.

Publications

Associations between neighborhood, family factors and symptom change in childhood attention deficit hyperactivity disorder.

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