scholarly journals Overlap between attention-deficit hyperactivity disorder and neurodevelopmental, externalising and internalising disorders: separating unique from general psychopathology effects

2020 ◽  
Vol 218 (1) ◽  
pp. 35-42
Author(s):  
Ebba Du Rietz ◽  
Erik Pettersson ◽  
Isabell Brikell ◽  
Laura Ghirardi ◽  
Qi Chen ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Environmental Effects ◽  
Attention Deficit ◽  
Specific Factor ◽  
General Factor ◽  
General Psychopathology ◽  
Sibling Pairs ◽  
Hyperactivity Disorder ◽  
Factor Analytic Model ◽  
Internalising Disorders

BackgroundAlthough attention-deficit hyperactivity disorder (ADHD) is classified as a neurodevelopmental disorder in the latest diagnostic manuals, it shows phenotypic and genetic associations of similar magnitudes across neurodevelopmental, externalising and internalising disorders.AimsTo investigate if ADHD is aetiologically more closely related to neurodevelopmental than externalising or internalising disorder clusters, after accounting for a general psychopathology factor.MethodFull and maternal half-sibling pairs (N = 774 416), born between 1980 and 1995, were identified from the Swedish Medical Birth and Multi-Generation Registers, and ICD diagnoses were obtained from the Swedish National Patient Register. A higher-order confirmatory factor analytic model was fitted to examine associations between ADHD and a general psychopathology factor, as well as a neurodevelopmental, externalising and internalising subfactor. Quantitative genetic modelling was performed to estimate the extent to which genetic, shared and non-shared environmental effects influenced the associations with ADHD.ResultsADHD was significantly and strongly associated with all three factors (r = 0.67–0.75). However, after controlling for a general psychopathology factor, only the association between ADHD and the neurodevelopmental-specific factor remained moderately strong (r = 0.43, 95% CI = 0.42–0.45) and was almost entirely influenced by genetic effects. In contrast, the association between ADHD and the externalising-specific factor was smaller (r = 0.25, 95% CI = 0.24–0.27), and largely influenced by non-shared environmental effects. There remained no internalising-specific factor after accounting for a general factor.ConclusionsFindings suggest that ADHD comorbidity is largely explained by genetically influenced general psychopathology, but the strong link between ADHD and other neurodevelopmental disorders is also substantially driven by unique genetic influences.

scholarly journals ADHD is more closely linked to neurodevelopmental than externalizing and internalizing disorders: A genetically informed multivariate Swedish population study

2020 ◽  
Author(s):  
Ebba Du Rietz ◽  
Erik Pettersson ◽  
Isabell Brikell ◽  
Laura Ghirardi ◽  
Qi Chen ◽  
...  
Keyword(s):  
Environmental Effects ◽  
Neurodevelopmental Disorder ◽  
Internalizing Disorders ◽  
Specific Factor ◽  
General Factor ◽  
Genetic Associations ◽  
Swedish Population ◽  
General Psychopathology ◽  
Sibling Pairs ◽  
Factor Analytic Model

AbstractBackgroundWhile ADHD is currently classified as a neurodevelopmental disorder in the latest diagnostic manuals, the disorder shows phenotypic and genetic associations of similar magnitudes across neurodevelopmental, externalizing and internalizing disorders. This study aimed to investigate if ADHD is etiologically more closely related to neurodevelopmental than externalizing or internalizing disorder clusters after accounting for a general psychopathology factor.MethodsFull- and maternal half-sibling pairs (N=774,416), born between 1980 and 1995, were identified from the Swedish Medical Birth and Multi-Generation Registers, and ICD-diagnoses were obtained using the Swedish National Patient Register. A higher-order confirmatory factor analytic model was performed to examine associations between ADHD and a general psychopathology factor as well as a neurodevelopmental, externalizing, and internalizing subfactor. Quantitative genetic modelling was performed to estimate the extent to which genetic, shared and non-shared environmental effects influenced the associations with ADHD.ResultsADHD was significantly and strongly associated with all three neurodevelopmental, externalizing and internalizing factors (r=0.67-0.75). However, after controlling for a general psychopathology factor, only the association between ADHD and the neurodevelopmental-specific factor remained moderately strong (r=0.43, 95%Confidence Interval [CI]=0.42-0.45) and was almost entirely influenced by genetic effects. In contrast, the association between ADHD and the externalizing-specific factor was smaller (r=0.25, 95%CI=0.24-0.27), and largely influenced by non-shared environmental effects. There remained no internalizing-specific factor after accounting for a general factor.ConclusionsADHD comorbidity is largely explained by genetically influenced general psychopathology, but the strong link between ADHD and other neurodevelopmental disorders is also substantially driven by unique genetic influences.

scholarly journals Does Cannabis, Cocaine and Alcohol Use Impact Differently on Adult Attention Deficit/Hyperactivity Disorder Clinical Picture?

2021 ◽  
Vol 10 (7) ◽  
pp. 1481
Author(s):  
Vincenza Spera ◽  
Alessandro Pallucchini ◽  
Marco Carli ◽  
Marco Maiello ◽  
Angelo G. I. Maremmani ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Substance Use ◽  
Attention Deficit ◽  
General Psychopathology ◽  
Hyperactivity Disorder ◽  
Legal Problems ◽  
Dual Disorder ◽  
Adhd Subtype

While the association between adult Attention Deficit/Hyperactivity Disorder (A-ADHD) and Substance Use Disorders (SUDs) has been widely explored, less attention has been dedicated to the various substance use variants. In a previous paper, we identified two variants: type 1 (use of stimulants/alcohol) and type 2 (use of cannabinoids). In this study, we compared demographic, clinical and symptomatologic features between Dual Disorder A-ADHD (DD/A-ADHD) patients according to our substance use typology, and A-ADHD without DD (NDD/A-ADHD) ones. NDD patients were more frequently diagnosed as belonging to inattentive ADHD subtype compared with type 1 DD/A-ADHD patients, but not with respect to type 2 DD/ADHD. NDD/A-ADHD patients showed less severe symptoms of hyperactivity/impulsivity than DD/A-ADHD type 1, but not type 2. Type 1 and type 2 patients shared the feature of displaying higher impulsiveness than NDD/A-ADHD ones. General psychopathology scores were more severe in type 2 DD/ADHD patients, whereas type 1 patients showed greater similarity to NDD/A-ADHD. Legal problems were more strongly represented in type 1 than in type 2 patients or NDD/A-ADHD ones. Our results suggest that type 1 and type 2 substance use differ in their effects on A-ADHD patients—an outcome that brings with it different likely implications in dealing with the diagnostic and therapeutic processes.

Long-term risk of epilepsy, cerebral palsy and attention-deficit/hyperactivity disorder in children affected by a threatened abortion in utero

2021 ◽  
Author(s):  
Elena Dudukina ◽  
Erzsébet Horváth-Puhó ◽  
Henrik Toft Sørensen ◽  
Vera Ehrenstein
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cerebral Palsy ◽  
Attention Deficit ◽  
Cox Regression ◽  
In Utero ◽  
Autism Spectrum ◽  
Sibling Pairs ◽  
Hyperactivity Disorder ◽  
Hazard Ratios ◽  
Threatened Abortion

Abstract Background The birth of a child affected by a threatened abortion (TAB) in utero is associated with autism spectrum disorder; association with other neurological disorders is unknown. Methods This nationwide registry-based cohort study included singletons live-born in Denmark (1979–2010), followed through 2016. The outcomes were epilepsy, cerebral palsy (CP) and attention-deficit/hyperactivity disorder (ADHD). We used Cox regression to compute hazard ratios (HRs), adjusted for birth year, birth order, parental age, morbidity, medication use and maternal socio-economic factors. To remove time-invariant family-shared confounding, we applied sibling analyses. Results The study population included 1 864 221 singletons live-born in 1979–2010. Among the TAB-affected children (N = 59 134) vs TAB-unaffected children, at the end of follow-up, the cumulative incidence was 2.2% vs 1.6% for epilepsy, 0.4% vs 0.2% for CP and 5.5% vs 4.2% for ADHD (for children born in 1995–2010). The adjusted HRs were 1.25 [95% confidence interval (CI) 1.16–1.34] for epilepsy, 1.42 (95% CI 1.20–1.68) for CP and 1.21 (95% CI 1.14–1.29) for ADHD. In the sibling design, the adjusted HRs were unity for epilepsy (full siblings: 0.96, 95% CI 0.82–1.12; maternal: 1.04, 95% CI 0.90–1.20; paternal: 1.08, 95% CI 0.93–1.25) and ADHD (full: 1.08, 95% CI 0.92–1.27; maternal: 1.04, 95% CI 0.90–1.20; paternal: 1.08, 95% CI 0.93–1.25). For CP, HRs shifted away from unity among sibling pairs (full: 2.92, 95% CI 1.33–6.39; maternal: 2.03, 95% CI 1.15–3.57; paternal: 3.28, 95% CI 1.36–7.91). Conclusions The birth of a child affected by TAB in utero was associated with a greater risk of CP, but not epilepsy or ADHD.

Bifactor Models of Attention-Deficit/Hyperactivity Disorder (ADHD): An Evaluation of Three Necessary but Underused Psychometric Indexes

Assessment ◽  
2016 ◽  
Vol 25 (7) ◽  
pp. 885-897 ◽  
Author(s):  
Víctor B. Arias ◽  
Fernando P. Ponce ◽  
Daniel. E. Núñez
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Measurement Model ◽  
Clinical Samples ◽  
General Factor ◽  
Common Variance ◽  
Hyperactivity Disorder ◽  
Bifactor Models ◽  
Specific Factors ◽  
Inattention And Hyperactivity

Background: In the past decade, the bifactor model of attention-deficit/hyperactivity disorder (ADHD) has been extensively researched. This model consists of an ADHD general dimension and two specific factors: inattention and hyperactivity/impulsivity. All studies conclude that the bifactor is superior to the traditional two-correlated factors model, according to the fit obtained by factor analysis. However, the proper interpretation of a bifactor not only depends on the fit but also on the quality of the measurement model. Objective: To evaluate the model-based reliability, distribution of common variance and construct replicability of general and specific ADHD factors. Method: We estimated expected common variance, omega hierarchical/subscale and H-index from standardized factor loadings of 31 ADHD bifactor models previously published. Results and Conclusion: The ADHD general factor explained most of the common variance. Given the low reliable variance ratios, the specific factors were difficult to interpret. However, in clinical samples, inattention acquired sufficient specificity and stability for interpretation beyond the general factor. Implications for research and clinical practice are discussed.

scholarly journals Imaging gene and environmental effects on cerebellum in Attention-Deficit/Hyperactivity Disorder and typical development

2013 ◽  
Vol 2 ◽  
pp. 103-110 ◽  
Author(s):  
Patrick de Zeeuw ◽  
Janna van Belle ◽  
Sarai van Dijk ◽  
Juliette Weusten ◽  
Bobby Koeleman ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Environmental Effects ◽  
Attention Deficit ◽  
Typical Development ◽  
Hyperactivity Disorder

scholarly journals The factor structure of attention-deficit/hyperactivity disorder in schoolchildren

2020 ◽  
Author(s):  
Trine Wigh Arildskov ◽  
Anne Virring ◽  
Rikke Lambek ◽  
Anders Helles Carlsen ◽  
Edmund J.S. Sonuga-Barke ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
General Population ◽  
Factor Structure ◽  
Attention Deficit ◽  
Factor Model ◽  
Clinical Sample ◽  
General Factor ◽  
Hyperactivity Disorder ◽  
Specific Factors ◽  
Three Factor

ABSTRACTThis study investigated the factor structure of attention-deficit/hyperactivity disorder (ADHD) by comparing the fit of a single-factor model, a correlated model with two or three factors, and a bifactor model with one general and two or three specific factors. Different three-factor solutions that varied with regard to the specification of the item “talks excessively” as impulsivity or hyperactivity were also tested. Parent ratings on the ADHD-Rating Scale (ADHD-RS-IV) were collected in a sample of 2044 schoolchildren (1st to 3rd grade) from the general population and in a clinical sample of 165 children and adolescents with ADHD referred to a public regional child and adolescent psychiatric hospital. Confirmatory factor analyses found a satisfactory fit for most models in both samples. However, a correlated three-factor model where “talks excessively” was included as an indicator of impulsivity and especially the bifactor version of this model with one general and three specific factors fit the data slightly better in the general population. In the clinical sample, a number of models performed equally well (the same version of the correlated three-factor model and all the bifactor models). Overall, the factor structure of ADHD seems to be better characterized by a bifactor model with a strong general factor and two or three weaker specific factors. Due to the strong general factor, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.

scholarly journals Unraveling the Optimum Latent Structure of Attention-Deficit/Hyperactivity Disorder: Evidence Supporting ICD and HiTOP Frameworks

2021 ◽  
Vol 12 ◽  
Author(s):  
Rapson Gomez ◽  
Lu Liu ◽  
Robert Krueger ◽  
Vasileios Stavropoulos ◽  
Jenny Downs ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scale ◽  
Community Sample ◽  
International Classification Of Diseases ◽  
Equation Model ◽  
Specific Factor ◽  
Behavior Rating Scale ◽  
Hyperactivity Disorder ◽  
Icd 10

Attention Deficit/hyperactivity disorder (ADHD) is conceptualized differently in the Diagnostic and Statistical Manual (DSM-5), the International Classification of Diseases-10 (ICD-10), and the Hierarchical Taxonomy of Psychopathology (HiTOP) frameworks. This study applied independent cluster confirmatory factor analysis (ICM-CFA), exploratory structure equation model with target rotation (ESEM), and the S-1 bi-factor CFA approaches to evaluate seven ADHD models yielded by different combinations of these taxonomic frameworks. Parents and teachers of a community sample of children (between 6 and 12 years of age) completed the Disruptive Behavior Rating Scale (for ADHD symptoms) and the Strengths and Difficulties Questionnaire (for validation). Our findings for both parent and teacher ratings provided the most support for the S-1 bi-factor CFA model comprised of (i) a g-factor based on ICD-10 impulsivity symptoms as the reference indicators and (ii) inattention and hyperactivity as specific factors. However, the hyperactivity-specific factor lacked clarity and reliability. Thus, our findings indicate that ADHD is best viewed as a disorder primarily reflecting impulsivity, though with a separable inattention (but no hyperactivity) component, i.e., “ADID (attention deficit/impulsivity disorder).” This model aligns with the HiTOP proposals.

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