Sexual orientation disparities in mood disorders and suicidality appear to develop as early as middle childhood. Clinicians are encouraged to assess sexual orientation among children as young as 9–10 years old, and provide appropriate normalization of sexual orientation, and referrals for mental health treatment, as indicated.
Child Sexual Orientation and Gender Identity in the Adolescent Brain Cognitive Development Cohort Study
Sexual and gender minorities (ie, individuals who do not identify as heterosexual and those whose gender identities differ from their birth sex) experience significantly elevated physical and mental health morbidities compared with heterosexual and cisgender individuals.1 By collecting sexual orientation and gender identity (SOGI) data in a US representative cohort of 9- to 10-year-old children, the recently released Adolescent Brain Cognitive Development (ABCD) Study2 provides an opportunity to understand the development of health disparities and resilience by SOGI at earlier ages than previous research. Both children and parental figures reported SOGI data, bolstering measurement rigor. Baseline analysis of ABCD Study SOGI data can contextualize the opportunities afforded by the data set for epidemiologic surveillance.
The structure of cognition in 9 and 10 year-old children and associations with problem behaviors: Findings from the ABCD study’s baseline neurocognitive battery
The Adolescent Brain Cognitive Development (ABCD) study is poised to be the largest single-cohort long-term longitudinal study of neurodevelopment and child health in the United States. Baseline data on 4521 children aged 9–10 were released for public access on November 2, 2018. In this paper we performed principal component analyses of the neurocognitive assessments administered to the baseline sample. The neurocognitive battery included seven measures from the NIH Toolbox as well as five other tasks. We implemented a Bayesian Probabilistic Principal Components Analysis (BPPCA) model that incorporated nesting of subjects within families and within data collection sites. We extracted varimax-rotated component scores from a three-component model and associated these scores with parent-rated Child Behavior Checklist (CBCL) internalizing, externalizing, and stress reactivity. We found evidence for three broad components that encompass general cognitive ability, executive function, and learning/memory. These were significantly associated with CBCL scores in a differential manner but with small effect sizes. These findings set the stage for longitudinal analysis of neurocognitive and psychopathological data from the ABCD cohort as they age into the period of maximal adolescent risk-taking.
Image processing and analysis methods for the Adolescent Brain Cognitive Development Study
The Adolescent Brain Cognitive Development (ABCD) Study is an ongoing, nationwide study of the effects of environmental influences on behavioral and brain development in adolescents. The ABCD Study is a collaborative effort, including a Coordinating Center, 21 data acquisition sites across the United States, and a Data Analysis and Informatics Center (DAIC). The main objective of the study is to recruit and assess over eleven thousand 9-10-year-olds and follow them over the course of 10 years to characterize normative brain and cognitive development, the many factors that influence brain development, and the effects of those factors on mental health and other outcomes. The study employs state-of-the-art multimodal brain imaging, cognitive and clinical assessments, bioassays, and careful assessment of substance use, environment, psychopathological symptoms, and social functioning. The data will provide a resource of unprecedented scale and depth for studying typical and atypical development. Here, we describe the baseline neuroimaging processing and subject-level analysis methods used by the ABCD DAIC in the centralized processing and extraction of neuroanatomical and functional imaging phenotypes. Neuroimaging processing and analyses include modality-specific corrections for distortions and motion, brain segmentation and cortical surface reconstruction derived from structural magnetic resonance imaging (sMRI), analysis of brain microstructure using diffusion MRI (dMRI), task-related analysis of functional MRI (fMRI), and functional connectivity analysis of resting-state fMRI.
Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years
Eating disorders (EDs) are associated with significant morbidity and mortality.1 The prevalence of early-onset EDs has increased in the past several decades, with younger children more likely than adolescents to experience psychiatric comorbidity. The single nationally representative study that has reported 12-month prevalence rates of EDs among children aged 8 to 15 years found 0.1% total for children aged 8 to 11 years, with 0.3% for girls and 0.1% for boys aged 8 to 15 years old.2 However, this previous study used Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria and did not report the prevalence of specific ED diagnoses. The aims of the present study were to report the prevalence rates of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED) in addition to a global “any ED” diagnosis, using Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria among a US representative sample of children aged 9 and 10 years. Prevalence rates were tested by participant sex.
Screen media activity and brain structure in youth: Evidence for diverse structural correlation networks from the ABCD study
The adolescent brain undergoes profound structural changes which is influenced by many factors. Screen media activity (SMA; e.g., watching television or videos, playing video games, or using social media) is a common recreational activity in children and adolescents; however, its effect on brain structure is not well understood. A multivariate approach with the first cross-sectional data release from the Adolescent Brain Cognitive Development (ABCD) study was used to test the maturational coupling hypothesis, i.e. the notion that coordinated patterns of structural change related to specific behaviors. Moreover, the utility of this approach was tested by determining the association between these structural correlation networks and psychopathology or cognition. ABCD participants with usable structural imaging and SMA data (N = 4277 of 4524) were subjected to a Group Factor Analysis (GFA) to identify latent variables that relate SMA to cortical thickness, sulcal depth, and gray matter volume. Subject scores from these latent variables were used in generalized linear mixed-effect models to investigate associations between SMA and internalizing and externalizing psychopathology, as well as fluid and crystalized intelligence. Four SMA-related GFAs explained 37% of the variance between SMA and structural brain indices. SMA-related GFAs correlated with brain areas that support homologous functions. Some but not all SMA-related factors corresponded with higher externalizing (Cohen's d effect size (ES) 0.06–0.1) but not internalizing psychopathology and lower crystalized (ES: 0.08–0.1) and fluid intelligence (ES: 0.04–0.09). Taken together, these findings support the notion of SMA related maturational coupling or structural correlation networks in the brain and provides evidence that individual differences of these networks have mixed consequences for psychopathology and cognitive performance.
Associations between 24 hour movement behaviours and global cognition in US children: a cross-sectional observational study
Childhood and adolescence are crucial periods for brain development, and the behaviours during a typical 24 h period contribute to cognitive performance. The Canadian 24-Hour Movement Guidelines for Children and Youth recommend at least 60 min physical activity per day, 2 h or less recreational screen time per day, and 9–11 h sleep per night in children aged 8–11 years. We investigated the relationship between adherence to these recommendations and global cognition.
Convergent influences of lifestyle behaviour on neurocognitive development in children
Comment on: Walsh, J.J., Barnes, J.D., Cameron, J.D., Goldfield, G.S., Chaput, JP, Gunnell, K.E., Ledoux, AA, Zemek, R.L., Tremblay, M.S. (2018). Associations between 24 hour movement behaviours and global cognition in US children: a cross-sectional observational study.
The Lancet Child & Adolescent Health, Available online 27 September 2018.
Healthy lifestyle behaviours are the primary modifiable risk factors for prevention of chronic disease. 1 Recognition of the interdependence between various lifestyle behaviours has grown and investigation of their potentially synergistic benefits has increased. 2 In The Lancet Child & Adolescent Health, Jeremy Walsh and colleagues' report 3 an investigation of the effects of three movement behaviours—physical activity, sleep, and recreational screen time—independently and in combination on children's neurocognitive development. They analysed the curated data from the first year of the ongoing Adolescent Brain and Cognitive Development (ABCD) prospective cohort study, which is measuring lifestyle behaviours and global cognition, fluid intelligence, and crystallised intelligence among children.
Assessment of the Prodromal Questionnaire–Brief Child Version for Measurement of Self-reported Psychoticlike Experiences in Childhood
These results provide support for the construct validity and demonstrate adequate psychometric properties of a self-report instrument designed to measure childhood PLEs, providing evidence that the PQ-BC may be a useful measure of early risk for psychotic disorders. Furthermore, these data suggest that PLEs at school age are associated with many of the same familial, cognitive, and emotional factors associated with psychotic symptoms in older populations, consistent with the dimensionality of psychosis across the lifespan.
Outreach and innovation: Communication strategies for the ABCD Study
The Adolescent Brain Cognitive Development (ABCD) Study, a large, longitudinal study of brain development and child health, relies on the engagement of communities, educators, and families to ensure its success. To that end, community and partner relationships, development of targeted messages and materials for specific audiences (educators, families, youth, scientists), and continued and consistent outreach must be an integral part of the Consortium activities. The ABCD Consortium has made these efforts a priority and developed a framework to raise awareness about the study and promote sustained broad-base support from diverse stakeholders.
Recruiting the ABCD Sample: Design Considerations and Procedures
The ABCD study is a new and ongoing project of very substantial size and scale involving 21 data acquisition sites. It aims to recruit 11,500 children and follow them for ten years with extensive assessments at multiple timepoints. To deliver on its potential to adequately describe adolescent development, it is essential that it adopt recruitment procedures that are efficient and effective and will yield a sample that reflects the nation’s diversity in an epidemiologically informed manner. Here, we describe the sampling plans and recruitment procedures of this study. Participants are largely recruited through the school systems with school selection informed by gender, race and ethnicity, socioeconomic status, and urbanicity. Procedures for school selection designed to mitigate selection biases, dynamic monitoring of the accumulating sample to correct deviations from recruitment targets, and a description of the recruitment procedures designed to foster a collaborative attitude between the researchers, the schools and the local communities, are provided.
A description of the ABCD organizational structure and communication framework
The Adolescent Brain Cognitive Development (ABCD) study is designed to be the largest study of brain development and child health in the United States, performing comprehensive assessments of 11,500 children repeatedly for 10 years. An endeavor of this magnitude requires an organized framework of governance and communication that promotes collaborative decision-making and dissemination of information. The ABCD consortium structure, built upon the Matrix Management approach of organizational theory, facilitates the integration of input from all institutions, numerous internal workgroups and committees, federal partners, and external advisory groups to make use of a broad range of expertise to ensure the study’s success.
A brief validated screen to identify boys and girls at risk for early marijuana use
To guide recruitment, the ABCD Study requires a method for identifying children at high risk for early-onset substance use that may be utilized during the recruitment process. This study was undertaken to inform the development of a brief screen for identifying youths’ risk of early-onset substance use and other adverse outcomes. To be acceptable by participants in this context, consideration of potential items was limited to child characteristics previously determined to be potentially pertinent and parental cigarette smoking. To focus the analyses on a single target substance use outcome pertinent to the stated goals of the ABCD Study, early-onset marijuana use was selected. Utilizing data collected prior to the initiation of the ABCD Study, four longitudinal data sets were used in nine secondary data analyses to test, replicate and validate a brief screening assessment for boys and girls to identify those at risk for early-onset marijuana use by ages 14–15. The combination of child externalizing problems reported by the parent (4 items: destroys things belonging to his/her family or others; disobedience at school; lying or cheating; steals outside the home) and parent smoking (1 item) proved to be the optimal screen. This was largely replicated across the four data sets. Indicators of predictive efficiency were modest in magnitude and statistically significant in 8 out of the 9 analyses. The results informed the screen’s optimal threshold for identifying children at risk for early-onset marijuana use. The addition of child internalizing problems did not improve these predictions. Further analyses showed the predictive utility of the screen for several other substance use outcomes at ages 15 to 18, including alcohol and nicotine use. The results support the use of a short screening assessment to identify youth at risk for early-onset substance use in the ABCD Study and other research.
Current, future and potential use of mobile and wearable technologies andsocial media data in the ABCD study to increase understanding of contributors to child health
Mobile and wearable technologies and novel methods of data collection are innovating health-related research. These technologies and methods allow for multi-system level capture of data across environmental, physiological, behavioral, and psychological domains. In the Adolescent Brain Cognitive Development (ABCD) Study, there is great potential for harnessing the acceptability, accessibility, and functionality of mobile and social technologies for in-vivo data capture to precisely measure factors, and interactions between factors, that contribute to childhood and adolescent neurodevelopment and psychosocial and health outcomes. Here we discuss advances in mobile and wearable technologies and methods of analysis of geospatial, ecologic, social network and behavioral data. Incorporating these technologies into the ABCD study will allow for interdisciplinary research on the effects of place, social interactions, environment, and substance use on health and developmental outcomes in children and adolescents.
Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data
Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9–10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9–10-year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.
Biospecimens and the ABCD study: Rationale, methods of collection, measurement and early data
Biospecimen collection in the Adolescent Brain Cognitive Development (ABCD) study – of hair samples, shed deciduous (baby) teeth, and body fluids – will serve dual functions of screening for study eligibility, and providing measures of biological processes thought to predict or correlate with key study outcomes on brain and cognitive development. Biosamples are being collected annually to screen for recency of drug use prior to the neuroimaging or cognitive testing visit, and to store for the following future studies: (1) on the effects of exposure to illicit and recreational drugs (including alcohol and nicotine); (2) of pubertal hormones on brain and cognitive developmental trajectories; (3) on the contribution of genomics and epigenomics to child and adolescent development and behavioral outcomes; and (4) with pre- and post-natal exposure to environmental neurotoxicants and drugs of abuse measured from novel tooth analyses. The present manuscript describes the rationales for inclusion and selection of the specific biospecimens, methodological considerations for each measure, future plans for assessment of biospecimens during follow-up visits, and preliminary ABCD data to illustrate methodological considerations.
The Adolescent Brain Cognitive Development (ABCD) study: Imaging acquisition across 21 sites
The ABCD study is recruiting and following the brain development and health of over 10,000 9–10 year olds through adolescence. The imaging component of the study was developed by the ABCD Data Analysis and Informatics Center (DAIC) and the ABCD Imaging Acquisition Workgroup. Imaging methods and assessments were selected, optimized and harmonized across all 21 sites to measure brain structure and function relevant to adolescent development and addiction. This article provides an overview of the imaging procedures of the ABCD study, the basis for their selection and preliminary quality assurance and results that provide evidence for the feasibility and age-appropriateness of procedures and generalizability of findings to the existent literature.
Adolescent neurocognitive development and impacts of substance use: Overview of the adolescent brain cognitive development (ABCD) baseline neurocognition battery
Adolescence is characterized by numerous social, hormonal and physical changes, as well as a marked increase in risk-taking behaviors. Dual systems models attribute adolescent risk-taking to tensions between developing capacities for cognitive control and motivational strivings, which may peak at this time. A comprehensive understanding of neurocognitive development during the adolescent period is necessary to permit the distinction between premorbid vulnerabilities and consequences of behaviors such as substance use. Thus, the prospective assessment of cognitive development is fundamental to the aims of the newly launched Adolescent Brain and Cognitive Development (ABCD) Consortium. This paper details the rationale for ABC’lected measures of neurocognition, presents preliminary descriptive data on an initial sample of 2299 participants, and provides a context for how this large-scale project can inform our understanding of adolescent neurodevelopment.
Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods
One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States.
The Adolescent Brain Cognitive Development (ABCD) Study is a longitudinal, observational study of over 10,000 youth recruited at 21 sites throughout the United States. Comprehensive biennial assessments and more limited interim assessments measure health, mental health, neurocognition, family, cultural and environmental variables, substance use, genetic and other biomarkers, and structural and functional brain development. Within this Special Issue, readers will find much information about the rationale and objectives of the study, the broad ranging assessment protocols and new as well as traditional methodologies applied at baseline, the recruitment and retention strategies, and the anticipated final composition of the cohort. Information is also provided about how the study is coordinated and conducted, how decisions are made, how data quality is monitored, and how ethical standards are protected. In this introduction we will focus instead on the position of the ABCD Study in the changing landscape of biomedical research.
The adolescent brain cognitive development study external advisory board
Why should the Adolescent Brain Cognitive Development study (ABCD Study) have an External Advisory Board (EAB)? ABCD Study has approximately two-dozen principal investigators, all experts and leaders in the diverse fields of study required to accomplish ABCD Study’s goals. Furthermore, as part of an NIH consortium, ABCD Study investigators work in close collaboration with scientific experts from multiple National Institutes of Health (NIH) Institutes and Offices (https://abcdstudy.org/federal-partners.html) and have ready access to their expertise. And NIH has constituted an Observational Study Management Board (OSMB) to offer oversight and counsel to ABCD Study regarding myriad ethical issues that might arise in the course of a 10-year longitudinal study of 10,000 children. So why also have an EAB? In a way, it is the organizational structure of ABCD Study, its cost, its complexity, its extraordinarily ambitious goals, and its importance to the scientific community and public health that together obligate oversight from an unbiased set of experts who can advise ABCD Study across a wide range of issues.
Retention efforts are critical to maintain relationships with research participants over time. This is especially important for the Adolescent Brain Cognitive Development (ABCD) study, where families are asked to stay engaged with the study throughout the course of 10 years. This high-degree of involvement is essential to longitudinally track child and adolescent development. At a minimum, we will connect with families every 6 months by telephone, and every year in person, with closer contact with the youth directly as they transition into adolescence. Differential retention, when related to non-random issues pertaining to demographic or risk features, can negatively impact the generalizability of study outcomes. Thus, to ensure high rates of retention for all participants, the ABCD study employs a number of efforts to support youth and families. This overview details the framework and concrete steps for retention.
Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description
The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth’s current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.
The conception of the ABCD study: From substance use to a broad NIH collaboration
Adolescence is a time of dramatic changes in brain structure and function, and the adolescent brain is highly susceptible to being altered by experiences like substance use. However, there is much we have yet to learn about how these experiences influence brain development, how they promote or interfere with later health outcomes, or even what healthy brain development looks like. A large longitudinal study beginning in early adolescence could help us understand the normal variability in adolescent brain and cognitive development and tease apart the many factors that influence it. Recent advances in neuroimaging, informatics, and genetics technologies have made it feasible to conduct a study of sufficient size and scope to answer many outstanding questions. At the same time, several Institutes across the NIH recognized the value of collaborating in such a project because of its ability to address the role of biological, environmental, and behavioral factors like gender, pubertal hormones, sports participation, and social/economic disparities on brain development as well as their association with the emergence and progression of substance use and mental illness including suicide risk. Thus, the Adolescent Brain Cognitive Development study was created to answer the most pressing public health questions of our day.
The utility of twins in developmental cognitive neuroscience research: How twins strengthen the ABCD research design
The ABCD twin study will elucidate the genetic and environmental contributions to a wide range of mental and physical health outcomes in children, including substance use, brain and behavioral development, and their interrelationship. Comparisons within and between monozygotic and dizygotic twin pairs, further powered by multiple assessments, provide information about genetic and environmental contributions to developmental associations, and enable stronger tests of causal hypotheses, than do comparisons involving unrelated children. Thus a sub-study of 800 pairs of same-sex twins was embedded within the overall Adolescent Brain and Cognitive Development (ABCD) design. The ABCD Twin Hub comprises four leading centers for twin research in Minnesota, Colorado, Virginia, and Missouri. Each site is enrolling 200 twin pairs, as well as singletons. The twins are recruited from registries of all twin births in each State during 2006–2008. Singletons at each site are recruited following the same school-based procedures as the rest of the ABCD study. This paper describes the background and rationale for the ABCD twin study, the ascertainment of twin pairs and implementation strategy at each site, and the details of the proposed analytic strategies to quantify genetic and environmental influences and test hypotheses critical to the aims of the ABCD study.
Biomedical ethics and clinical oversight in multisite observational neuroimaging studies with children and adolescents: The ABCD experience
Observational neuroimaging studies with children and adolescents may identify neurological anomalies and other clinically relevant findings. Planning for the management of this information involves ethical considerations that may influence informed consent, confidentiality, and communication with participants about assessment results. Biomedical ethics principles include respect for autonomy, beneficence, non-maleficence, and justice. Each project presents unique challenges. The Adolescent Brain and Cognitive Development study (ABCD) collaborators have systematically developed recommendations with written guidelines for identifying and responding to potential risks that adhere to biomedical ethics principles. To illustrate, we will review the ABCD approach to three areas: (1) hazardous substance use; (2) neurological anomalies; and (3) imminent potential for self-harm or harm to others. Each ABCD site is responsible for implementing procedures consistent with these guidelines in accordance with their Institutional Review Board approved protocols, state regulations, and local resources. To assure that each site has related plans and resources in place, site emergency procedures manuals have been developed, documented and reviewed for adherence to ABCD guidelines. This article will describe the principles and process used to develop these ABCD bioethics and medical oversight guidelines, the concerns and options considered, and the resulting approaches advised to sites.