Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T06:23:52.378Z Has data issue: false hasContentIssue false

Genetic and environmental influences on adult attention deficit hyperactivity disorder symptoms: a large Swedish population-based study of twins

Published online by Cambridge University Press:  16 August 2012

H. Larsson*
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Karolinska Institutet Center of Neurodevelopmental Disorders, Stockholm, Sweden
P. Asherson
Affiliation:
MRC Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's CollegeLondon, UK
Z. Chang
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
T. Ljung
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
B. Friedrichs
Affiliation:
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
J.-O. Larsson
Affiliation:
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
P. Lichtenstein
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: Dr H. Larsson, Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, PO Box 281, SE-171 77 Stockholm, Sweden. (Email: [email protected])

Abstract

Background

Attention deficit hyperactivity disorder (ADHD) frequently persists into adulthood. Family and twin studies delineate a disorder with strong genetic influences among children and adolescents based on parent- and teacher-reported data but little is known about the genetic and environmental contribution to DSM-IV ADHD symptoms in adulthood. We therefore aimed to investigate the impact of genetic and environmental influences on the inattentive and hyperactive–impulsive symptoms of ADHD in adults.

Method

Twin methods were applied to self-reported assessments of ADHD symptoms from a large population-based Swedish twin study that included data from 15 198 Swedish male and female twins aged 20 to 46 years.

Results

The broad heritability [i.e. A + D, where A is an additive genetic factor and D (dominance) a non-additive genetic factor] was 37% (A = 11%, D = 26%) for inattention and 38% (A = 18%, D = 20%) for hyperactivity–impulsivity. The results also indicate that 52% of the phenotypic correlation between inattention and hyperactivity–impulsivity (r = 0.43) was explained by genetic influences whereas the remaining part of the covariance was explained by non-shared environmental influences. These results were replicated across age strata.

Conclusions

Our findings of moderate broad heritability estimates are consistent with previous literature on self-rated ADHD symptoms in older children, adolescents and adults and retrospective reports of self-rated childhood ADHD by adults but differ from studies of younger children with informant ratings. Future research needs to clarify whether our data indicate a true decrease in the heritability of ADHD in adults compared to children, or whether this relates to the use of self-ratings in contrast to informant data.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, LA, Spencer, T, Faraone, SV, Kessler, RC, Howes, MJ, Biederman, J, Secnik, K (2006). Validity of pilot Adult ADHD Self-Report Scale (ASRS) to rate adult ADHD symptoms. Annals of Clinical Psychiatry 18, 145148.CrossRefGoogle ScholarPubMed
Alberts-Corush, J, Firestone, P, Goodman, JT (1986). Attention and impulsivity characteristics of the biological and adoptive parents of hyperactive and normal control children. American Journal of Orthopsychiatry 56, 413423.CrossRefGoogle ScholarPubMed
Barkley, RA, Fischer, M, Smallish, L, Fletcher, K (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology 111, 279289.CrossRefGoogle ScholarPubMed
Barkley, RA, Murphy, KR, Mariellen, F (2008). ADHD in Adults: What the Science Says. Guilford Press: New York.Google Scholar
Bergen, SE, Gardner, CO, Kendler, KS (2007). Age-related changes in heritability of behavioral phenotypes over adolescence and young adulthood: a meta-analysis. Twin Research and Human Genetics 10, 423433.CrossRefGoogle Scholar
Biederman, J, Faraone, SV, Mick, E, Spencer, T, Wilens, T, Kiely, K, Guite, J, Ablon, JS, Reed, E, Warburton, R (1995). High risk for attention deficit hyperactivity disorder among children of parents with childhood onset of the disorder: a pilot study. American Journal of Psychiatry 152, 431435.Google ScholarPubMed
Biederman, J, Petty, CR, Evans, M, Small, J, Faraone, SV (2010 a). How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Research 177, 299304.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, CR, Monuteaux, MC, Fried, R, Byrne, D, Mirto, T, Spencer, T, Wilens, TE, Faraone, SV (2010 b). Adult psychiatric outcomes of girls with attention deficit hyperactivity disorder: 11-year follow-up in a longitudinal case-control study. American Journal of Psychiatry 167, 409417.CrossRefGoogle Scholar
Boomsma, DI, Saviouk, V, Hottenga, JJ, Distel, MA, de Moor, MH, Vink, JM, Geels, LM, van Beek, JH, Bartels, M, de Geus, EJ, Willemsen, G (2010). Genetic epidemiology of attention deficit hyperactivity disorder (ADHD index) in adults. PloS ONE 5, e10621.CrossRefGoogle ScholarPubMed
Burt, SA (2009). Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychological Bulletin 135, 608637.CrossRefGoogle ScholarPubMed
Curko Kera, EA, Marks, DJ, Berwid, OG, Santra, A, Halperin, JM (2004). Self-report and objective measures of ADHD-related behaviors in parents of preschool children at risk for ADHD. CNS Spectrums 9, 639647.CrossRefGoogle ScholarPubMed
De Los Reyes, A, Kazdin, AE (2005). Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychological Bulletin 131, 483509.CrossRefGoogle ScholarPubMed
Ehringer, MA, Rhee, SH, Young, S, Corley, R, Hewitt, JK (2006). Genetic and environmental contributions to common psychopathologies of childhood and adolescence: a study of twins and their siblings. Journal of Abnormal Child Psychology 34, 117.CrossRefGoogle ScholarPubMed
Epstein, JN, Conners, CK, Erhardt, D, Arnold, LE, Hechtman, L, Hinshaw, SP, Hoza, B, Newcorn, JH, Swanson, JM, Vitiello, B (2000). Familial aggregation of ADHD characteristics. Journal of Abnormal Child Psychology 28, 585594.CrossRefGoogle ScholarPubMed
Faraone, SV, Biederman, J, Mick, E (2006). The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine 36, 159165.CrossRefGoogle ScholarPubMed
Faraone, SV, Biederman, J, Monuteaux, MC (2000). Toward guidelines for pedigree selection in genetic studies of attention deficit hyperactivity disorder. Genetic Epidemiology 18, 116.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Faraone, SV, Perlis, RH, Doyle, AE, Smoller, JW, Goralnick, JJ, Holmgren, MA, Sklar, P (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry 57, 13131323.CrossRefGoogle ScholarPubMed
Freitag, CM, Rohde, LA, Lempp, T, Romanos, M (2010). Phenotypic and measurement influences on heritability estimates in childhood ADHD. European Child and Adolescent Psychiatry 19, 311323.CrossRefGoogle ScholarPubMed
Friedrichs, B, Igl, W, Larsson, H, Larsson, JO (2012). Coexisting psychiatric problems and stressful life events in adults with symptoms of ADHD – a large Swedish population-based study of twins. Journal of Attention Disorders 16, 1322.CrossRefGoogle ScholarPubMed
Frisell, T, Lichtenstein, P, Rahman, Q, Langstrom, N (2010). Psychiatric morbidity associated with same-sex sexual behaviour: influence of minority stress and familial factors. Psychological Medicine 40, 315324.CrossRefGoogle ScholarPubMed
Furberg, H, Lichtenstein, P, Pedersen, NL, Thornton, L, Bulik, CM, Lerman, C, Sullivan, PF (2008). The STAGE cohort: a prospective study of tobacco use among Swedish twins. Nicotine and Tobacco Research 10, 17271735.CrossRefGoogle ScholarPubMed
Goodman, R (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry 38, 581586.CrossRefGoogle ScholarPubMed
Haberstick, BC, Timberlake, D, Hopfer, CJ, Lessem, JM, Ehringer, MA, Hewitt, JK (2008). Genetic and environmental contributions to retrospectively reported DSM-IV childhood attention deficit hyperactivity disorder. Psychological Medicine 38, 10571066.CrossRefGoogle ScholarPubMed
Hudziak, JJ, Derks, EM, Althoff, RR, Rettew, DC, Boomsma, DI (2005). The genetic and environmental contributions to attention deficit hyperactivity disorder as measured by the Conners' Rating Scales – Revised. American Journal of Psychiatry 162, 16141620.CrossRefGoogle ScholarPubMed
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163, 716723.CrossRefGoogle ScholarPubMed
Kuntsi, J, Rijsdijk, F, Ronald, A, Asherson, P, Plomin, R (2005). Genetic influences on the stability of attention-deficit/hyperactivity disorder symptoms from early to middle childhood. Biological Psychiatry 57, 647654.CrossRefGoogle ScholarPubMed
Larsson, H, Lichtenstein, P, Larsson, JO (2006). Genetic contributions to the development of ADHD subtypes from childhood to adolescence. Journal of the American Academy of Child and Adolescent Psychiatry 45, 973981.CrossRefGoogle Scholar
Larsson, JO, Larsson, H, Lichtenstein, P (2004). Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study. Journal of the American Academy of Child and Adolescent Psychiatry 43, 12671275.CrossRefGoogle ScholarPubMed
Levy, F, Hay, DA, McStephen, M, Wood, C, Waldman, I (1997). Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study. Journal of the American Academy of Child and Adolescent Psychiatry 36, 737744.CrossRefGoogle ScholarPubMed
Lichtenstein, P, Sullivan, PF, Cnattingius, S, Gatz, M, Johansson, S, Carlstrom, E, Bjork, C, Svartengren, M, Wolk, A, Klareskog, L, de Faire, U, Schalling, M, Palmgren, J, Pedersen, NL (2006). The Swedish Twin Registry in the third millennium: an update. Twin Research and Human Genetics 9, 875882.CrossRefGoogle ScholarPubMed
Loeber, R, Green, SM, Lahey, BB, Stouthamer-Loeber, M (1991). Differences and similarities between children, mothers, and teachers as informants on disruptive child behavior. Journal of Abnormal Child Psychology 19, 7595.CrossRefGoogle ScholarPubMed
Martin, N, Scourfield, J, McGuffin, P (2002). Observer effects and heritability of childhood attention-deficit hyperactivity disorder symptoms. British Journal of Psychiatry 180, 260265.CrossRefGoogle ScholarPubMed
McLoughlin, G, Ronald, A, Kuntsi, J, Asherson, P, Plomin, R (2007). Genetic support for the dual nature of attention deficit hyperactivity disorder: substantial genetic overlap between the inattentive and hyperactive-impulsive components. Journal of Abnormal Child Psychology 35, 9991008.CrossRefGoogle ScholarPubMed
Murphy, P, Schachar, R (2000). Use of self-ratings in the assessment of symptoms of attention deficit hyperactivity disorder in adults. American Journal of Psychiatry 157, 11561159.CrossRefGoogle ScholarPubMed
Neale, MC, Boker, SM, Xie, G, Maes, HH (2003). Mx Statistical Modeling. Department of Psychiatry, Virginia Commonwealth University: Richmond, VA.Google Scholar
Neale, MC, Roysamb, E, Jacobson, K (2006). Multivariate genetic analysis of sex limitation and G × E interaction. Twin Research and Human Genetics 9, 481489.CrossRefGoogle Scholar
Nikolas, MA, Burt, SA (2010). Genetic and environmental influences on ADHD symptom dimensions of inattention and hyperactivity: a meta-analysis. Journal of Abnormal Psychology 119, 117.CrossRefGoogle ScholarPubMed
Plomin, R, DeFries, J, McClearn, G, McGuffin, P (2008). Behavioral Genetics. Worth Publishers: New York.Google Scholar
Rhee, SH, Waldman, ID, Hay, DA, Levy, F (1999). Sex differences in genetic and environmental influences on DSM-III-R attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology 108, 2441.CrossRefGoogle ScholarPubMed
Rietveld, MJ, Hudziak, JJ, Bartels, M, van Beijsterveldt, CE, Boomsma, DI (2003). Heritability of attention problems in children: I. Cross-sectional results from a study of twins, age 3–12 years. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 117B, 102113.CrossRefGoogle ScholarPubMed
Rietveld, MJ, Hudziak, JJ, Bartels, M, van Beijsterveldt, CE, Boomsma, DI (2004). Heritability of attention problems in children: longitudinal results from a study of twins, age 3 to 12. Journal of Child Psychology and Psychiatry 45, 577588.CrossRefGoogle ScholarPubMed
Sandra Kooij, JJ, Marije Boonstra, A, Swinkels, SH, Bekker, EM, de Noord, I, Buitelaar, JK (2008). Reliability, validity, and utility of instruments for self-report and informant report concerning symptoms of ADHD in adult patients. Journal of Attention Disorders 11, 445458.CrossRefGoogle ScholarPubMed
Saviouk, V, Hottenga, JJ, Slagboom, EP, Distel, MA, de Geus, EJ, Willemsen, G, Boomsma, DI (2011). ADHD in Dutch adults: heritability and linkage study. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 156B, 352362.CrossRefGoogle ScholarPubMed
Schultz, MR, Rabi, K, Faraone, SV, Kremen, W, Lyons, MJ (2006). Efficacy of retrospective recall of attention-deficit hyperactivity disorder symptoms: a twin study. Twin Research and Human Genetics 9, 220232.CrossRefGoogle ScholarPubMed
Statistics Sweden (2011). Educational Attainment of the Population 2010. Statistics Sweden: Stockholm.Google Scholar
Thapar, A, Harrington, R, Ross, K, McGuffin, P (2000). Does the definition of ADHD affect heritability? Journal of the American Academy of Child and Adolescent Psychiatry 39, 15281536.CrossRefGoogle ScholarPubMed
van den Berg, SM, Willemsen, G, de Geus, EJ, Boomsma, DI (2006). Genetic etiology of stability of attention problems in young adulthood. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 141B, 5560.CrossRefGoogle ScholarPubMed
Wilens, TE, Faraone, SV, Biederman, J (2004). Attention-deficit/hyperactivity disorder in adults. Journal of the American Medical Association 292, 619623.CrossRefGoogle ScholarPubMed
Supplementary material: File

Larsson supplementary material

Larsson supplementary material

Download Larsson supplementary material(File)
File 32.3 KB