A Common Genetic Factor Explains the Covariation Among ADHD ODD and CD Symptoms in 9–10 Year Old Boys and Girls

Abstract

Previous studies examining the covariation among Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) have yielded inconsistent results. Some studies have concluded that the covariation among these symptoms is due to common genetic influences, whereas others have found a common environmental overlap. The present study investigated the genetic and environmental correlations among these three childhood disorders, based on a sample of 1,241 twins, age 9-10 years. A latent externalizing behavior factor was found to explain the covariance among ADHD, ODD and CD symptoms. Genetic influences explained more than half of the variance in this externalizing factor in both boys and girls. There were also unique genetic and environmental influences in each set of symptoms, suggesting some etiological independence of the three disorders. Our findings have implications for molecular genetic studies trying to identify susceptibility genes, as well as for possible prevention of externalizing disorders through identification of at-risk children early in life. KeywordsADHD; CD; ODD; covariation; genetic influences; twins Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are three of the most prevalent disruptive behavior disorders in children and adolescents. They affect approximately 1-15% of all school age children, and account for a large amount of childhood referrals to mental health clinics (Brown et al., 2001;Maughan et al., 2004). They often lead to stress and frustration in the affected children, their families, teachers and peers. Numerous studies have reported comorbidity among these disruptive behavior disorders in both epidemiological and clinical samples (Angold, Costello & Erkanli, 1999;Biederman, Newcorn & Sprich, 1991;Faraone et al., 1998b;Maughan et al., 2004), often making them difficult to isolate and understand individually. Such high levels of comorbidity among supposedly different domains of externalizing problems, such as inattention, hyperactivity, aggression and defiance make these various problem behaviors complex and particularly hard to treat. To date, the genetic and environmental etiology that underlies the comorbidity among these disruptive behavior disorders is unclear.ADHD is characterized by pervasive and impairing symptoms of inattention, hyperactivity and impulsivity (American Psychiatric Association, 2004). The disorder is associated with academic underachievement, substance use and dependence, psychosocial problems and social NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript maladjustment, including unemployment in adulthood (Biederman & Faraone, 2006;Kuperman et al., 2001).Like ADHD, ODD is also a common psychiatric disorder in children (Maughan et al., 2004). The disorder typically occurs in early childhood and is characterized by a pattern of negativistic, disobedient, hostile and defiant behaviors. In contrast to ODD, CD is a more severe d...

Heart rate variability as a transdiagnostic biomarker of psychopathology

“…As discussed above, this is consistent with wellreplicated findings from behavioral genetics studies conducted with children, adolescents, and adults (e.g., Caspi et al, 2014;Krueger et al, 2002;Tuvblad et al, 2009;Wright et al, 2013).…”

“…measured both directly among children and via low constraint among adults), ODD, and CD (e.g.,Lahey, Van Hulle, Singh, Waldman, & Rathouz, 2011;Tuvblad, Zheng, Raine, & Baker, 2009). More recent work…”

Future Directions in Emotion Dysregulation and Youth Psychopathology

“…Consistent with a major thesis of this article, twin studies indicate that both internalizing and externalizing liabilities are highly heritable, but that specific behavioral syndromes are shaped considerably by environments (Krueger et al, 2002;Lahey et al, 2011;Tuvblad et al, 2009). Thus, whether a child who inherits trait impulsivity (i.e., liability to externalizing disorders; see Beauchaine & McNulty, 2013) develops ADHD or more serious externalizing conduct depends largely on environmental experience (see Figure 1).…”

“…The externalizing factor included alcohol dependence, drug dependence, and antisocial personality disorder. Additional factor analyses conducted since provide support for Krueger's initial findings (e.g., Krueger, Markon, Patrick, Benning, & Kramer, 2007;Krueger et al, 2002) and extend the externalizing factor to include hyperactivity=impulsivity, oppositional defiant disorder, and conduct disorder (e.g., Lahey, Van Hulle, Singh, Waldman, & Rathouz, 2011;Tuvblad, Zheng, Raine, & Baker, 2009). More recent work demonstrates that thought disorder emerges as a third higher order factor when psychotic symptoms are included (e.g., Wright et al, 2013).…”

Genetic Risks and ADHD Symptomatology: Exploring the Effects of Parental Antisocial Behaviors in an Adoption-Based Study

“…Studies that have been conducted to explore these types of issues tend to employ bivariate genetic modeling techniques to estimate the proportion of covariance between two measures that is the result of genetic factors common to both phenotypes. A line of research using bivariate genetic modeling techniques has found shared genetic factors to explain the covariance between ADHD and measures of conduct disorder, oppositional defiant disorder, aggression, and violence [21][22][23][24].…”