Kelsey E. Woods, Christina M. Danko, and Andrea Chronis-Tuscano
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate levels of hyperactivity, impulsivity, and/or inattention. ADHD is chronic, may persist into adulthood, and is associated with impairment in social and academic/work domains across the lifespan. Children and adolescents with ADHD often present with executive function deficits and emotion dysregulation, and these deficits may increase impairment and risk for co-occurring disorders. The etiology of ADHD is not yet understood, though research suggests that biological and environmental factors (e.g., family, community) contribute to its development and course. It should be noted that ADHD commonly co-occurs with additional psychiatric disorders, such as oppositional defiant disorder (ODD), conduct disorder (CD), and major depressive disorder.
Evidence-based assessment of ADHD requires information from multiple informants using multiple assessment methods to determine the presence of ADHD symptoms across settings and any co-occurring disorders. The evidence-based treatment options for ADHD are manifold. Pharmacotherapy for ADHD is common, although numerous behavioral interventions are also effective. Stimulant medications are commonly prescribed and are typically effective in ameliorating core ADHD symptoms. There is also evidence that the nonstimulant medication atomoxetine substantially decreases the symptoms of ADHD. Importantly, medication therapy works to reduce symptoms but typically does not alleviate the impairments associated with the disorder. Combined medication and behavioral interventions are more likely to reduce impairments and normalize behavior.
Deborah M. Capaldi, David C. R. Kerr, and Stacey S. Tiberio
Intergenerational studies are key to informing research, preventive intervention, and policy regarding family influences on healthy development and maladjustment. Continuities in family socialization and contextual risks across generations, as well as genetic factors, are associated with the development of psychopathology—including externalizing problems in children—and with intergenerational associations in the use of marijuana, alcohol, tobacco, and other drugs; these continuities are reflected in the low-to-moderate associations generally found in prospective studies. Until recent years, estimates of intergenerational continuities in problem behaviors and the processes explaining such associations (e.g., parenting behaviors) have been based largely on retrospective reports by adults about their own parents’ behaviors. Now there are some long-term prospective studies spanning as many as 30 years that can assess linkages between behaviors in one generation and the next. Whereas such studies have considerable design and implementation challenges, and are very expensive, it is of critical importance to examine the magnitude of associations of behaviors across generations. For example, a modest association across generations suggests either that genetic factors have a limited influence on that behavior or that they are subject to considerable moderation by environmental factors. These prospective studies relate to theoretical developments regarding intergenerational influences that are reviewed—for example, individual differences in genetic sensitivity to environmental influences. The theoretical approach employed in the Oregon Youth Study—Three Generation Study is a Dynamic Developmental Systems (DDS) model of continuous feedback across systems throughout development. A new hypothesis encompassed by DDS is developmental congruence of intergenerational associations in problem behaviors. As used in geometry, congruence refers to figures of a similar shape and size. This term has been adapted to refer to the expectation that ages of onset and patterns of growth in key behaviors will show similarity across generations. This is based on the theory that genetic and temperamental factors increase an individual’s risk when these factors are expressed at sensitive developmental periods. Thus, the timing of these manifestations (e.g., susceptibility to deviant peer influences) is expected to be similar across generations. Developmental similarity is also likely due to continuities in social-risk context and family mechanisms, such as parenting.