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ObjectiveWe tested mediation of birth weight and ADHD symptoms by multiple biologically plausible neurocognitive functions and evaluated familiality of observed indirect effects.Method647 youth from 284 multiplex families with ADHD completed the Arithmetic, Digit Span, Vocabulary, and Block Design subtests of the Wechsler Intelligence Scale for Children (WISC). Multiple mediation tested WISC subtests as mediators of birth weight and multi-informant ADHD symptoms. Familiality of indirect effects was estimated via moderated mediation comparing conditional indirect effects across siblings concordant and discordant for ADHD.ResultsControlling for IQ and demographic factors, Arithmetic uniquely mediated birth weight and ADHD symptoms. Conditional indirect effects through Arithmetic did not differ across ADHD concordant and discordant siblings.ConclusionThese cross-sectional findings support previous prospective longitudinal research implicating Arithmetic (i.e., fluid reasoning) as a preliminary causal mediator of birth weight and ADHD symptoms, and suggest that this pathway is independent of genetic influences on ADHD.

Objective: To ascertain the association of childhood ADHD and oppositional defiant disorder (ODD) on functional impairment and to test the moderating influence of callous-unemotional (CU) traits. Method: Ethnically diverse 6- to 9-year-old children with (n = 59) and without (n = 47) ADHD were ascertained using multiple methods (i.e., rating scales and structured interview) and informants (i.e., parent, teacher, and interviewer). Results: Using ratings of impairment that were independent of the diagnostic assessment of ADHD and ODD, the association between ADHD and impairment was significantly moderated by CU traits, such that CU traits positively predicted impairment at low and moderate levels of ADHD but not at high levels of ADHD. CU traits did not moderate the association of ODD and impairment. Conclusion: The authors discuss findings within the context of multiple pathways to and from negative outcomes and the utility of evaluating CU traits in studies of ADHD and conduct problems. (Contains 4 tables and 3 figures.)

Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were obtained. Results: Structural equation modeling indicated that parental ADHD was positively associated with a broad child problems factor after a second-order factor of child problems best accounted for the high intercorrelations among the internalizing, ADHD, and externalizing child psychopathology factors. Parental depression did not significantly predict the second-order child problems factor, but it specifically predicted the child internalizing factor. Conclusion: These results suggest that parental ADHD may be a nonspecific risk factor for child psychopathology broadly, whereas parental depression may function as a specific risk factor for child internalizing problems. (Contains 2 tables, 2 figures, and 1 note.)

Objective: Although childhood ADHD is a risk factor for internalizing problems, it consists of separable inattention and hyperactivity dimensions that differentially predict outcomes. Oppositional defiant disorder also consists of separable dimensions (i.e., irritable, oppositional), co-occurs with ADHD, and predicts internalizing outcomes. To discern independent associations with internalizing problems, dimensions must be considered simultaneously. Methods: Controlling for age, sex, and race, we tested inattention, hyperactivity, irritability, and oppositionality as time-varying predictors of 6 to 7-year prospective change in parent- and teacher-rated internalizing problems in 230 ethnically- diverse (50% Caucasian) 5 to 10 year old youth (M = 7.4 years, 68% male) with (n = 120) and without ADHD (n = 110). Results: Escalating inattention and irritability, but not hyperactivity and oppositionality, uniquely predicted internalizing problems. Conclusion: These findings suggest that inattention and irritability are unique risk factors for later internalizing problems. These dimensions may catalyze internalizing problems across development and constitute important intervention targets. [ABSTRACT FROM AUTHOR]

Objective: There is replicated evidence that individual ADHD symptoms differentially predict ADHD diagnostic status, and that non-Diagnostic and Statistical Manual of Mental Disorders (DSM)-based symptom algorithms are superior to DSM criteria for ruling in or ruling out ADHD. However, these findings have been limited to case-control samples, despite the need to replicate them in independent and more representative samples and to increase their generalizability. Method: We analyzed the base rates and psychometric properties of ADHD symptoms in the population-based National Longitudinal Study of Adolescent Health (Add Health; http://www.cpc.unc.edu/projects/addhealth ) sample, and evaluated the predictive utility of empirically derived ADHD symptoms against the DSM approach with respect to academic, health, and relational functional outcomes. The sample consisted of 11,247 (54% female) ethnically diverse (45% non-White) individuals who retrospectively self-reported the severity of their ADHD symptoms from 5 to 12 years. Results: Individual ADHD symptoms variably predicted ADHD status, and whereas most symptoms were most predictive when endorsed at the two highest severity levels in previous studies, symptoms in Add Health were often most predictive of ADHD when endorsed at the highest severity level. Conclusion: The divergence in optimal severity thresholds for ADHD symptoms potentially reflects the different symptom base rates in clinical versus population-based samples. The accuracy of the different classification approaches also suggested that different symptom algorithms may be superior to evaluate ADHD depending on the assessment setting. [ABSTRACT FROM AUTHOR]

Objective: Despite its association with increased severity and treatment resistance, relatively little is known about the correlates of early-onset childhood depression. ADHD and executive functioning (EF) are each related to depression. Given their covariation, we tested the independent association of ADHD dimensions (i.e., inattention, hyperactivity) and EF with childhood depression using structural equation modeling to identify potential targets for intervention. Method: Participants were 225 five- to 10-year-old children (68% male) with (n = 117) and without (n = 108) ADHD. Youth completed laboratory assessments of EF, and parent, teacher, and youth reports of depression were gathered. Results: With control of EF and anxiety, across informants, inattention, but not hyperactivity, was positively related to child depression. EF was positively associated with depression according to parent ratings only. Conclusion: We consider the association of inattention and EF with childhood depression, including implications for intervention and prevention from a developmental psychopathology framework. [ABSTRACT FROM AUTHOR]