Date Approved

2021

Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Committee Member

Carol Freedman-Doan, Ph.D.

Committee Member

Renee Lajiness-O’Neill, Ph.D.

Committee Member

Maggie Gindlesperger, Psy.D.

Committee Member

Joseph Breza, Ph.D.

Abstract

This study sought to broaden the findings of the current research on the relationship between late and moderate preterm (LAMP) birth and long-term neurocognitive outcomes—specifically those related to attention-deficit/hyperactivity disorder (ADHD). The purpose of this study was to better understand the relationship between gestational age (GA) and ADHD by (a) comparing prevalence of diagnosis between term-born and LAMP children, (b) comparing ADHD behavioral symptom severity between term-born and LAMP children, (c) and by examining neurocognitive status between term-born children and LAMP children (with and without ADHD diagnoses). The study also examined other factors that contribute to the relationship between GA and ADHD, including consideration of other risk factors and potential symptom-mitigating factors. The final sample for this study included 169 patients between the ages of 8 and 12 years who had completed an outpatient neuropsychological evaluation. GA was not related to ADHD diagnostic status, but lower GA predicted high ADHD-related symptom severity as indicated by caregiver report on the Conners-3. Though LAMP children did not differ from their term-born peers across measures of neurocognitive functioning, lower GA showed a marginally significant negative relationship with overall neurocognitive functioning (WISC-V FSIQ). Risk factors such as family history of ADHD and in-utero exposure to substances were consistently significantly related to ADHD symptom severity, and cumulative risk negatively impacted overall cognitive functioning, attention, working memory, and executive functioning. Adaptive skills and social skills were found to mitigate ADHD symptomatology as indicated by caregiver report on the BASC-3, though total symptom mitigating factors did not influence cognitive outcomes. Lastly, moderation analyses showed that gestational age interacts with birthweight at a marginally significant level in predicting overall cognitive functioning.

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