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Is There a Female Protective Effect Against Attention-Deficit/Hyperactivity Disorder? Evidence From Two Representative Twin Samples
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6851-3297
Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden.
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2016 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 55, no 6, 504-512 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Attention-deficit/hyperactivity disorder (ADHD) is more frequent in males than in females. The "female protective effect" posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested whether cotwins of females displaying extreme ADHD traits would display more ADHD traits than cotwins of males displaying extreme ADHD traits.

Method: Parents of approximately 7,000 pairs of nonidentical twins in Sweden, and approximately 4,000 pairs of twins in England and Wales, completed dimensional assessments of ADHD traits. Probands were selected on the basis of scoring within the highest 10% of the distribution in each sample. Dimensional scores of cotwins of probands, as well as the categorical recurrence rate, were investigated by proband sex.

Results: Cotwins of female probands displayed higher mean ADHD trait scores (mean = 0.62-0.79) than cotwins of male probands (mean = 0.38-0.55) in both samples. This trend was significant in the Swedish sample (p < .01) and when the 2 samples were merged into a single, larger sample (p < .001). When the samples were merged, there was also a significant association between proband sex and cotwin's categorical status, with more cotwins of female probands also being probands than cotwins of male probands.

Conclusion: These findings support a female protective effect against ADHD behaviors, suggesting that females require greater exposure to genetic and environmental factors associated with ADHD in order to develop the condition.

Place, publisher, year, edition, pages
New York, USA: Elsevier, 2016. Vol. 55, no 6, 504-512 p.
Keyword [en]
ADHD, sex differences, genetics, twin study
National Category
Medical and Health Sciences Psychiatry Pediatrics Psychology
Identifiers
URN: urn:nbn:se:oru:diva-54631DOI: 10.1016/j.jaac.2016.04.004ISI: 000377424300010PubMedID: 27238069Scopus ID: 2-s2.0-84991222355OAI: oai:DiVA.org:oru-54631DiVA: diva2:1064479
Note

Funding Agency:

Swedish Council for Health, Working Life and Welfare and the Swedish Research Council Twins Early Development Study (TEDS) - Medical Research Council 

Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2017-10-18Bibliographically approved

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CiteExportLink to record
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Citation style
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