Michael B Kozlowski, Jaden A Sangoi, Hannah E Morton, Elizabeth K Nousen, Jessica M Tipsord, McKenzie T Figuracion, Sarah Pieper, Madelyn Heise, Erica D Musser, Joel T Nigg, Sarah L Karalunas
The density-dependent emergence of brain-behavior correlations in girls offers a plausible network-level explanation for the diagnostic camouflage effect reported in females with ADHD. Pediatric ADHD manifests through sex-specific network reconfigurations, a right-hemispheric inhibitory-circuit deficit in boys versus an antero-posterior sensory-gating alteration in girls.
Currently, the field faces controversy about how to integrate novel, trait-based dimensions into existing psychological diagnostic frameworks. The problem is salient for attention-deficit/hyperactivity disorder (ADHD), which encompasses a partially coherent neurodevelopmental syndrome that is nonetheless heterogeneous with respect to mechanism and outcomes. Here, we suggest that temperament profiles, related to trait-based variation in emotional response and regulation, provide a viable way to link the complexity of within-group trait variation to differences in clinical outcomes. Across two large, independent samples of adolescents with ADHD (Oregon ADHD-1000, ABCD) we identified largely reproducible temperament profiles: a high approach motivation profile ("Surgent") and a high negative emotion profile ("Irritable"). In both samples, the Irritable profile prospectively predicted worsening clinical outcomes over multiple years of longitudinal follow-up. Temperament profiling approaches can contribute to improved risk/resilience prediction among individuals with ADHD and help bridge dimensional models of psychopathology with developmental process and clinical decision-making.