Impulsivity as key bridge symptoms in cross-sectional and longitudinal networks of ADHD and ODD

Impulsivity is viewed as key to attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD). Yet, to date, no work has provided an item-level analysis in longitudinal samples across the critical developmental period from childhood into adolescence, despite prior work suggesting items exhibit differential relevance with respect to various types of impairment. The current study conducted a novel longitudinal network analysis of ADHD and oppositional defiant disorder (ODD) symptoms between childhood and adolescence, with the important applied prediction of social skills in adolescence.

Participants were 310 children over-recruited for clinical ADHD issues followed longitudinally for six years in total with gold standard diagnostic procedures and parent and teacher ratings of symptoms and social outcomes.

Findings from baseline, Year 3, and Year 6 suggested Difficulty waiting turn, Blurts, and Interrupts/intrudes were key bridge items across cross-sectional and longitudinal parent-reported DBD networks. Furthermore, shortened symptom lists incorporating these symptoms were stronger predictors of teacher-rated social skills 5 years later compared to total DBD scores.

Such findings are consistent with the trait impulsivity theory of DBD and ADHD and may inform useful screening tools and personalized intervention targets for children at risk for DBD during adolescence.