Skip to main content Accessibility help
×
×
Home

Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study

  • Laura Ghirardi (a1), Erik Pettersson (a1), Mark J. Taylor (a1), Christine M. Freitag (a2), Barbara Franke (a3), Philip Asherson (a4), Henrik Larsson (a1) (a5) and Ralf Kuja-Halkola (a1)...

Abstract

Background

Traits of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are strongly associated in children and adolescents, largely due to genetic factors. Less is known about the phenotypic and aetiological overlap between ADHD and ASD traits in adults.

Methods

We studied 6866 individuals aged 20–28 years from the Swedish Study of Young Adult Twins. Inattention (IA) and hyperactivity/impulsivity (HI) were assessed using the WHO Adult ADHD Self-Report Scale-V1.1. Repetitive and restricted behaviours (RRB) and social interaction and communication (SIC) were assessed using the Autism-Tics, ADHD, and other Comorbidities inventory. We used structural equation modelling to decompose covariance between these ADHD and ASD trait dimensions into genetic and shared/non-shared environmental components.

Results

At the phenotypic level, IA was similarly correlated with RRB (r = 0.33; 95% Confidence Interval (CI) 0.31–0.36) and with SIC (r = 0.32; 95% CI 0.29–0.34), whereas HI was more strongly associated with RRB (r = 0.38; 95% CI 0.35–0.40) than with SIC (r = 0.24; 95% CI 0.21–0.26). Genetic and non-shared environmental effects accounted for similar proportions of the phenotypic correlations, whereas shared environmental effects were of minimal importance. The highest genetic correlation was between HI and RRB (r = 0.56; 95% 0.46–0.65), and the lowest was between HI and SIC (r = 0.33; 95% CI 0.23–0.43).

Conclusions

We found evidence for dimension-specific phenotypic and aetiological overlap between ADHD and ASD traits in adults. Future studies investigating mechanisms underlying comorbidity between ADHD and ASD may benefit from exploring several symptom-dimensions, rather than considering only broad diagnostic categories.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.

Corresponding author

Author for correspondence: Laura Ghirardi, E-mail: laura.ghirardi@ki.se

References

Hide All
Adler, LA, Spencer, T, Faraone, SV, Kessler, RC, Howes, MJ, Biederman, J and Secnik, K (2006) Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms. Annals of Clinical Psychiatry 18, 145148.
American Psychological Association (APA) (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Arlington: American Psychiatric Publishing.
Boomsma, DI, Saviouk, V, Hottenga, JJ, Distel, MA, de Moor, MH, Vink, JM, Geels, LM, van Beek, JH, Bartels, M, de Geus, EJ and Willemsen, G (2010) Genetic epidemiology of attention deficit hyperactivity disorder (ADHD index) in adults. PLoS One 5, e10621.
Brikell, I, Kuja-Halkola, R and Larsson, H (2015) Heritability of attention-deficit hyperactivity disorder in adults. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 168, 406413.
Chang, Z, Lichtenstein, P, Asherson, PJ and Larsson, H (2013) Developmental twin study of attention problems: high heritabilities throughout development. JAMA Psychiatry 70, 311–308.
Clark, T, Feehan, C, Tinline, C and Vostanis, P (1999) Autistic symptoms in children with attention defcit-hyperactivity disorder. European Child and Adolescent Psychiatry 8, 5055.
Colvert, E, Tick, B, McEwen, F, Stewart, C, Curran, SR, Woodhouse, E, Gillan, N, Hallett, V, Lietz, S, Garnett, T, Ronald, A, Plomin, R, Rijsdijk, F, Happé, F and Bolton, P (2015) Heritability of autism spectrum disorder in a UK population-based twin sample. JAMA Psychiatry 72, 415423.
Cortina, JM (1993) What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology 78, 98.
Demontis, D, Walters, RK, Martin, J, Mattheisen, M, Als, TD, Agerbo, E, Belliveau, R, Bybjerg-Grauholm, J, Bækved-Hansen, M, Cerrato, F, Chambert, K, Churchhouse, C, Dumont, A, Eriksson, N, Gandal, M, Goldstein, J, Grove, J, Hansen, CS, Hauberg, M, Hollegaard, M, Howrigan, DP, Huang, H, Maller, J, Martin, AR, Moran, J, Pallesen, J, Palmer, DS, Pedersen, CB, Pedersen, MG, Poterba, T, Poulsen, JB, Ripke, S, Robinson, EB, Satterstrom, FK, Stevens, C, Turley, P, Won, H, Andreassen, OA, Burton, C, Boomsma, D, Cormand, B, Dalsgaard, S, Franke, B, Gelernter, J, Geschwind, D, Hakonarson, H, Haavik, J, Kranzler, H, Kuntsi, J, Langley, K, Lesch, K-P, Middeldorp, C, Reif, A, Rohde, LA, Roussos, P, Schachar, R, Sklar, P, Sonuga-Barke, E, Sullivan, PF, Thapar, A, Tung, J, Waldman, I, Nordentoft, M, Hougaard, DM, Werge, T, Mors, O, Mortensen, PB, Daly, MJ, Faraone, SV, Børglum, AD and Neale, BM (2017) Discovery of the first genome-wide significant risk loci for ADHD. bioRxiv. (https://www.biorxiv.org/content/early/2017/06/03/145581). Accessed 1 August 2018.
Faraone, SV, Biederman, J and Mick, E (2006) The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine 36, 159165.
Gadow, KD, DeVincent, CJ and Pomeroy, J (2006) ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders 36, 271283.
Ghirardi, L, Brikell, I, Kuja-Halkola, R, Freitag, CM, Franke, B, Asherson, P, Lichtenstein, P and Larsson, H (2018) The familial co-aggregation of ASD and ADHD: a register-based cohort study. Molecular Psychiatry 23, 257262.
Grove, J, Ripke, S, Als, TD, Mattheisen, M, Walters, R, Won, H, Pallesen, J, Agerbo, E, Andreassen, OA, Anney, R, Belliveau, R, Bettella, F, Buxbaum, JD, Bybjerg-Grauholm, J, Bækved-Hansen, M, Cerrato, F, Chambert, K, Christensen, JH, Churchhouse, C, Dellenvall, K, Demontis, D, De Rubeis, S, Devlin, B, Djurovic, S, Dumont, A, Goldstein, J, Hansen, CS, Hauberg, ME, Hollegaard, MV, Hope, S, Howrigan, DP, Huang, H, Hultman, C, Klei, L, Maller, J, Martin, J, Martin, AR, Moran, J, Nyegaard, M, Nærland, T, Palmer, DS, Palotie, A, Pedersen, CB, Pedersen, MG, Poterba, T, Poulsen, JB, Pourcain, BS, Qvist, P, Rehnström, K, Reichenberg, A, Reichert, J, Robinson, E, Roeder, K, Roussos, P, Saemundsen, E, Sandin, S, Satterstrom, FK, Smith, GD, Stefansson, H, Stefansson, K, Steinberg, S, Stevens, C, Sullivan, PF, Turley, P, Walters, GB, Xu, X, Geschwind, D, Nordentoft, M, Hougaard, DM, Werge, T, Mors, O, Mortensen, PB, Neale, BM, Daly, MJ and Børglum, AD (2017) Common risk variants identified in autism spectrum disorder. bioRxiv. (https://www.biorxiv.org/content/early/2017/11/27/224774). Accessed 1 August 2018.
Grzadzinski, R, Di Martino, A, Brady, E, Mairena, MA, O'Neale, M, Petkova, E, Lord, C and Castellanos, FX (2011). Examining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? Journal of Autism and Developmental Disorders 41, 11781191.
Grzadzinski, R, Dick, C, Lord, C and Bishop, S (2016) Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5. Molecular Autism 7, 7.
Hansson, SL, Röjvall, AS, Rastam, M, Gillberg, C, Gillberg, C and Anckarsäter, H (2005) Psychiatric telephone interview with parents for screening of childhood autism–tics, attention-deficit hyperactivity disorder and other comorbidities (A–TAC). The British Journal of Psychiatry 187, 262267.
Hoekstra, RA, Bartels, M, Verweij, CJ and Boomsma, DI (2007) Heritability of autistic traits in the general population. Archives of Pediatrics & Adolescent Medicine 161, 372377.
Hultman, CM, Torrang, A, Tuvblad, C, Cnattingius, S, Larsson, JO and Lichtenstein, P (2007) Birth weight and attention-deficit/hyperactivity symptoms in childhood and early adolescence: a prospective Swedish twin study. Journal of the American Academy of Child and Adolescent Psychiatry 46, 370377.
Jokiranta-Olkoniemi, E, Cheslack-Postava, K, Sucksdorff, D, Suominen, A, Gyllenberg, D, Chudal, R, Leivonen, S, Gissler, M, Brown, AS and Sourander, A (2016) Risk of psychiatric and neurodevelopmental disorders among siblings of probands with autism spectrum disorders. JAMA Psychiatry 73, 622629.
Kessler, RC, Adler, L, Ames, M, Demler, O, Faraone, S, Hiripi, E, Howes, MJ, Jin, R, Secnik, K, Spencer, T, Ustun, TB and Walters, EE (2005) The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychological Medicine 35, 245256.
Kessler, RC, Adler, LA, Gruber, MJ, Sarawate, CA, Spencer, T and Van Brunt, DL (2007) Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research 16, 5265.
Kotte, A, Joshi, G, Fried, R, Uchida, M, Spencer, A, Woodworth, KY, Kenworthy, T, Faraone, SV and Biederman, J (2013) Autistic traits in children with and without ADHD. Pediatrics 132, e612e622.
Kroger, A, Hanig, S, Seitz, C, Palmason, H, Meyer, J and Freitag, CM (2011) Risk factors of autistic symptoms in children with ADHD. European Child Adolescent Psychiatry 20, 561570.
Larsson, H, Anckarsater, H, Rastam, M, Chang, Z and Lichtenstein, P (2012 a) Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8500 twin pairs. Journal of Child Psychology and Psychiatry 53, 7380.
Larsson, H, Asherson, P, Chang, Z, Ljung, T, Friedrichs, B, Larsson, JO and Lichtenstein, P (2012 b) Genetic and environmental influences on adult attention deficit hyperactivity disorder symptoms: a large Swedish population-based study of twins. Psychological Medicine 43, 197207.
Lichtenstein, P, De Faire, U, Floderus, B, Svartengren, M, Svedberg, P and Pedersen, NL (2002) The Swedish Twin Registry: a unique resource for clinical, epidemiological and genetic studies. Journal of Internal Medicine 252, 184205.
Lichtenstein, P, Sullivan, PF, Cnattingius, S, Gatz, M, Johansson, S, Carlstrom, E, Björk, C, Svartengren, M, Wolk, A, Klareskog, L, de Faire, U, Schalling, M, Palmgren, J and Pedersen, NL (2006) The Swedish Twin Registry in the third millennium: an update. Twin Research and Human Genetics 9, 875882.
Losh, M, Esserman, D, Anckarsäter, H, Sullivan, PF and Lichtenstein, P (2011) Lower birth weight indicates higher risk of autistic traits in discordant twin pairs. Psychological Medicine 42, 10911102.
Lundstrom, S, Chang, Z, Kerekes, N, Gumpert, CH, Rastam, M, Gillberg, C, Lichtenstein, P and Anckarsäter, H (2011) Autistic-like traits and their association with mental health problems in two nationwide twin cohorts of children and adults. Psychological Medicine 41, 24232433.
Lundström, S, Chang, Z, Råstam, M, Gillberg, C, Larsson, H, Anckarsäter, H and Lichtenstein, P (2012) Autism spectrum disorders and autistic-like traits: similar etiology in the extreme end and the normal variation. Archives of General Psychiatry 69, 4652.
Magnusson, PKE, Almqvist, C, Rahman, I, Ganna, A, Viktorin, A, Walum, H, Halldner, L, Lundström, S, Ullén, F, Långström, N, Larsson, H, Nyman, A, Gumpert, CH, Råstam, M, Anckarsäter, H, Cnattingius, S, Johannesson, M, Ingelsson, E, Klareskog, L, de Faire, U, Pedersen, NL and Lichtenstein, P (2012) The Swedish Twin Registry: establishment of a biobank and other recent developments. Twin Research and Human Genetics 16, 317329.
Martin, J, Hamshere, ML, O'Donovan, MC, Rutter, M and Thapar, A (2014) Factor structure of autistic traits in children with ADHD. Journal of Autism and Developmental Disorders 44, 204215.
Martin, J, Taylor, MJ and Lichtenstein, P (2018) Assessing the evidence for shared genetic risks across psychiatric disorders and traits. Psychological Medicine 48, 17591774.
Middeldorp, CM, Hammerschlag, AR, Ouwens, KG, Groen-Blokhuis, MM, Pourcain, BS, Greven, CU, Pappa, I, Tiesler, CMT, Ang, W, Nolte, IM, Vilor-Tejedor, N, Bacelis, J, Ebejer, JL, Zhao, H, Davies, GE, Ehli, EA, Evans, DM, Fedko, IO, Guxens, M, Hottenga, JJ, Hudziak, JJ, Jugessur, A, Kemp, JP, Krapohl, E, Martin, NG, Murcia, M, Myhre, R, Ormel, J, Ring, SM, Standl, M, Stergiakouli, E, Stoltenberg, C, Thiering, E, Timpson, NJ, Trzaskowski, M, van der Most, PJ, Wang, C, EArly Genetics and Lifecourse Epidemiology (EAGLE) Consortium, Psychiatric Genomics Consortium ADHD Working Group, Nyholt, DR, Medland, SE, Neale, B, Jacobsson, B, Sunyer, J, Hartman, CA, Whitehouse, AJO, Pennell, CE, Heinrich, J, Plomin, R, Smith, GD, Tiemeier, H, Posthuma, D and Boomsma, DI (2016) A genome-wide association meta-analysis of attention-deficit/hyperactivity disorder symptoms in population-based pediatric cohorts. Journal of the American Academy of Child and Adolescent Psychiatry 55, 896905. e6.
Mulligan, A, Anney, RJ, O'Regan, M, Chen, W, Butler, L, Fitzgerald, M, Buitelaar, J, Steinhausen, HC, Rothenberger, A, Minderaa, R, Nijmeijer, J, Hoekstra, PJ, Oades, RD, Roeyers, H, Buschgens, C, Christiansen, H, Franke, B, Gabriels, I, Hartman, C, Kuntsi, J, Marco, R, Meidad, S, Mueller, U, Psychogiou, L, Rommelse, N, Thompson, M, Uebel, H, Banaschewski, T, Ebstein, R, Eisenberg, J, Manor, I, Miranda, A, Mulas, F, Sergeant, J, Sonuga-Barke, E, Asherson, P, Faraone, SV and Gill, M (2009) Autism symptoms in attention-deficit/hyperactivity disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. Journal of Autism and Developmental Disorders 39, 197209.
Musser, ED, Hawkey, E, Kachan-Liu, SS, Lees, P, Roullet, JB, Goddard, K, Steiner, RD and Nigg, JT (2014) Shared familial transmission of autism spectrum and attention-deficit/hyperactivity disorders. Journal of Child Psychology and Psychiatry 55, 819827.
Neale, M and Cardon, L (2013) Methodology for Genetic Studies of Twins and Families. Doordrecht: Springer Science & Business Media.
Neale, MC, Hunter, MD, Pritikin, JN, Zahery, M, Brick, TR, Kirkpatrick, RM, Estabrook, R, Bates, TC, Maes, HH and Boker, SM (2016) Openmx 2.0: extended structural equation and statistical modeling. Psychometrika 81, 535549.
Park, S-H, Guastella, AJ, Lynskey, M, Agrawal, A, Constantino, JN, Medland, SE, Song, YJC, Martin, NG and Colodro-Conde, L (2017) Neuroticism and the overlap between autistic and ADHD traits: findings from a population sample of young adult Australian twins. Twin Research and Human Genetics 20, 319329.
Pettersson, E, Sjolander, A, Almqvist, C, Anckarsater, H, D'Onofrio, BM, Lichtenstein, P and Larsson, H (2015) Birth weight as an independent predictor of ADHD symptoms: a within-twin pair analysis. Journal of Child Psychology and Psychiatry 56, 453459.
Pinto, R, Rijsdijk, F, Ronald, A, Asherson, P and Kuntsi, J (2016) The genetic overlap of attention-deficit/hyperactivity disorder and autistic-like traits: an investigation of individual symptom scales and cognitive markers. Journal of Abnormal Child Psychology 44, 335345.
Plomin, R, Haworth, CM and Davis, OS (2009) Common disorders are quantitative traits. Nature Reviews Genetics 10, 872878.
Polderman, TJ, Hoekstra, R, Vinkhuyzen, A, Sullivan, PF, van der Sluis, S and Posthuma, D (2013) Attentional switching forms a genetic link between attention problems and autistic traits in adults. Psychological Medicine 43, 19851996.
Polderman, TJ, Hoekstra, RA, Posthuma, D and Larsson, H (2014) The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17770 twins. Translational Psychiatry 4, e435.
Rijsdijk, FV and Sham, PC (2002) Analytic approaches to twin data using structural equation models. Briefings in Bioinformatics 3, 119133.
Robinson, EB, St Pourcain, B, Anttila, V, Kosmicki, JA, Bulik-Sullivan, B, Grove, J, Maller, J, Samocha, KE, Sanders, SJ, Ripke, S, Martin, J, Hollegaard, MV, Werge, T, Hougaard, DM, iPSYCH-SSI-Broad Autism Group, Neale, BM, Evans, DM, Skuse, D, Mortensen, PB, Børglum, AD, Ronald, A, Smith, GD and Daly, MJ (2016) Genetic risk for autism spectrum disorders and neuropsychiatric variation in the general population. Nature Genetics 48, 552555.
Rommelse, NN, Geurts, HM, Franke, B, Buitelaar, JK and Hartman, CA (2011) A review on cognitive and brain endophenotypes that may be common in autism spectrum disorder and attention-deficit/hyperactivity disorder and facilitate the search for pleiotropic genes. Neuroscience & Biobehavioral Reviews 35, 13631396.
Ronald, A, Simonoff, E, Kuntsi, J, Asherson, P and Plomin, R (2008) Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample. Journal of Child Psychology and Psychiatry 49, 535542.
Ronald, A, Edelson, LR, Asherson, P and Saudino, KJ (2010) Exploring the relationship between autistic-like traits and ADHD behaviors in early childhood: findings from a community twin study of 2-year-olds. Journal of Abnormal Child Psychology 38, 185196.
Simonoff, E, Pickles, A, Charman, T, Chandler, S, Loucas, T and Baird, G (2008) Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry 47, 921929.
Taylor, MJ, Charman, T, Robinson, EB, Plomin, R, Happe, F, Asherson, P and Ronald, A (2013) Developmental associations between traits of autism spectrum disorder and attention deficit hyperactivity disorder: a genetically informative, longitudinal twin study. Psychological Medicine 43, 17351746.
Taylor, MJ, Charman, T and Ronald, A (2015) Where are the strongest associations between autistic traits and traits of ADHD? evidence from a community-based twin study. European Child and Adolescent Psychiatry 24, 11291138.
Taylor, MJ, Gillberg, C, Lichtenstein, P and Lundstrom, S (2017) Etiological influences on the stability of autistic traits from childhood to early adulthood: evidence from a twin study. Molecular Autism 8, 5.
Thapar, A, Cooper, M and Rutter, M (2017) Neurodevelopmental disorders. The Lancet. Psychiatry 4, 339346.
Ustun, B, Adler, LA, Rudin, C, Faraone, SV, Spencer, TJ, Berglund, P, Gruber, MJ and Kessler, RC (2017) The world health organization adult attention-deficit/hyperactivity disorder self-report screening scale for DSM-5. JAMA Psychiatry 74, 520526.
Yerys, BE, Wallace, GL, Sokoloff, JL, Shook, DA, James, JD and Kenworthy, L (2009) Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Research 2, 322333.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Ghirardi et al. supplementary material
Ghirardi et al. supplementary material 1

 Word (64 KB)
64 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed