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Course of psychopathology in female youth: Analysis with extant longitudinal data


Although attention-deficit/hyperactivity disorder (ADHD) is more prevalent in boys than girls, little doubt exists that ADHD is also an important cause of psychiatric disability in girls. Despite this, the scientific literature on females with ADHD is scarce, and mostly cross-sectional. Thus, large-scale studies examining the course and outcome of psychopathology in ADHD in girls are sorely needed. Such information can inform patients, families, teachers and clinicians and facilitate prevention and intervention efforts for females with ADHD, an understudied population. We propose a data analysis project that utilizes an existing longitudinal database to address these questions. The overall goal of this application is to use longitudinal measurements, a multigenerational perspective and an extensive assessment of multiple domains of functioning to investigate the developmental course and outcome of psychopathology in female youth with and without ADHD. Our specific aims are to: 1) examine the risk for psychopathology associated with ADHD across development; 2) describe the clinical characteristics of psychopathology in a sample of ADHD girls; 3) estimate the effect of antecedent risk factors on psychopathology in a sample of ADHD girls; and 4) to estimate the effect of psychopathology on subsequent functional outcomes in a sample of ADHD girls. The psychopathological conditions to be examined are: conduct disorder, major depression, bipolar disorder, anxiety disorders, and eating disorders. We will use an existing data source that will provide us with ample statistical power and considerable cost-effectiveness. The dataset is comprised of a five-year prospective case-control family-genetic study of female youth with (n=140) and without (n=122) ADHD, aged 6-18 years at baseline, consecutively ascertained from either community pediatricians or psychiatrists at an academic medical center. At the five-year follow-up, 123 (88 percent) and 112 (92 percent) of the ADHD and control children, respectively, were re-assessed at a mean age of 16.7 years. This study used blinded structured psychiatric diagnostic interviews, cognitive and neuropsychological tests and psychosocial and global functioning measures to assess the probands and their first-degree relatives. State of the art statistical techniques will be employed. A better understanding of the predictors, course and outcome of psychopathology among girls with ADHD has important clinical and public health implications. Such knowledge would alert clinicians to the importance of recognizing psychiatric comorbid disorders in girls with ADHD for treatment planning and forecasting prognosis, and could help design improved preventive and intervention programs. From a public health perspective, the ability to predict the course of psychopathology in girls with ADHD could help focus limited societal resources on those at higher risk for persistent illness with complicated outcomes.


Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.