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Original Article |

Developmental Twin Study of Attention Problems:  High Heritabilities Throughout Development

Zheng Chang, MSc; Paul Lichtenstein, PhD; Philip J. Asherson, PhD; Henrik Larsson, PhD
JAMA Psychiatry. 2013;70(3):311-318. doi:10.1001/jamapsychiatry.2013.287.
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Context  The genetic and environmental link between attention-deficit/hyperactivity disorder in childhood and the adult manifestation of the disorder is poorly understood because of a lack of longitudinal studies with cross-informant data.

Objective  To explore the relative contribution of genetic and environmental influences on symptoms of attention problems from childhood to early adulthood.

Design  Analysis was conducted using longitudinal structural equation modeling with multiple informants.

Setting  The Swedish Twin Study of Child and Adolescent Development.

Participants  One thousand four hundred eighty twin pairs were prospectively followed up from childhood to young adulthood.

Main Outcome Measures  Symptoms were obtained using parent and self-ratings of the Attention Problems Scale at ages 8 to 9, 13 to 14, 16 to 17, and 19 to 20 years.

Results  The best-fitting model revealed high heritability of attention problems as indexed by parent and self-ratings from childhood to early adulthood (h2 = 0.77-0.82). Genetic effects operating at age 8 to 9 years continued, explaining 41%, 34%, and 24% of the total variance at ages 13 to 14, 16 to 17, and 19 to 20 years. Moreover, new sets of genetic risk factors emerged at ages 13 to 14, 16 to 17, and 19 to 20 years.

Conclusions  The shared view of self- and informant-rated attention problems is highly heritable in childhood, adolescence, and early adulthood, suggesting that the previous reports of low heritability for attention-deficit/hyperactivity disorder in adults are best explained by rater effects. Both genetic stability and genetic innovation were present throughout this developmental stage, suggesting that attention problems are a developmentally complex phenotype characterized by both continuity and change across the life span.

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Figures

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Grahic Jump Location

Figure 1. The model used in the current analyses presented for 1 source of liability, such as additive genetic effects. The model contains 4 latent factors of AP1 to AP4 reflecting the “true” level of attention problems (AP) for each point. These latent variables are indexed by ratings of AP by parental report (P) and self-report (S). The degree to which the parent- and self-reported ratings of AP index these latent factors is reflected by the paths λp and λs. The genetic and environmental influences on AP1 to AP4 are modeled as a Cholesky decomposition. See the “Data Analysis” subsection and “Results” section for further details (adapted from Kendler et al32).

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Grahic Jump Location

Figure 2. The proportion of the total variance in latent estimation of attention problems accounted for genetic factors (A) and unique environmental factors (B) through development.

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Grahic Jump Location

Figure 3. Variance components that contribute to the observed ratings of attention problems for parental report (A) and self-report (B).

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