title: Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study.
abstract: BACKGROUND
  Attention deficit hyperactivity disorder (ADHD) is theorized to have temperamental precursors early in life. These are difficult to identify because many core features of ADHD, such as breakdowns in executive function and self-control, involve psychological and neural systems that are too immature to reliably show dysfunction in early life. ADHD also involves emotional dysregulation, and these temperamental features appear earlier as well. Here, we report a first attempt to utilize indices of emotional regulation to identify ADHD-related liability in infancy.
  
  
  METHODS
  Fifty women were recruited in the 2nd trimester of pregnancy, with overselection for high parental ADHD symptoms. Measures of maternal body mass index, nutrition, substance use, stress, and mood were examined during pregnancy as potential confounds. Offspring were evaluated at 6 months of age using LABTAB procedures designed to elicit fear, anger, and regulatory behavior. Mothers completed the Infant Behavior Questionnaire about their child's temperament.
  
  
  RESULTS
  After control for associated covariates, including maternal depression and prenatal stress, family history of ADHD was associated with measures of anger/irritability, including infant negative vocalizations during the arm restraint task (p = .004), and maternal ratings of infant distress to limitations (p = .036). In the regulation domain, familial ADHD was associated with less parent-oriented attention seeking during the still face procedure (p < .001), but this was not echoed in the maternal ratings of recovery from distress.
  
  
  CONCLUSIONS
  Affective response at 6 months of age may identify infants with familial history of ADHD, providing an early indicator of ADHD liability. These preliminary results provide a foundation for further studies and will be amplified by enlarging this cohort and following participants longitudinally to evaluate ADHD outcomes.
authors.affiliation: Department of Biology, University of Portland, Portland, OR, USA.|Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Beaverton, OR, USA.
authors.forename: Elinor L
authors.initials: EL
authors.lastname: Sullivan
authors.affiliation: School of Education, Teaching & Health, Center for Behavioral Neuroscience, American University, Washington, DC, USA.
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Holton
authors.affiliation: Departments of Psychology and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Nousen
authors.affiliation: Department of Biology, University of Portland, Portland, OR, USA.
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Barling
authors.affiliation: Departments of Psychology and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Ceri A
authors.initials: CA
authors.lastname: Sullivan
authors.affiliation: Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Cathi B
authors.initials: CB
authors.lastname: Propper
authors.affiliation: Departments of Psychology and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Joel T
authors.initials: JT
authors.lastname: Nigg
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D042241:Early Diagnosis; D004644:Emotions / Q000502:physiology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000502:physiology*; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D012306:Risk; D000068356:Self-Control; D013694:Temperament / Q000502:physiology*
keywords: ADHD risk; early identification; emotional dysregulation; infant temperament; markers; maternal precursors