Genetic Influence on Parent-Reported Attention-Related Problems in a Norwegian General Population Twin Sample

doi:10.1097/00004583-199605000-00013

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 35, Issue 5, May 1996, Pages 588-598

https://doi.org/10.1097/00004583-199605000-00013 Get rights and content

ABSTRACT

Objective

To assess the genetic and environmental influences on attention problems in a general population twin sample and to investigate whether there are changes in the relative genetic influence on attention problems with increasing severity.

Method

Parental ratings of the Child Behavior Checklist were collected from five Norwegian national cohorts of same-sex twins. The sample comprises 526 identical and 389 fraternal pairs.

Results

Considerable genetic influence on attention problems was found for both sexes and across age groups (aged 5 to 9 years and 12 to 15 years). A two-parameter model with additive genetic influence and nonshared environment showed a good fit, with heritability ranging from .73 in boys aged 5 to 9 years, to .76 in girls aged 5 to 9 years. There was no change in the relative genetic influence across severity after accounting for the influence of cerebral palsy, epilepsy, and low birth weight.

Conclusion

The results indicate a substantial genetic influence on attention problems across sex, age, and severity.

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A barrier to understanding this disorder is that ADHD is polygenic and associated with multiple small-effect gene variants. ADHD is ∼80 % heritable with ∼75 % monozygotic twin concordance in cases where environmental risks are not shared (Coolidge et al., 2000; Faraone et al., 2005; Gillis et al., 1992; Gjone et al., 1996; Levy et al., 1997; Matheny and Brown, 1971). Twin and adoption studies show genetic overlap between ADHD and other conditions, including cognitive impairment, autism spectrum disorder, bipolar disorder, and major depressive disorder (Andersson and Tuvblad, 2020; Angold and Costello, 1993; Coolidge et al., 2000; Faraone et al., 2005; Hudziak et al., 2000; Jacob et al., 2007; Leitner, 2014; Martin et al., 2006; Mulligan et al., 2009; Rommelse et al., 2010; Sandstrom et al., 2021; Schiweck et al., 2021; Singh et al., 2006).
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These results indicate genetic overlap between a diagnosis of ADHD and AP scale scores across raters and age groups and provides evidence for a dimensional model of ADHD. Future GWA studies on ADHD can likely benefit from the inclusion of population-based cohorts and the analysis of continuous scores.
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Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent childhood psychiatric disorders. Most children with the disorder continue to exhibit significant symptoms as adults as well. Symptoms include inattention, hyperactivity or restlessness, and poor impulse control. ADHD is associated with a strong genetic component via twin, adoption, and family pedigree studies. Molecular genetic study findings, however, suggest genetic heterogeneity underlying similar ADHD phenotypes with support for many genes with only small effects typically contributing to the disorder. Both the dopaminergic and noradrenergic system appear to be altered in ADHD. Structural and functional alterations in frontal and cingulate cortices, basal ganglia, and cerebellar regions are routinely found in ADHD. These altered neurotransmitter systems and neuroanatomical regions subserve cognitive control and reward responsivity functioning – processes that are impaired in ADHD. Current recommendations for evaluating ADHD include the use of interviews and cross-informant and normed rating scales for children and adults with suspected ADHD. Possible comorbid disorders or disorders that may mimic ADHD should also be evaluated. The efficacy of pharmacological treatment for children and adults is well established. Stimulant medications are the recommended first-line psychopharmacological treatment of ADHD; however there are nonstimulant medications that are efficacious in treating ADHD and associated symptoms. School and parent-based behavioral interventions for ADHD can also address ADHD-associated symptoms in children. The benefits of medication or behavioral interventions may not be sustained after active treatment and monitoring of the treatment cease. There is initial support for the application of cognitive-behavioral treatment of ADHD symptoms in adults. Future research should attempt more targeted treatment informed by advances in neuroscience findings.
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: This work was supported by grants from the Norwegian Research Council, Anders Jahres Foundation, Solveig and Johan P. Sommers Foundation, and the Norwegian Centre for Child Research. The Medical Birth Register of Norway is acknowledged for providing the twin sample.

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ARTICLESGenetic Influence on Parent-Reported Attention-Related Problems in a Norwegian General Population Twin Sample

ABSTRACT

Objective

Method

Results

Conclusion

J Am Acad Child Adolesc Psychiatry

Manual for the Child Behavior Checklist/2–3 and 1992 Profile

Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)

Genes, personality, and psychopathology: a latent class analysis of liability to symptoms of attention-deficit hyperactivity disorder in twins

Genetics of attention-deficit hyperactivity disorder

Child Adolesc Psychiatr Clin North Am

Segregation analysis of attention deficit hyperactivity disorder: evidence for single gene transmission

Psychiatr Genet

ARTICLES
Genetic Influence on Parent-Reported Attention-Related Problems in a Norwegian General Population Twin Sample