Heterogeneity and Subtyping in Attention-Deficit/Hyperactivity Disorder—Considerations for Emerging Research Using Person-Centered Computational Approaches

Sarah L. Karalunas, Joel T. Nigg

Research output: Contribution to journalReview article

Abstract

Few if any experts believe that existing psychiatric diagnostic categories included in DSM and ICD are actually discrete disease entities. Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the problems in the existing psychiatric classification system. ADHD symptoms reliably cluster into two correlated dimensions in factor analysis. However, children with ADHD vary considerably in their symptom profiles, symptom trajectories, clinical outcomes, and biological and psychological correlates. Thus, the field has sought alternative approaches that harness the dimensions of emotional, cognitive, and behavioral functioning that underlie ADHD and other existing psychiatric categories to create informative phenotypes that improve clinical prediction and clarify etiology. Within ADHD, cognitive (neuropsychological) and temperament/personality features have received considerable attention. In some cases, subphenotypes based on these features appear to improve on existing classifications and could eventually be translated into clinical practice. This review summarizes findings from subphenotyping efforts in ADHD that use cognitive, emotion-related, and other features to highlight major considerations for research applying person-oriented approaches to inform an improved psychiatric nosology. Considerations related to feature selection, validation of newly proposed divisions, defining populations of interest, and incorporating a developmental perspective are discussed.

Original languageEnglish (US)
JournalBiological Psychiatry
DOIs
StateAccepted/In press - Jan 1 2020

Fingerprint

Attention Deficit Disorder with Hyperactivity
Psychiatry
Research
Temperament
Statistical Factor Analysis
Personality
Emotions
Psychology
Phenotype
Population

Keywords

  • ADHD
  • Heterogeneity
  • Neurodevelopmental disorders
  • Person-centered approaches
  • Psychiatric classification
  • Taxonomy

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

@article{c1832ad553ec4227b0f6c70143446ffe,
title = "Heterogeneity and Subtyping in Attention-Deficit/Hyperactivity Disorder—Considerations for Emerging Research Using Person-Centered Computational Approaches",
abstract = "Few if any experts believe that existing psychiatric diagnostic categories included in DSM and ICD are actually discrete disease entities. Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the problems in the existing psychiatric classification system. ADHD symptoms reliably cluster into two correlated dimensions in factor analysis. However, children with ADHD vary considerably in their symptom profiles, symptom trajectories, clinical outcomes, and biological and psychological correlates. Thus, the field has sought alternative approaches that harness the dimensions of emotional, cognitive, and behavioral functioning that underlie ADHD and other existing psychiatric categories to create informative phenotypes that improve clinical prediction and clarify etiology. Within ADHD, cognitive (neuropsychological) and temperament/personality features have received considerable attention. In some cases, subphenotypes based on these features appear to improve on existing classifications and could eventually be translated into clinical practice. This review summarizes findings from subphenotyping efforts in ADHD that use cognitive, emotion-related, and other features to highlight major considerations for research applying person-oriented approaches to inform an improved psychiatric nosology. Considerations related to feature selection, validation of newly proposed divisions, defining populations of interest, and incorporating a developmental perspective are discussed.",
keywords = "ADHD, Heterogeneity, Neurodevelopmental disorders, Person-centered approaches, Psychiatric classification, Taxonomy",
author = "Karalunas, {Sarah L.} and Nigg, {Joel T.}",
year = "2020",
month = "1",
day = "1",
doi = "10.1016/j.biopsych.2019.11.002",
language = "English (US)",
journal = "Biological Psychiatry",
issn = "0006-3223",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Heterogeneity and Subtyping in Attention-Deficit/Hyperactivity Disorder—Considerations for Emerging Research Using Person-Centered Computational Approaches

AU - Karalunas, Sarah L.

AU - Nigg, Joel T.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Few if any experts believe that existing psychiatric diagnostic categories included in DSM and ICD are actually discrete disease entities. Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the problems in the existing psychiatric classification system. ADHD symptoms reliably cluster into two correlated dimensions in factor analysis. However, children with ADHD vary considerably in their symptom profiles, symptom trajectories, clinical outcomes, and biological and psychological correlates. Thus, the field has sought alternative approaches that harness the dimensions of emotional, cognitive, and behavioral functioning that underlie ADHD and other existing psychiatric categories to create informative phenotypes that improve clinical prediction and clarify etiology. Within ADHD, cognitive (neuropsychological) and temperament/personality features have received considerable attention. In some cases, subphenotypes based on these features appear to improve on existing classifications and could eventually be translated into clinical practice. This review summarizes findings from subphenotyping efforts in ADHD that use cognitive, emotion-related, and other features to highlight major considerations for research applying person-oriented approaches to inform an improved psychiatric nosology. Considerations related to feature selection, validation of newly proposed divisions, defining populations of interest, and incorporating a developmental perspective are discussed.

AB - Few if any experts believe that existing psychiatric diagnostic categories included in DSM and ICD are actually discrete disease entities. Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the problems in the existing psychiatric classification system. ADHD symptoms reliably cluster into two correlated dimensions in factor analysis. However, children with ADHD vary considerably in their symptom profiles, symptom trajectories, clinical outcomes, and biological and psychological correlates. Thus, the field has sought alternative approaches that harness the dimensions of emotional, cognitive, and behavioral functioning that underlie ADHD and other existing psychiatric categories to create informative phenotypes that improve clinical prediction and clarify etiology. Within ADHD, cognitive (neuropsychological) and temperament/personality features have received considerable attention. In some cases, subphenotypes based on these features appear to improve on existing classifications and could eventually be translated into clinical practice. This review summarizes findings from subphenotyping efforts in ADHD that use cognitive, emotion-related, and other features to highlight major considerations for research applying person-oriented approaches to inform an improved psychiatric nosology. Considerations related to feature selection, validation of newly proposed divisions, defining populations of interest, and incorporating a developmental perspective are discussed.

KW - ADHD

KW - Heterogeneity

KW - Neurodevelopmental disorders

KW - Person-centered approaches

KW - Psychiatric classification

KW - Taxonomy

UR - http://www.scopus.com/inward/record.url?scp=85077661720&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85077661720&partnerID=8YFLogxK

U2 - 10.1016/j.biopsych.2019.11.002

DO - 10.1016/j.biopsych.2019.11.002

M3 - Review article

AN - SCOPUS:85077661720

JO - Biological Psychiatry

JF - Biological Psychiatry

SN - 0006-3223

ER -