Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder

MTA Results

Lily Hechtman, James M. Swanson, Margaret H. Sibley, Annamarie Stehli, Kimberley D. Lakes, Elizabeth B. Owens, John T. Mitchell, L. Eugene Arnold, Brooke S G Molina, Stephen P. Hinshaw, Peter S. Jensen, Howard B. Abikoff, Guillermo Perez Algorta, Andrea L. Howard, Betsy Hoza, J. Quyen Nichols, Joy Etcovitch, Sylviane Houssais, Benedetto Vitiello, Joanne B. Severe & 31 others Peter S. Jensen, L. Eugene Arnold, Kimberly Hoagwood, John Richters, Donald Vereen, Stephen P. Hinshaw, Glen R. Elliott, Karen C. Wells, Jeffery N. Epstein, Desiree W. Murray, C. Keith Conners, John March, James Swanson, Timothy Wigal, Dennis P. Cantwell, Howard B. Abikoff, Lily Hechtman, Laurence L. Greenhill, Jeffrey H. Newcorn, Brooke Molina, Betsy Hoza, William E. Pelham, Robert D. Gibbons, Sue Marcus, Kwan Hur, Helena C. Kraemer, Thomas Hanley, Karen Stern, for the, MTA Cooperative Group, MTA Cooperative Group

Research output: Contribution to journalArticle

Abstract

Objective To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Method Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus symptom-desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Results Three patterns of functional outcomes emerged. Post−secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Conclusion Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

Original languageEnglish (US)
Pages (from-to)945-952.e2
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume55
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Pemetrexed
Attention Deficit Disorder with Hyperactivity
Sexual Behavior
Public Assistance
Combined Modality Therapy

Keywords

  • ADHD
  • adult outcomes
  • follow-up
  • functional outcomes
  • MTA

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder : MTA Results. / Hechtman, Lily; Swanson, James M.; Sibley, Margaret H.; Stehli, Annamarie; Lakes, Kimberley D.; Owens, Elizabeth B.; Mitchell, John T.; Arnold, L. Eugene; Molina, Brooke S G; Hinshaw, Stephen P.; Jensen, Peter S.; Abikoff, Howard B.; Perez Algorta, Guillermo; Howard, Andrea L.; Hoza, Betsy; Nichols, J. Quyen; Etcovitch, Joy; Houssais, Sylviane; Vitiello, Benedetto; Severe, Joanne B.; Jensen, Peter S.; Arnold, L. Eugene; Hoagwood, Kimberly; Richters, John; Vereen, Donald; Hinshaw, Stephen P.; Elliott, Glen R.; Wells, Karen C.; Epstein, Jeffery N.; Murray, Desiree W.; Conners, C. Keith; March, John; Swanson, James; Wigal, Timothy; Cantwell, Dennis P.; Abikoff, Howard B.; Hechtman, Lily; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Molina, Brooke; Hoza, Betsy; Pelham, William E.; Gibbons, Robert D.; Marcus, Sue; Hur, Kwan; Kraemer, Helena C.; Hanley, Thomas; Stern, Karen; for the; MTA Cooperative Group; MTA Cooperative Group.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 55, No. 11, 01.11.2016, p. 945-952.e2.

Research output: Contribution to journalArticle

Hechtman, L, Swanson, JM, Sibley, MH, Stehli, A, Lakes, KD, Owens, EB, Mitchell, JT, Arnold, LE, Molina, BSG, Hinshaw, SP, Jensen, PS, Abikoff, HB, Perez Algorta, G, Howard, AL, Hoza, B, Nichols, JQ, Etcovitch, J, Houssais, S, Vitiello, B, Severe, JB, Jensen, PS, Arnold, LE, Hoagwood, K, Richters, J, Vereen, D, Hinshaw, SP, Elliott, GR, Wells, KC, Epstein, JN, Murray, DW, Conners, CK, March, J, Swanson, J, Wigal, T, Cantwell, DP, Abikoff, HB, Hechtman, L, Greenhill, LL, Newcorn, JH, Molina, B, Hoza, B, Pelham, WE, Gibbons, RD, Marcus, S, Hur, K, Kraemer, HC, Hanley, T, Stern, K, for the, MTA Cooperative Group & MTA Cooperative Group 2016, 'Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 55, no. 11, pp. 945-952.e2. https://doi.org/10.1016/j.jaac.2016.07.774
Hechtman, Lily ; Swanson, James M. ; Sibley, Margaret H. ; Stehli, Annamarie ; Lakes, Kimberley D. ; Owens, Elizabeth B. ; Mitchell, John T. ; Arnold, L. Eugene ; Molina, Brooke S G ; Hinshaw, Stephen P. ; Jensen, Peter S. ; Abikoff, Howard B. ; Perez Algorta, Guillermo ; Howard, Andrea L. ; Hoza, Betsy ; Nichols, J. Quyen ; Etcovitch, Joy ; Houssais, Sylviane ; Vitiello, Benedetto ; Severe, Joanne B. ; Jensen, Peter S. ; Arnold, L. Eugene ; Hoagwood, Kimberly ; Richters, John ; Vereen, Donald ; Hinshaw, Stephen P. ; Elliott, Glen R. ; Wells, Karen C. ; Epstein, Jeffery N. ; Murray, Desiree W. ; Conners, C. Keith ; March, John ; Swanson, James ; Wigal, Timothy ; Cantwell, Dennis P. ; Abikoff, Howard B. ; Hechtman, Lily ; Greenhill, Laurence L. ; Newcorn, Jeffrey H. ; Molina, Brooke ; Hoza, Betsy ; Pelham, William E. ; Gibbons, Robert D. ; Marcus, Sue ; Hur, Kwan ; Kraemer, Helena C. ; Hanley, Thomas ; Stern, Karen ; for the ; MTA Cooperative Group ; MTA Cooperative Group. / Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder : MTA Results. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2016 ; Vol. 55, No. 11. pp. 945-952.e2.
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abstract = "Objective To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Method Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50{\%}) versus symptom-desistent (50{\%}) subgroups. Functional outcomes were measured with standardized and demographic instruments. Results Three patterns of functional outcomes emerged. Post−secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Conclusion Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.",
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T1 - Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder

T2 - MTA Results

AU - Hechtman, Lily

AU - Swanson, James M.

AU - Sibley, Margaret H.

AU - Stehli, Annamarie

AU - Lakes, Kimberley D.

AU - Owens, Elizabeth B.

AU - Mitchell, John T.

AU - Arnold, L. Eugene

AU - Molina, Brooke S G

AU - Hinshaw, Stephen P.

AU - Jensen, Peter S.

AU - Abikoff, Howard B.

AU - Perez Algorta, Guillermo

AU - Howard, Andrea L.

AU - Hoza, Betsy

AU - Nichols, J. Quyen

AU - Etcovitch, Joy

AU - Houssais, Sylviane

AU - Vitiello, Benedetto

AU - Severe, Joanne B.

AU - Jensen, Peter S.

AU - Arnold, L. Eugene

AU - Hoagwood, Kimberly

AU - Richters, John

AU - Vereen, Donald

AU - Hinshaw, Stephen P.

AU - Elliott, Glen R.

AU - Wells, Karen C.

AU - Epstein, Jeffery N.

AU - Murray, Desiree W.

AU - Conners, C. Keith

AU - March, John

AU - Swanson, James

AU - Wigal, Timothy

AU - Cantwell, Dennis P.

AU - Abikoff, Howard B.

AU - Hechtman, Lily

AU - Greenhill, Laurence L.

AU - Newcorn, Jeffrey H.

AU - Molina, Brooke

AU - Hoza, Betsy

AU - Pelham, William E.

AU - Gibbons, Robert D.

AU - Marcus, Sue

AU - Hur, Kwan

AU - Kraemer, Helena C.

AU - Hanley, Thomas

AU - Stern, Karen

AU - for the

AU - MTA Cooperative Group

AU - MTA Cooperative Group

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Method Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus symptom-desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Results Three patterns of functional outcomes emerged. Post−secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Conclusion Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

AB - Objective To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Method Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus symptom-desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Results Three patterns of functional outcomes emerged. Post−secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Conclusion Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

KW - ADHD

KW - adult outcomes

KW - follow-up

KW - functional outcomes

KW - MTA

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