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Developmental trajectories of DSM-IV symptoms of attention-deficit/hyperactivity disorder: genetic effects, family risk and associated psychopathology
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Karolinska Institutet Center for Neurodevelopmental Disorders, Stockholm, Sweden.ORCID iD: 0000-0002-6851-3297
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Developmental Science, Birkbeck College, University of London.
2011 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 52, no 9, p. 954-963Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: DSM-IV specifies three ADHD subtypes; the combined, the hyperactive-impulsive and the inattentive. Little is known about the developmental relationships underlying these subtypes. The objective of this study was to describe the development of parent-reported hyperactivity-impulsivity and inattention symptoms from childhood to adolescence and to study their associations with genetic factors, family risk, and later adjustment problems in early adulthood.

METHOD: Data in this study comes from 1,450 twin pairs participating in a population-based, longitudinal twin study. Developmental trajectories were defined using parent-ratings of hyperactivity-impulsivity and inattention symptoms at age 8-9, 13-14, and 16-17. Twin methods were used to explore genetic influences on trajectories. Family risk measures included low socioeconomic status, large family size and divorce. Self-ratings of externalizing and internalizing problems in early adulthood were used to examine adjustment problems related to the different trajectory combinations.

RESULTS: We found two hyperactivity-impulsivity trajectories (low, high/decreasing) and two inattention trajectories (low, high/increasing). Twin modeling revealed a substantial genetic component underlying both the hyperactivity-impulsivity and the inattention trajectory. Joint trajectory analyses identified four groups of adolescents with distinct developmental patterns of hyperactivity-impulsivity and inattention: a low/low group, a primarily hyperactive, a primarily inattentive and a combined (high/high) trajectory type. These trajectory combinations showed discriminant relations to adjustment problems in early adulthood. The hyperactive, inattentive and combined trajectory subtypes were associated with higher rates of family risk environments compared to the low/low group.

CONCLUSION: Study results showed that for those on a high trajectory, hyperactivity decreased whereas inattention increased. The combinations of these trajectories lend developmental insight into how children shift from (i) a combined to inattentive subtype, and (ii) a hyperactive-impulsive to a combined subtype. This study suggests that ADHD subtypes cannot be viewed as discrete and stable categories.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011. Vol. 52, no 9, p. 954-963
Keyword [en]
ADHD; twins; family factors; comorbidity; development
National Category
Psychology Psychiatry
Research subject
Psychology; Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-54527DOI: 10.1111/j.1469-7610.2011.02379.xISI: 000294282100007PubMedID: 21434915Scopus ID: 2-s2.0-79960954270OAI: oai:DiVA.org:oru-54527DiVA, id: diva2:1064321
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilThe Swedish Brain Foundation
Note

Funding Agency:

Karolinska Institutet Center of Neurodevelopmental Disorders

Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2017-11-29Bibliographically approved

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