Continuity in features of anxiety and attention deficit/hyperactivity disorder in young preschool children

Kristin Romvig Overgaard,Beate Oerbeck,Svenn Torgersen,Anne Myhre,Pål Zeiner,Heidi Aase,Ted Reichborn-Kjennerud

doi:10.1007/s00787-014-0538-7

Abstract

Anxiety disorders and attention deficit/hyperactivity disorder (ADHD) develop before school age, but little is known about early developmental pathways. Here we test two hypotheses: first, that early signs of anxiety and ADHD at 18 months predict symptoms of anxiety and ADHD at age 3½ years; second, that emotional dysregulation at 18 months predicts the outcome of co-occurring anxiety and ADHD at age 3½ years. The study was part of the prospective Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The 628 participants were clinically assessed at 3½ years. Questionnaire data collected at 18 months were categorized into early behavioural scales of anxiety, ADHD, and emotional dysregulation. We investigated continuity in features of anxiety and ADHD from 18 months to 3½ years of age through logistic regression analyses. Anxiety symptoms at 3½ years were predicted by early signs of anxiety (Odds ratio (OR) = 1.41, CI = 1.15–1.73) and emotional dysregulation (OR = 1.33, CI = 1.15–1.54). ADHD symptoms at 3½ years were predicted by early signs of ADHD (OR = 1.51, CI = 1.30–1.76) and emotional dysregulation (OR = 1.31, CI = 1.13–1.51). Co-occurring anxiety and ADHD symptoms at 3½ years were predicted by early signs of anxiety (OR = 1.43, CI = 1.13–1.84), ADHD (OR = 1.30, CI = 1.11–1.54), and emotional dysregulation (OR = 1.34, CI = 1.13–1.58). We conclude that there were modest continuities in features of anxiety and ADHD through early preschool years, while emotional dysregulation at age 18 months was associated with symptoms of anxiety, ADHD, and co-occurring anxiety and ADHD at age 3½ years.

Highlights

Anxiety disorders and attention deficit/hyperactivity disorder (ADHD) tend to have an onset at a young age and result in chronicity and impairment [1, 2], but little is known about their trajectories through early preschool years
As both anxiety and ADHD have an onset at a young age, emotional dysregulation as a possible risk factor for this co-occurrence needs to be investigated at an early developmental stage
Emotional dysregulation at age 18 months was found to predict the outcome of co-occurring symptoms of anxiety and ADHD at 3 years of age, and predicted anxiety and ADHD when one symptom cluster occurred without the other

Summary

Introduction

Anxiety disorders and attention deficit/hyperactivity disorder (ADHD) tend to have an onset at a young age and result in chronicity and impairment [1, 2], but little is known about their trajectories through early preschool years. Emotional dysregulation has been implicated in the development of co-occurring disorders in ADHD [33,34,35,36] As both anxiety and ADHD have an onset at a young age, emotional dysregulation as a possible risk factor for this co-occurrence needs to be investigated at an early developmental stage. In this prospective, longitudinal study of preschool children we set out to test two hypotheses: the first that early signs of anxiety and ADHD at 18 months would predict the outcome of anxiety and ADHD symptoms at 3 years of age, both when occurring alone and together; the second, that emotional dysregulation at 18 months of age would predict co-occurring anxiety and ADHD symptoms at 3 years of age

Methods

Ethical approval

Results

Discussion