Abstract
Background: Attention deficit/hyperactivity disorder (ADHD) is associated with emotional problems, and their co-occurrence often leads to worse outcomes. We investigated the developmental associations between ADHD and emotional problems from childhood to early adolescence and examined the genetic and environmental contributions to their developmental link. We further tested whether this developmental association remained across the transition to young adulthood. Methods: We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2,232 British twins. In childhood, ADHD and emotional problems were assessed at ages 5, 7, 10 and 12 with mothers’ and teachers’ reports. At age 18, we used self-reported symptoms according to DSM-5 criteria for ADHD, and DSM-IV for anxiety and depression. Results: Longitudinal analyses showed that earlier ADHD was associated with later emotional problems consistently across childhood. However, earlier emotional problems were not associated with later ADHD symptoms. The developmental association between ADHD and later emotional problems in childhood was entirely explained by common genetic factors. Consistent with results in childhood, earlier symptoms of ADHD were associated with later emotional problems during the transition to young adulthood. Conclusions: Our findings demonstrate that ADHD symptoms are predictors of the development of emotional problems, from childhood up to young adulthood, through shared genetic influences. Interventions targeting ADHD symptoms might prevent the development of emotional problems. Clinicians treating youth with ADHD must be aware of their risk for developing emotional problems and ought to assess, monitor and treat emotional problems alongside ADHD symptoms from childhood to adulthood.
| Original language | English |
|---|---|
| Pages (from-to) | 1234-1242 |
| Number of pages | 9 |
| Journal | Journal of Child Psychology and Psychiatry and Allied Disciplines |
| Volume | 61 |
| Issue number | 11 |
| DOIs | |
| State | Published - 1 Nov 2020 |
Bibliographical note
Funding Information:The E-Risk Study is funded by the Medical Research Council (UKMRC grant G1002190). Additional support was provided by National Institute of Child Health and Human Development (grant HD077482) and by the Jacobs Foundation. J.A-B. is an MRC Skills Development Fellow. T.M. is a British Academy Postdoctoral Fellow. H.L.F. is supported by an MQ Fellows Award (MQ14F40). L.A. is the Mental Health Leadership Fellow for the UK Economic and Social Research Council (ESRC). A.S. is supported by the Humanitarian Trust Fellowship. The authors are grateful to the study members and their families and teachers for their participation. The authors would like to thank Terrie E. Moffitt and Avshalom Caspi, the founders of the E-Risk Study, CACI, Inc., and to members of the E-Risk team for their dedication, hard work and insights. The authors have declared that they have no competing or potential conflicts of interest.Key points ADHD and emotional problems tend to co-occur, but little is known about their developmental association in childhood and up to young adulthood. In a nationally representative longitudinal twin study, we showed that symptoms of ADHD in childhood were associated with later emotional problems. Early emotional problems, however, did not lead to later ADHD symptoms. This developmental association in childhood was entirely explained by common genetic factors. ADHD symptoms in childhood were associated with emotional problems (symptoms of anxiety and depression) in young adulthood, but not the other way around. Interventions targeting ADHD symptoms could contribute to preventing the development of emotional problems. Furthermore, emotional problems should be assessed, monitored and treated alongside ADHD symptoms from childhood to adulthood. ADHD and emotional problems tend to co-occur, but little is known about their developmental association in childhood and up to young adulthood. In a nationally representative longitudinal twin study, we showed that symptoms of ADHD in childhood were associated with later emotional problems. Early emotional problems, however, did not lead to later ADHD symptoms. This developmental association in childhood was entirely explained by common genetic factors. ADHD symptoms in childhood were associated with emotional problems (symptoms of anxiety and depression) in young adulthood, but not the other way around. Interventions targeting ADHD symptoms could contribute to preventing the development of emotional problems. Furthermore, emotional problems should be assessed, monitored and treated alongside ADHD symptoms from childhood to adulthood.
Publisher Copyright:
© 2020 Association for Child and Adolescent Mental Health
Keywords
- Attention deficit/hyperactivity disorder
- anxiety
- depression
- development
- genetics
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Developmental and Educational Psychology
- Psychiatry and Mental health
