Developmental Pathways From Childhood Neurodevelopmental Traits to Early Adolescent Psychiatric Dimensions: The Role of Environmental and Lifestyle Factors

Objective Transdiagnostic dimensional approaches have advanced our understanding of psychiatric comorbidity and developmental continuity, but have rarely been applied to investigate links between neurodevelopmental (eg, attention-deficit/hyperactivity disorder, autism) and other psychiatric conditions. Building on recent research delineating a transdiagnostic “neurodevelopmental spectrum,” we examined longitudinal associations between this spectrum in late childhood and other psychiatric dimensions in early adolescence, and the role of environmental and lifestyle factors as potential mediators of these associations. Method In 11,875 children from the Adolescent Brain Cognitive Development℠ (ABCD) Study, we extracted neurodevelopmental, externalizing, internalizing, detachment, and somatoform dimensions at ages 10, 11, and 12 years through confirmatory factor analysis of Child Behavior Checklist items. Using linear mixed models, we tested prospective associations between the neurodevelopmental spectrum at age 10 years and other psychiatric dimensions at ages 11 and 12 years. Mediation models examined whether environmental (eg, family conflict, school involvement) and lifestyle (eg, sleep problems, screen use) factors at age 11 mediated these associations. Results Strong longitudinal associations emerged between the neurodevelopmental spectrum and all other psychiatric dimensions (β = 0.417-0.641, p < .001). Sleep problems were the most consistent mediator, accounting for 12% to 29% of these associations. Most results remained significant after multiple testing corrections and adjusting for covariates, mediators, and psychiatric dimensions at baseline. Conclusion Our transdiagnostic dimensional approach revealed that neurodevelopmental traits prospectively predict elevations in major psychiatric symptom dimensions during the transition to adolescence. Sleep problems emerged as a key lifestyle factor underlying these associations and a promising target for transdiagnostic prevention programs to improve mental health outcomes in this population.