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Internalizing and Externalizing Problems in Children with ASD, ADHD, and OCD: Identifying Behavioural Profiles Within and Across Diagnostic Categories / Behavioural Profiles Within and Across ASD, ADHD, and OCD

Updated: Current version includes the name of Supervisor, and Co-supervisor. Error corrected in preliminary pages. / Background: Emerging evidence suggests that there is both within-disorder heterogeneity and across-disorder overlap in the clinical presentation of children with ASD, ADHD, and OCD. Two prevalent dimensional phenotypes in children with these NDDs that warrant close attention, and are suitable for cross-disorder investigation, are internalizing and externalizing problems.
Objectives: The current study uses a data-driven, diagnosis-agnostic approach to identify homogenous clusters that describe behavioural profiles of internalizing and externalizing problems within and across ASD, ADHD, and OCD.
Methods: Data on 1565 children (M = 10.76 years) were drawn from the Province of Ontario Neurodevelopmental Disorder (POND) Network. Non-hierarchical clustering approaches were used to empirically derive, distinct behavioural profiles of internalizing and externalizing problems indexed by the Child Behavior Checklist (CBCL). Empirically derived groups were characterized using measures of adaptive functioning indexed by the Adaptive Behaviour Assessment (ABAS-II), and interpreted in relation to original diagnoses.
Results: Cluster analyses identified four distinct behavioural profiles that cut across all diagnostic groups: High Internalizing Externalizing (HIE; 15%), High Externalizing (HE; 21%), Low Internalizing Externalizing (LIE; 38%), and Low Externalizing (LE; 26%). Derived clusters had variable levels of adaptive behaviours and reflected different behavioural profiles than the ones defined by the original diagnostic category groups of ASD, ADHD, and OCD.
Conclusion: Data-driven, diagnosis-agnostic approaches can inform our understanding of the between and within phenotypic heterogeneity seen in ASD, ADHD, and OCD. Empirical ways of classifying children with homogeneous behavioural profiles may complement existing diagnostic models in our efforts to develop cross-disorder, more personalized interventions for children with neurodevelopmental disorders. / Thesis / Master of Science (MSc) / ASD, ADHD, and OCD are heterogenous neurodevelopmental disorders (NDDs) with some overlapping clinical characteristics and etiological factors. Internalizing and externalizing behavioural problems persist across these three NDDs, and in this study, are used to identify unique behavioural profiles. Study findings reveal four groups with distinct behavioural profiles of internalizing and externalizing problems that are not identified by the original diagnostic groups. This empirical way of classifying children with similar behavioural profiles can be used in combination with diagnostic labels to enhance transdiagnostic interventions that can be tailored to each child’s needs.

Identiferoai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/26081
Date January 2020
CreatorsAssi, Amanda
ContributorsGeorgiades, Stelios, Hall, Geoffrey, Neuroscience
Source SetsMcMaster University
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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