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Codevelopment of ADHD and externalizing behavior from childhood to adulthood
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Psychological and Brain Sciences, Indiana University, Bloomington IN, USA.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6851-3297
2015 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 56, no 6, p. 640-647Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) frequently co-occurs with externalizing disorders, but a clear understanding of the etiologic underpinnings is hampered by the limited understanding of the codevelopment of the traits from childhood into early adulthood.

METHODS: Using a birth cohort of 2600 twins, the Swedish Twin study of Child and Adolescent Development study, assessed at ages 8-9, 13-14, 16-17, and 19-20, we investigated the codevelopment of ADHD and externalizing behavior from childhood to adulthood. The analyses examined ADHD-like and externalizing traits, as rated by twins and their parents using the Attention Problems scale and Externalizing scale of the Child Behavior Checklist, and estimated cross-lagged effects (one trait at one time-point predicting the other at the next). The covariation between the traits were decomposed into stable (effects carried over from the prior time-points) and innovative (new effects for each time-point) sources; each source was further decomposed into additive genetics, shared and nonshared environment.

RESULTS: The analysis suggested that externalizing traits in middle childhood (age 8-9) predicted ADHD-like traits in early adolescence (age 13-14), whereas the reverse association was nonsignificant. In contrast, ADHD-like traits in lateadolescence (age 16-17) predicted externalizing traits in early adulthood (age 19-20). The correlation between ADHD-like and externalizing traits increased over time. At all time-points, innovative sources contributed substantially to maintained comorbidity. Genetic effects explained 67% of the covariation at each time-point; importantly, nearly 50% of these effects were innovative.

CONCLUSIONS: This study challenges the belief that ADHD generally precedes externalizing behaviors; rather, change in the etiologic factors across the development is the rule. The effects were due to both new genetic and environmental factors emerging up to young adulthood. Clinicians and researchers needs to consider complex etiologic and developmental models for the comorbidity between ADHD and externalizing behaviors.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 56, no 6, p. 640-647
Keywords [en]
ADHD; antisocial behavior; longitudinal studies; comorbidity; genetics; behavioral
National Category
Psychology Psychiatry
Research subject
Psychology; Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-54615DOI: 10.1111/jcpp.12340ISI: 000354464300005PubMedID: 25303006Scopus ID: 2-s2.0-84929164076OAI: oai:DiVA.org:oru-54615DiVA, id: diva2:1064449
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) 340-2013-5867

National Institute of Child Health and Human Development HD061817

Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2018-07-05Bibliographically approved

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