Clinical Phenotype Identification in Chinese Children with ADHD Using Latent Profile Analysis and Implications for...

Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial clinical heterogeneity, underscoring the need for a shift toward precision nursing approaches. The present study aimed to identify relatively homogeneous subgroups (phenotypes) among children with ADHD based on multidimensional clinical characteristics and to validate their distinct cognitive profiles using objective cognitive assessments, thereby providing an empirical basis for the development of a precision nursing practice pathway.

A cohort of 403 treatment-naïve children with newly diagnosed ADHD were included. Behavioral, emotional, and social functioning were evaluated using the Swanson, Nolan, and Pelham Version IV Scale, the Strengths and Difficulties Questionnaire, and the Weiss Functional Impairment Rating Scale-Parent Report. Cognitive validation was conducted using the Continuous Performance Test (CPT). The primary analytical methods included latent profile analysis (LPA) and between-group comparisons.

The optimal LPA model identified three distinct classes: the "functionally balanced type" (25.8%), the "impulsivity-predominant type" (55.6%), and the "emotional-cognitive dysregulation subtype" (18.6%). Cognitive validation using the CPT indicated that the impulsivity-predominant type demonstrated a significantly higher commission error rate, whereas the emotional-cognitive dysregulation subtype exhibited significantly greater reaction time variability.

The "behavioral subtyping-cognitive validation" framework proposed in this study links subjective behavioral clustering with objective cognitive indicators relevant to nursing care. This approach provides an important empirical foundation for shifting ADHD management from a uniform model toward mechanism-informed precision intervention.