Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria.
Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria.
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DOI：
10.1001/jamapsychiatry.2014.763
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发表时间：
2014-09
期刊：
影响因子：
25.8
通讯作者：
Nigg, Joel T.
中科院分区：
文献类型：
--
作者：
Karalunas, Sarah L.;Fair, Damien;Musser, Erica D.;Aykes, Kamari;Iyer, Swathi P.;Nigg, Joel T.
Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosological distinctions limits both mechanistic understanding and clinical prediction. Here, we demonstrate an approach consistent with the NIMH Research Domain Criteria (RDoC) initiative to identifying superior, neurobiologically-valid subgroups with better predictive capacity than existing psychiatric categories for childhood Attention-Deficit Hyperactivity Disorder (ADHD). Refine subtyping of childhood ADHD by using biologically-based behavioral dimensions (i.e. temperament), novel classification algorithms, and multiple external validators. In doing so, we demonstrate how refined nosology is capable of improving on current predictive capacity of long-term outcomes relative to current DSM-based nosology. 437 clinically well-characterized, community-recruited children with and without ADHD participated in an on-going longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and to examine external validators including physiological and MRI measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using three widely-accepted external validators: peripheral physiology (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity MRI), and clinical outcomes (at one-year longitudinal follow-up). The community detection algorithm suggested three novel types of ADHD, labeled as “Mild” (normative emotion regulation); “Surgent” (extreme levels of positive approach-motivation); and “Irritable” (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations, including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcome one year later. Results suggest that a biologically-informed temperament-based typology, developed with a discovery-based community detection algorithm, provided a superior description of heterogeneity in the ADHD population than any current clinical nosology. This demonstration sets the stage for more aggressive attempts at a tractable, biologically-based nosology.
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影响因子：
10.6
作者：
Fair, Damien A.;Posner, Jonathan;Nagel, Bonnie J.;Bathula, Deepti;Dias, Taciana G. Costa;Mills, Kathryn L.;Blythe, Michael S.;Giwa, Aishat;Schmitt, Colleen F.;Nigg, Joel T.
通讯作者：
Nigg, Joel T.
影响因子：
3.7
作者：
Berntson, GG;Lozano, DL;Cacioppo, JT
通讯作者：
Cacioppo, JT
DOI：
10.1097/00004583-200011000-00022
发表时间：
2000-11-01
影响因子：
13.3
作者：
Faraone, SV
通讯作者：
Faraone, SV
DOI：
10.1073/pnas.1115365109
发表时间：
2012-04-24
影响因子：
11.1
作者：
Fair, Damien A.;Bathula, Deepti;Nigg, Joel T.
通讯作者：
Nigg, Joel T.
影响因子：
2.4
作者：
Karalunas SL;Huang-Pollock CL;Nigg JT
通讯作者：
Nigg JT