Archival Report
Obsessive-Compulsive Symptoms Among Children in the Adolescent Brain and Cognitive Development Study: Clinical, Cognitive, and Brain Connectivity Correlates

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Abstract

Background

Childhood obsessive-compulsive symptoms (OCSs) are common and can be an early risk marker for obsessive-compulsive disorder. The Adolescent Brain and Cognitive Development (ABCD) Study provides a unique opportunity to characterize OCSs in a large normative sample of school-age children and to explore corticostriatal and task-control circuits implicated in pediatric obsessive-compulsive disorder.

Methods

The ABCD Study acquired data from 9- and 10-year-olds (N = 11,876). Linear mixed-effects models probed associations between OCSs (Child Behavior Checklist) and cognition (NIH Toolbox), brain structure (subcortical volume, cortical thickness), white matter (diffusion tensor imaging), and resting-state functional connectivity.

Results

OCS scores showed good psychometric properties and high prevalence, and they were related to familial/parental factors, including family conflict. Higher OCS scores related to better cognitive performance (β = .06, t9966.60 = 6.28, p < .001, ηp2 = .01), particularly verbal, when controlling for attention-deficit/hyperactivity disorder, which related to worse performance. OCSs did not significantly relate to brain structure but did relate to lower superior corticostriatal tract fractional anisotropy (β = −.03, t = −3.07, p = .002, ηp2 = .02). Higher OCS scores were related to altered functional connectivity, including weaker connectivity within the dorsal attention network (β = −.04, t7262.87 = −3.71, p < .001, ηp2 = .002) and weaker dorsal attention–default mode anticorrelation (β = .04, t7251.95 = 3.94, p < .001, ηp2 = .002). Dorsal attention–default mode connectivity predicted OCS scores at 1 year (β = −.04, t2407.61 = −2.23, p = .03, ηp2 = .03).

Conclusions

OCSs are common and may persist throughout childhood. Corticostriatal connectivity and attention network connectivity are likely mechanisms in the subclinical-to-clinical spectrum of OCSs. Understanding correlates and mechanisms of OCSs may elucidate their role in childhood psychiatric risk and suggest potential utility of neuroimaging, e.g., dorsal attention–default mode connectivity, for identifying children at increased risk for obsessive-compulsive disorder.

Section snippets

Overview

The ABCD Study is a multisite study (21 sites across the United States) with the overall goals of 1) assessing variability in adolescent brain and cognitive development and 2) understanding factors that influence development (34). Using a school-based recruitment strategy (public and private elementary schools), the ABCD Study has collected baseline clinical, questionnaire, behavioral, and neuroimaging data from 9- and 10-year-olds with ongoing longitudinal assessments (35). Exclusion criteria

Participants

Tables 1 and 2 summarize demographic and clinical characteristics of the full sample and compare them by K-SADS OCD diagnosis (Tables S2 and S3 compare by OCS score ≥5). A total of 1099 children (9.41%) had a lifetime parent-reported diagnosis of OCD, including 898 current (7.68%) and 501 past (4.29%). Lifetime OCD prevalence varied by site (χ221 = 59.29, p < .001) from 5.79% to 13.77%. Yet, site differences (n = 10,137, F21 = 1.49, p = .07) were largely accounted for by our demographic

Discussion

We leveraged the large normative ABCD Study dataset to probe OCSs among 9- and 10-year-old children across the United States. Complex associations with cognitive performance were detected: Specifically, higher OCS scores were related to better cognitive performance, particularly verbal, only when covarying for ADHD. Although we did not detect associations with brain structure, OCS scores did relate to differences in structural and functional connectivity of corticostriatal and attentional

Acknowledgments and Disclosures

Data used in the preparation of this article were obtained from the ABCD Study (https://abcdstudy.org), held in the National Institute of Mental Health Data Archive. The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, and U24DA041147. A full list of supporters is available at //abcdstudy.org/nih-collaborators

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