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Pervasive versus situational childhood ADHD: latent classes and their clinical characteristics, based on parent and teacher ratings in a large longitudinal population sample
Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology. Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-1307-4928
Number of Authors: 32024 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 33, p. 2253-2266Article in journal (Refereed) Published
Abstract [en]

Attention-deficit/hyperactivity disorder (ADHD) diagnoses require symptoms to be present in two settings. Low levels of concordance between symptoms rated at home and school raise questions regarding this approach. The aim was to examine whether there are sub-groups with context-specific expressions of ADHD symptoms (i.e., at home or school only) with clinically significant problems sufficient to support a new diagnostic formulation. We applied latent class transition analysis to parent and teacher data (N = 10,476) from the Avon Longitudinal Study of Parents and Children (ALSPAC), collected at ages 8, 10, and 20 years. We examined the short-term stability of emergent classes and their childhood and adult-associated risk profiles. In addition to an Unaffected class (similar to 45%), there was a Pervasive Combined class with elevated inattentive and hyperactive/impulsive symptoms at both home and school (similar to 11%) and three classes with situational expressions; School Combined (similar to 9%), Home Combined (similar to 18%), and School Inattentive (similar to 16%). Stability ranged from 0.27 to 0.78. The Pervasive Combined class was most symptomatic and impaired. School inattentive also displayed clinical symptom levels, whereas the School and Home Combined classes displayed subclinical levels. Different profiles regarding sex, cognition, conduct problems, and substance use emerged for the three situational classes. Distinct groupings of pervasive and situational ADHD expressions are identifiable in the general population. The isolation of a stable and burdensome Pervasive Combined class lends support to the current diagnostic approach. However, there are indications of situational expressions of ADHD with clinical symptom levels and associated difficulties.

Place, publisher, year, edition, pages
2024. Vol. 33, p. 2253-2266
Keywords [en]
ALSPAC, pervasive and situational ADHD, latent class analysis, longitudinal
National Category
Psychiatry Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-223792DOI: 10.1007/s00787-023-02308-3ISI: 001084812900001PubMedID: 37845375Scopus ID: 2-s2.0-85174207073OAI: oai:DiVA.org:su-223792DiVA, id: diva2:1812215
Note

Open access funding provided by Stockholm University. The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This research was specifically funded by the Wellcome Trust and MRC (grant ref. 092731) and NIH (grant ref. 5R01AA018333-0). The first author was funded by a postdoc grant from the Ryoichi Sasakawa Young Leaders Fellowship Fund and a postdoc grant from the Stiftelsen Sven Jerrings fond.

Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2024-08-20Bibliographically approved

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Frick, Matilda

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