(PS1-C75) Predictors of Longitudinal Changes in Symptoms and Impairment in Adolescent Girls with ADHD

Attention deficit/hyperactivity disorder (ADHD) in girls had been largely under researched up until the 21^st century, and still much is unknown or unclear about female presentations of the disorder. The aim of this study is to characterize the sample of adolescent girls (n=235, ages 10-17) from the ADHD Teen Integrative Data Analysis Longitudinal (TIDAL) dataset (Sibley & Coxe, 2020). The TIDAL dataset was created using integrative data analysis to combine data from four randomized controlled trials on ADHD psychosocial treatment resulting in a sample of ethnically diverse adolescents (n=854) with ADHD. This study investigates how behavior therapy [engagement-focused (ENGAGE), comprehensive (COMP), standard (STANDARD), community-based usual care (UC), no treatment (NOTX)] medication engagement (consistent, inconsistent, negligible), clinical problem profile (simplex, internalizing, disruptive/disorganized), and family adversity predict changes in ADHD symptoms and related impairment over time using data from baseline and posttreatment (mean months after baseline: 5.41) in the sample of girls. A measure of parent-reported ADHD symptoms was created based on DSM-IV-TR and DSM-5 ADHD checklists; academic functioning was measured using GPA; the parent-report Conflict Behavior Questionnaire-20 measured parent-teen conflict; and the academic skills subscale from the teacher-reported Adolescent Academic Problems Checklist measured organizational functioning. Hierarchical linear regression models were used to examine the relationship between the predictive variables and the outcomes, and how each added variable affected the relationship. Initial analyses indicated that ENGAGE significantly predicted lower ADHD symptoms, less organization problems, and less parent-teen conflict at follow up. Usual care was also associated with lower ADHD symptoms and less organization problems, and STANDARD was associated with lower hyperactivity/impulsivity symptoms. Consistent medication use during behavior therapy was associated with lower inattention symptoms. The disruptive/disorganized presenting problems profile predicted lower GPA, higher inattention symptoms, and lower organization problems; and lower family adversity predicted higher inattention symptoms and more organizational problems. All other variables were nonsignificant. Additional analyses are ongoing to examine whether gender moderates response to treatment. The results of this study indicate that engagement-focused behavior therapy is particularly effective at reducing ADHD symptoms and related impairment for adolescent girls with ADHD. Girls presenting with the disruptive/disorganized profile and those presenting with less family adversity may be more at-risk subgroups that could be targets for further interventions.