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Attentional Control Explains Covariation Between Symptoms of Attention-Deficit/Hyperactivity Disorder and Anxiety During Adolescence.

ABSTRACT: Symptoms of attention-deficit/hyperactivity disorder (ADHD) and anxiety are common during adolescence and frequently co-occur. However, the genetic and environmental influences that underlie this co-occurrence are understudied. Using a large twin sample (N = 1,017), we examined cross-sectional genetic and environmental influences on ADHD and anxiety symptoms during childhood. We also explored whether these influences were shared with attentional control, a putative mechanism for symptom comorbidity. We found evidence for common genetic and nonshared environmental influences on the covariation among attentional control, ADHD, and anxiety symptoms, supporting the putative role of attentional control as a mechanism by which comorbid problems may develop. Genetic factors also accounted for symptom co-occurrence after controlling for covariation with attentional control, suggesting the presence of additional unmeasured mechanisms.

SUBMITTER: Brooker RJ

PROVIDER: S-EPMC6858492 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Attentional Control Explains Covariation Between Symptoms of Attention-Deficit/Hyperactivity Disorder and Anxiety During Adolescence.

Brooker Rebecca J RJ Moore Mollie N MN Van Hulle Carol A CA Beekman Charles R CR Begnoche J Patrick JP Lemery-Chalfant Kathryn K Goldsmith H Hill HH

Journal of research on adolescence : the official journal of the Society for Research on Adolescence 20190516 1

Symptoms of attention-deficit/hyperactivity disorder (ADHD) and anxiety are common during adolescence and frequently co-occur. However, the genetic and environmental influences that underlie this co-occurrence are understudied. Using a large twin sample (N = 1,017), we examined cross-sectional genetic and environmental influences on ADHD and anxiety symptoms during childhood. We also explored whether these influences were shared with attentional control, a putative mechanism for symptom comorbid ...[more]

PMID: 31095814

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Project description:BackgroundChildren with autism spectrum disorder (ASD) often have co-occurring symptoms of attention-deficit/hyperactivity disorder (ADHD) and/or anxiety. It is unclear whether these disorders arise from shared or distinct developmental pathways. We explored this question by testing the specificity of early-life (infant and toddler) predictors of mid-childhood ADHD and anxiety symptoms compared to ASD symptoms.MethodsInfants (n = 104) at high and low familial risk for ASD took part in research assessments at 7, 14, 24 and 38 months, and 7 years of age. Symptoms of ASD, ADHD and anxiety were measured by parent report at age 7. Activity levels and inhibitory control, also measured by parent report, in infancy and toddlerhood were used as early-life predictors of ADHD symptoms. Fearfulness and shyness measured in infancy and toddlerhood were used as early-life predictors of anxiety symptoms. Correlations and path analysis models tested associations between early-life predictors and mid-childhood ADHD and anxiety symptoms compared to mid-childhood ASD symptoms, and the influence of controlling for ASD symptoms on those associations.ResultsIncreased activity levels and poor inhibitory control were correlated with ADHD symptoms and not ASD or anxiety; these associations were unchanged in path models controlling for risk-group and ASD symptoms. Increased fearfulness and shyness were correlated with anxiety symptoms, but also ASD symptoms. When controlling for risk-group in path analysis, the association between shyness and anxiety became nonsignificant, and when further controlling for ASD symptoms the association between fearfulness and anxiety became marginal.ConclusionsThe specificity of early-life predictors to ADHD symptoms suggests early developmental pathways to ADHD might be distinct from ASD. The overlap in early-life predictors of anxiety and ASD suggests that these disorders are difficult to differentiate early in life, which could reflect the presence of common developmental pathways or convergence in early behavioural manifestations of these disorders.

Project description:Background:For the diagnosis of attention-deficit/hyperactivity disorder (ADHD), the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes that adherence to six symptoms in either group (inattention and hyperactivity/impulsivity) will lead to the diagnosis of one of three presentations of the disorder. Underlying this diagnostic algorithm is the assumption that the 18 symptoms have equal relevance for the diagnosis of ADHD, all are equally severe, and all have the same power to detect the presence of the disorder in all its degrees of severity, without considering the possibility of using marker symptoms. However, several studies have suggested that ADHD symptoms differ in both their power to discriminate the presence of the disorder and the degree of severity they represent. The aim of the present study was to replicate the results of previous research by evaluating the discriminative capacity and relative severity of ADHD symptoms, as well as to extend the investigation of this topic to Spanish-speaking Latin American samples. Methods:The properties of ADHD symptoms rated by the parents of 474 Chilean children were analyzed. Symptom parameters were estimated using the graded response model. Results:The results suggest that symptoms of ADHD differ substantially in both the accuracy with which they reflect the presence of the disorder, and their relative severity. Symptoms "easily distracted by extraneous stimuli" and "have difficulty sustaining attention in tasks" (inattention) and "is on the go, acting as if driven by motor" (hyperactivity/impulsivity) were the most informative, and those with relatively lower severity thresholds. Discussion:The fact that symptoms differ substantially in the probability of being observed conditionally to the trait level suggests the need to refine the diagnostic process by weighting the severity of the symptom, and even to assess the possibility of defining ADHD marker symptoms, as has been done in other disorders.

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Attentional Control Explains Covariation Between Symptoms of Attention-Deficit/Hyperactivity Disorder and Anxiety During Adolescence.

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Attentional Control Explains Covariation Between Symptoms of Attention-Deficit/Hyperactivity Disorder and Anxiety During Adolescence.

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