Attention Magazine December 2023

The Young Scientist Research Awards is an annual opportunity for pre-doctoral and post-doctoral ADHD researchers to both present and celebrate their accomplishments at the Annual International Conference on ADHD. This year, researchers from universities in seven states, as well as Canada and Malaysia, submitted detailed, high-quality applications exhibiting their participation and leadership in ADHD-centered research. As ever, awardee selection was an extremely competitive process. CHADD is pleased to announce the recipients of the 2023 awards: Zoe Smith, PhD, and Jessica N. Smith, MS.

In order to be considered for this esteemed award, the researchers submitted their curriculum vitae, academic record, recommendations from professors, and a list of publications and ongoing research studies. A panel of knowledgeable researchers from CHADD’s professional advisory board—Craig Bruce Hackett Surman, MD (co-chair); Joy Banks, PhD; David J. Marks, PhD; John Mitchell, PhD; Roberto Olivardia, PhD; and Margaret H. Sibley, PhD—volunteered their time and efforts to review applications.

Each applicant selected one of their research studies to be analyzed by reviewers for contribution of new knowledge, relevance and adequacy of both literature review and the data analysis significance, clarity of the problem, and rigor of methodology-design. Out of all the submissions, the applications from the award recipients merited the highest scores from the reviewers. Below, Dr. Zoe Smith and Ms. Jessica N. Smith provide synopses of their outstanding research submissions.

Jessica N. Smith, MS

Transdiagnostic Mechanisms of Youth Externalizing Psychopathology from Childhood to Adolescence: A Longitudinal Person-Centered Approach

ADHD is classically heterogeneous and associated with a high rate of comorbidity, most commonly with disruptive behavior problems. ADHD’s notable heterogeneity and comorbidity generates significant challenges for understanding its etiology. While recognition of this problem has led to more transdiagnostic research, this literature commonly suffers from (1) use of analytic methods that neglect the role of comorbidity in giving rise to ADHD’s heterogeneity, and vice versa; and (2) reliance on mostly cross-sectional studies, which limits examination of how symptoms and their putative mechanisms may develop over time.

First, while there is a large and robust literature on ADHD heterogeneity, the role of other comorbid disorders in this heterogeneity is rarely considered. At the same time, many studies seeking to understand comorbidity compare groups with and without particular DSM disorders for their differences in mechanisms, despite the fact that these approaches often control for the common variance between groups that may be important for understanding their comorbidity. Person-centered analytic approaches may be helpful in understanding the relationship between ADHD heterogeneity and common comorbidities by allowing for investigation of which symptoms naturally co-occur in the population within and between disorders without a priori grouping or controlling for shared variance.

Second, many studies of ADHD etiology are cross-sectional. However, cross-sectional studies are limited in their ability to improve our understanding of the ways in which ADHD and related disorders are heterotypic or homotypic in nature, as well as what mechanisms may drive changes in presentation(s) over time.

To address both of these limitations, the present study conducted the first latent transition analysis of externalizing psychopathology. The analyses included youth ages nine, twelve, and fifteen and integrated cognitive and emotional mechanisms as predictors of latent class and latent transition pathways. Findings suggest that oppositionality rarely occurred independent of hyperactivity/impulsivity, and that these symptoms shared mechanisms across development, potentially representing one etiological entity distinct from inattention.

Jessica N. Smith, MS, is a doctoral candidate in clinical science in child and adolescent psychology at Florida International University. Her research is focused on transdiagnostic mechanisms of ADHD’s high rate of comorbidity with various disorders of youth.

Zoe Smith, PhD

Trauma Experiences and Associations with Functional Outcomes for Black and/or Latine Adolescents with Attention-Deficit/Hyperactivity Disorder

Zoe Smith (Dr. Z) is the leader of the Advancing Community Centered Interventions (ACCTION) Team, whose research focuses on developing feasible, community-centered interventions for Black and/or Latina/é/o (Latiné) teens with ADHD and their families to increase wellbeing and decrease health disparities. Due to divestment in public mental health clinics on the South and West sides of Chicago, she identified the need in the Chicagoland area for culturally responsive and healing focused assessments to increase access to health resources to improve the safety and wellbeing of Black and/or Latiné teens.

As a Health Equity Scholar for Action and through funding from the Robert Wood Johnson Foundation (RWJF-79247), Dr. Z and the ACCTION team are focused on the Culturally Responsive Assessments for Teens (CRAFT) project, providing free, psychodiagnostic and academic assessments for Black and/or Latiné adolescents (ages twelve to seventeen) who are suspected of having ADHD. The team conducts a clinical interview, academic achievement assessment, provide an integrated report, feedback session, and twelve months of close follow-up and case management for participants. Families in Project CRAFT are also invited to join youth and parent advisory boards, to check in with families about their experience in CRAFT and also learn about their lived experiences being Black and/or Latiné with ADHD.

One thing Dr. Z and her team noted from completing these assessments is the high rates of trauma Black and/or Latiné teens experience, particularly after the COVID19 pandemic started. Black and/or Latiné teens with ADHD are experiencing many different aspects of trauma, including oppression-related trauma (e.g., racist experiences, discrimination), interpersonal trauma, and ACEs. In addition, these teens are experiencing complex, chronic stressors, which has led to showing symptoms of developmental trauma disorder and provides further evidence for the need to include developmentally and systematically informed diagnoses to help support teens.

Through project CRAFT, sixty percent of the families have started therapy or found a new therapist based on team recommendations, and many have sought IEPs or 504 plans to support their teen’s learning. It is also important to note that the teens that participate in project CRAFT are funny, thoughtful, and incredibly compassionate people who want to be astrophysicists, therapists, and researchers. Through the parent and teen advisory boards we’ve learned how families are feeling “seen” for the first time, despite many having been to other clinicians or pediatricians who invalidated their experiences of having ADHD.

Most of the participants in project CRAFT are receiving a first-time ADHD diagnosis despite a long history of ADHD symptoms and related impairment, which highlights the inequities experienced by Black and/or Latiné  teens with ADHD. The ultimate goal of this work is to uplift the voices and lived experiences of the families the ACCTION Team serves and to better understand how to increase equity in assessment, access to services, and much more.

Zoe Smith, PhD, is an assistant professor of psychology at Loyola University Chicago. Her research is focused on creating and providing culturally responsive mental health services for Black and/or Latina/e/o adolescents, particularly adolescents with ADHD

Rachel James, MSLIS, is the health sciences librarian at CHADD and manager of the Young Scientist Research Awards.