Irritability Predicts Hyperactive/Impulsive Symptoms Across Adolescence for Females
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Irritability Predicts Hyperactive/Impulsive Symptoms Across Adolescence for Females Sarah Kahle1 · Prerona Mukherjee1 · J. Faye Dixon1 · Ellen Leibenluft2 · Stephen P. Hinshaw3,4 · Julie B. Schweitzer1 Accepted: 11 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Irritability is common in Attention-Deficit Hyperactivity Disorder (ADHD), but little is known about whether irritability predicts the course of ADHD symptoms over time. Adolescence is a dynamic period of emotional development as well as shifts in ADHD symptoms; an important goal is to identify youth at risk of increasing or persisting symptoms. We examined irritability as a longitudinal predictor of change in adolescents’ ADHD symptoms, as well as how this link may differ in females versus males. The sample included 108 youth (72 males) age 12–16 years (M = 14.21 years, SD = 1.44 years), 62 of whom met criteria for ADHD. Approximately 18 months later, 80 participants (48 males) were followed up at Time 2. A dimensional approach was used to examine changes over time in parent-reported inattentive and hyperactive/impulsive symptoms. Longitudinal path analysis revealed that irritability at Time 1 predicted higher relative hyperactive/impulsive symptoms at Time 2 after controlling for age and longitudinal stability in all variables. A multiple-group analysis examining moderation by sex/gender revealed that this association was significant only for females. These results suggest that irritability may play a key role in the persistence and worsening of hyperactive/impulsive symptoms across adolescence for females, with potential implications for the diagnosis and treatment of females with ADHD. Keywords Attention-deficit hyperactivity disorder (ADHD) · Sex · Gender · Irritability · Emotion dysregulation · Adolescence
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10802-020-00723-7) contains supplementary material, which is available to authorized users. * Julie B. Schweitzer [email protected] Sarah Kahle [email protected] Prerona Mukherjee [email protected] J. Faye Dixon [email protected] Ellen Leibenluft [email protected] Stephen P. Hinshaw [email protected] 1
MIND Institute, University of California, Davis, CA, USA
2
Emotion and Development Branch, NIMH, Bethesda, MD, USA
3
University of California, Berkeley, CA, USA
4
University of California, San Francisco, CA, USA
The hallmarks of Attention-Deficit Hyperactivity Disorder (ADHD) include symptoms of inattention, hyperactivity, and impulsivity, but these symptoms often show maturational decreases across adolescence (Monuteaux et al. 2010), especially in the hyperactive/impulsive dimension (Biederman et al. 2000). However, for many youth these symptoms persist (Lee et al. 2008; Owens et al. 2009), with 40% of young adults still meeting full criteria for ADHD and as many as 90% continuing to show functional impacts (Biederman et al. 2012). ADHD is the most common neurodevelopmenta
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