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Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs.

Larsson, Henrik; Anckarsäter, Henrik LU ; Råstam, Maria LU ; Chang, Zheng and Lichtenstein, Paul (2012) In Journal of Child Psychology and Psychiatry and Allied Disciplines 53(1). p.73-80
Abstract
Background: Although the clinical utility of categorically defined attention-deficit hyperactivity disorder (ADHD) is well established, there is also strong evidence supporting the notion of ADHD as an extreme of a continuous trait. Nevertheless, the question of whether the etiology is the same for different levels of DSM-IV ADHD symptoms remains to be investigated. The aim of this study was to assess genetic links between the extreme and the subthreshold range of ADHD symptoms. Method: Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV ADHD symptoms and associated conditions. Two validated cutoff values were used for screening and assigning research diagnoses. Response rate was 80%. Twin... (More)
Background: Although the clinical utility of categorically defined attention-deficit hyperactivity disorder (ADHD) is well established, there is also strong evidence supporting the notion of ADHD as an extreme of a continuous trait. Nevertheless, the question of whether the etiology is the same for different levels of DSM-IV ADHD symptoms remains to be investigated. The aim of this study was to assess genetic links between the extreme and the subthreshold range of ADHD symptoms. Method: Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV ADHD symptoms and associated conditions. Two validated cutoff values were used for screening and assigning research diagnoses. Response rate was 80%. Twin methods were applied to investigate the extent to which ADHD is etiologically distinct from subthreshold variations in ADHD symptoms. Results: Extremes analyses indicated a strong genetic link between the extreme and the subthreshold variation, with almost identical group heritability estimates around .60 for the diagnostic (prevalence 1.78%) and screening (prevalence 9.75%) criteria of ADHD. Conclusion: A strong genetic link between the extreme and the subthreshold variation of DSM-IV based assessments of ADHD symptoms was found. The data suggest that ADHD is best viewed as the quantitative extreme of genetic and environmental factors operating dimensionally throughout the distribution of ADHD symptoms, indicating that the same etiologic factors are involved in the full range of symptoms of inattention, hyperactivity and impulsivity. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ADHD, DSM, etiology, twins
in
Journal of Child Psychology and Psychiatry and Allied Disciplines
volume
53
issue
1
pages
73 - 80
publisher
Wiley-Blackwell
external identifiers
  • wos:000298003300010
  • pmid:21923806
  • scopus:82955203855
ISSN
1469-7610
DOI
10.1111/j.1469-7610.2011.02467.x
language
English
LU publication?
yes
id
f8c0b1af-5897-4a1f-a5dd-184f8d570750 (old id 2168851)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21923806?dopt=Abstract
date added to LUP
2011-10-03 11:13:06
date last changed
2017-09-10 04:45:59
@article{f8c0b1af-5897-4a1f-a5dd-184f8d570750,
  abstract     = {Background: Although the clinical utility of categorically defined attention-deficit hyperactivity disorder (ADHD) is well established, there is also strong evidence supporting the notion of ADHD as an extreme of a continuous trait. Nevertheless, the question of whether the etiology is the same for different levels of DSM-IV ADHD symptoms remains to be investigated. The aim of this study was to assess genetic links between the extreme and the subthreshold range of ADHD symptoms. Method: Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV ADHD symptoms and associated conditions. Two validated cutoff values were used for screening and assigning research diagnoses. Response rate was 80%. Twin methods were applied to investigate the extent to which ADHD is etiologically distinct from subthreshold variations in ADHD symptoms. Results: Extremes analyses indicated a strong genetic link between the extreme and the subthreshold variation, with almost identical group heritability estimates around .60 for the diagnostic (prevalence 1.78%) and screening (prevalence 9.75%) criteria of ADHD. Conclusion: A strong genetic link between the extreme and the subthreshold variation of DSM-IV based assessments of ADHD symptoms was found. The data suggest that ADHD is best viewed as the quantitative extreme of genetic and environmental factors operating dimensionally throughout the distribution of ADHD symptoms, indicating that the same etiologic factors are involved in the full range of symptoms of inattention, hyperactivity and impulsivity.},
  author       = {Larsson, Henrik and Anckarsäter, Henrik and Råstam, Maria and Chang, Zheng and Lichtenstein, Paul},
  issn         = {1469-7610},
  keyword      = {ADHD,DSM,etiology,twins},
  language     = {eng},
  number       = {1},
  pages        = {73--80},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Child Psychology and Psychiatry and Allied Disciplines},
  title        = {Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs.},
  url          = {http://dx.doi.org/10.1111/j.1469-7610.2011.02467.x},
  volume       = {53},
  year         = {2012},
}