Dynamics of Neurocognitive Development in ADHD and Young Adult Outcomes

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PROJECT SUMMARY The key focus of this proposal is to characterize developmental mechanisms in Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is viewed as a neurodevelopmental disorder, yet most often identified in the elementary school age years and frequently leading to further psychopathology and negative outcomes by late adolescence and early adulthood. The project emphasizes the role of neurocognitive functions, particularly elements of executive functioning such as working memory and supportive functions such as attentional alertness, along with emotional features such as irritability. These are all hypothesized as component mechanisms of ADHD symptom change and stability and potential drivers of outcomes. Addressing mechanisms of change during development of psychopathology is directly in line with key program priorities. The training goals of this F32 will develop the applicant's expertise in ADHD, in executive functioning and other common cognitive functions associated with neurodevelopmental disorders like ADHD and autism spectrum disorder (ASD), strengthen her readiness with advanced and complex statistical models, and support her professional development and writing skills. This will build on her prior graduate school training in ASD and position her to conduct work on the relations among neurodevelopmental conditions and developmental mechanisms linking them during her career. The research aims dovetail with these training aims. Using a recently completed longitudinal data set from the sponsor's lab, the applicant will conduct secondary data analysis from a large community recruited, carefully characterized case-control cohort of youth recruited at age 7-12 and followed for over a decade in a lag-longitudinal design that now spans ages 7-20+ years. The first aim will identify how changes in specific neurocognitive components are related to ADHD symptoms across development using a denser and more enriched longitudinal data set than has been available heretofore. The second aim will extend those results by evaluating differences in neurocognitive function at particular key developmental timepoints in relation to social and other functional outcomes in young adulthood. The third aim will extend that work further by evaluating hypotheses concerning selected family and environment factors that might moderate the effect of neurocognitive function on ADHD outcomes. These analyses will capitalize on training in ADHD, neurocognitive study of development, and statistical models in complex designs. The research itself is innovative in the detailed testing of hypotheses regarding the role of executive and other neurocognitive functions during a dynamic developmental period in ADHD and in linking these to environmental moderators. The public health value should be significant in regard to further clarifying when and where in development to provide remediation support for youth with ADHD regarding component dimensions of functioning that appear to drive impairment and outcome.