{"id":16341,"date":"2026-07-27T16:00:33","date_gmt":"2026-07-27T14:00:33","guid":{"rendered":"https:\/\/www.proefschriftmaken.nl\/portfolio\/noa-van-der-plas\/"},"modified":"2026-07-27T16:48:00","modified_gmt":"2026-07-27T14:48:00","slug":"noa-van-der-plas","status":"publish","type":"us_portfolio","link":"https:\/\/www.proefschriftmaken.nl\/en\/portfolio\/noa-van-der-plas\/","title":{"rendered":"Noa van der Plas"},"content":{"rendered":"","protected":true},"excerpt":{"rendered":"","protected":true},"author":7,"featured_media":16342,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"us_portfolio_category":[45],"class_list":["post-16341","us_portfolio","type-us_portfolio","status-publish","post-password-required","hentry","us_portfolio_category-new-template"],"acf":{"naam_van_het_proefschift":"Growing up with ADHD","samenvatting":"Aandachtsdefici\u00ebntie-\/hyperactiviteitsstoornis (attention-deficit\/hyperactivity disorder, ADHD) is een neurologische ontwikkelingsstoornis die vaak begint in de kindertijd. ADHD is niet gelimiteerd tot de kindertijd. De ontwikkeling van de stoornis vanuit kindertijd tot de volwassenheid heeft uiteenlopende trajecten, vari\u00ebrend van volledige remissie tot persistentie van ADHD met ongunstige gevolgen.\n\nVolwassenen met ADHD in de kindertijd scoorden slechter op meer dan 60% van de uitkomsten vergeleken met hun broers\/zussen en de controles. De meeste groepsverschillen waren in de domeinen gedrags- en emotionele problemen, adaptief functioneren en neurocognitieve functies. De negatieve uitkomsten bleken grotendeels onafhankelijk van een huidige ADHD-diagnose, omdat zowel de groep met een persistente ADHD-diagnose als de groep met een remitterend ADHD-diagnose verschilde van de controles op het merendeel van de uitkomsten. De broers en zussen hadden geen verhoogd risico op negatieve uitkomsten.\n\nVan de volwassenen met ADHD in de kindertijd gebruikte slechts 26% ADHD-medicatie als volwassene. De kans was 3 tot 7 keer groter dat ze neurologische medicijnen gebruikten (analgetica en NSAID\u2019s). De verschillen in medicatiegebruik verdwenen grotendeels na correctie voor een huidige ADHD-diagnose of depressie. Over het algemeen waren de verschillen tussen mannen en vrouwen vergelijkbaar met verschillen tussen mannen en vrouwen in de algemene populatie; er was geen sprake van een \u2018dubbele last\u2019 van sekse bij ADHD.\n\nUit onze meta-analyses bleek dat een voorgeschiedenis van stimulantiagebruik geassocieerd was met een verhoogd risico op ADHD-persistentie. Daarnaast werd ADHD-persistentie geassocieerd met een verhoogd risico op depressie en verslaving. Onze eigen voorspellingsmodellen met machine learning konden de langetermijnuitkomsten van ADHD niet beter voorspellen dan de conventionele logistische regressie. Ondanks dat de prestaties suboptimaal waren werden er een aantal mogelijk relevante voorspellers gesuggereerd, namelijk angstsymptomen, autistische trekken en motorische co\u00f6rdinatieproblemen in de kindertijd.\n\nDe belangrijkste boodschap is dat de ontwikkeling naar volwassenheid heterogeen is en moeilijk te voorspellen. Er is een groep die in de volwassenheid gemiddeld zal functioneren, maar de volwassen met een ADHD-diagnose in de kindertijd hebben ook een verhoogd risico op blijvende moeilijkheden, vooral psychiatrische stoornissen en gedrags- en emotionele problemen. Stimulantiagebruik in de kindertijd is in onze steekproef niet gerelateerd aan functionele langetermijnuitkomsten (>10 jaar later).","summary":"The aims of this thesis were to map the nature and severity of the long-term outcomes of adults who received an ADHD diagnosis in childhood and identify predictors for these long-term outcomes. Such results can support a reliable prognosis for adulthood outcomes of children with ADHD and may suggest possible targets for early prevention strategies to ameliorate negative outcomes. This is of importance as ADHD has a highly heterogeneous trajectory from childhood into adulthood, with potentially negative long-term outcomes.\n\nIn Chapter 2, we investigated differences between adults with childhood ADHD (n = 154), their siblings (n = 138), and controls (n = 129) on the 51 long-term outcomes across 7 domains of functioning (i.e., psychiatric status, behavioral and emotional problems, academic and professional functioning, adaptive functioning, neurocognitive functioning, physical health, and healthcare service use). Compared to their siblings and controls, adults with childhood ADHD showed worse long-term outcomes on more than 60% of the outcomes across the 7 domains of functioning, while their other outcomes were similar. The 3 most affected domains were behavioral and emotional functioning, adaptive functioning, and neurocognitive functioning. Most identified differences translated into small-sized effects, but several identified differences translated into moderate or large-sized effects.\n\nChapter 3 served as an in-depth analysis of healthcare service use where pharmacy dispensing records of medication for ADHD, other psychotropic medication, and somatic medication of the last year were compared between adults with childhood ADHD, their siblings, and controls. We found that adults with a childhood ADHD diagnosis had elevated medication use, which might indicate a long-term health burden. Of the childhood ADHD group, only 26% used ADHD medication as adults; they were 6 to 8 times more likely to use ADHD medication and were prescribed more different ADHD medications compared to both their siblings and controls.\n\nIn Chapter 4 we investigated whether males or females with childhood ADHD were more at risk of specific long-term outcomes, as the sex differences in the general population might be more pronounced within ADHD. We investigated moderations of sex in ADHD and found that, generally, sex did not have a more pronounced effect in ADHD than in controls on the 51 long-term outcomes. A moderating effect was found only for social functioning, where males with childhood ADHD had difficulties in social functioning, but females with childhood ADHD and controls did not.\n\nIn Chapter 5, we summarized the current literature on childhood predictors of prevalent psychiatric outcomes of adults with a childhood ADHD diagnosis, including ADHD persistence, substance use disorder (SUD), conduct disorder (CD), antisocial personality disorder (ASPD), MDD, and anxiety disorders, by conducting a systematic review and meta-analysis. The meta-analyses showed that adults with childhood ADHD who had a history of childhood stimulant treatment were twice as likely to have persistent ADHD.\n\nIn Chapter 6, we used data from the 18-year follow-up of the IMAGE\/NeuroIMAGE sample to study whether stimulant treatment in childhood could be predictive of a broad range of long-term outcomes. The three groups (early-and-intense, late-and-moderate, and stimulant-na\u00efve) did not differ on most adult outcomes. We found differences for only 3 out of a total of 51 outcome measures (risk perception, cognitive flexibility, and sleep quality). Our results showed that stimulant medication use in childhood is not associated with risks or benefits for most adult outcomes.\n\nFinally, in Chapter 7, we investigated the potential of machine learning in identifying predictors for a) ADHD persistence and b) adult functioning, both assessed 18 years later. The best performing models were the conventional logistic regression for both ADHD persistence (AUC = .56) and long-term functioning (AUC = .59), showing that the more complex machine learning models did not outperform conventional logistic regression. Although all models showed a suboptimal performance, several possibly relevant predictors were suggested including anxiety symptoms, autistic traits, and motor coordination problems.","auteur":"Noa van der Plas","auteur_slug":"noa-van-der-plas","publicatiedatum":"9 september 2026","taal":"EN","url_flipbook":"https:\/\/ebook.proefschriftmaken.nl\/ebook\/noavanderplas?iframe=true","url_download_pdf":"https:\/\/ebook.proefschriftmaken.nl\/download\/f4a6945a-d58f-43c1-8e25-144e1c3e333f\/optimized","url_epub":"","ordernummer":"18111","isbn":"978-94-6534-437-9","doi_nummer":"","naam_universiteit":"Vrije Universiteit Amsterdam","afbeeldingen":16343,"naam_student:":"","binnenwerk":"","universiteit":"Vrije Universiteit Amsterdam","cover":"","afwerking":"","cover_afwerking":"","design":""},"_links":{"self":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/16341","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio"}],"about":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/types\/us_portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/comments?post=16341"}],"version-history":[{"count":1,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/16341\/revisions"}],"predecessor-version":[{"id":16344,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/16341\/revisions\/16344"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media\/16342"}],"wp:attachment":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media?parent=16341"}],"wp:term":[{"taxonomy":"us_portfolio_category","embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio_category?post=16341"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}