Genetic and environmental influences on attention-deficit/hyperactivity disorder symptoms in Chinese adolescents: a longitudinal twin study

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder. However, no study has examined genetic and environmental influences in the longitudinal developmental course of ADHD symptoms in a non-Western population. This study investigated changes of genetic and environmental influences and their contributions to the stability and change of ADHD symptoms of hyperactivity/impulsivity and inattention in Chinese adolescent twins. A prospective sample of 602 twin pairs (48% male) self-reported both DSM-IV ADHD symptom subscales three times at the approximate age of 12, 13, and 15 years. Longitudinal multivariate genetic analyses through structural equation modeling examined genetic and environmental contributions to the developmental course of ADHD symptoms. From early (time 1 & 2) to middle adolescence (time 3), both symptoms showed modest and non-significant genetic influences that became substantial and significant, whereas shared environmental influences were substantial and significant and became modest and non-significant. The same genetic factors influenced ADHD symptoms throughout adolescence, while shared and non-shared environmental influences largely came from new emerging factors. In early adolescence, genetic factor contributed to the stability of inattention, whereas shared environmental factor contributed to the stability of hyperactivity/impulsivity. Genetic influences of ADHD tended to be smaller, whereas shared environmental influences tended to be larger in Chinese than in Western populations. Genetic factors played a large role in the stability of ADHD throughout adolescence, while shared and non-shared environment primarily contributed to its change. Findings highlight the importance of shared family, neighborhood, and community experiences on child psychopathology in a collectivistic culture such as the Chinese society.

Association Between Greenness Surrounding Schools and Kindergartens and Attention-Deficit/Hyperactivity Disorder in Children in China

“…Prior evidence suggests that ADHD has a range of negative outcomes on individuals, as well as economic burdens on families and society. 3,4 Because environmental factors are associated with ADHD, 5 identifying such factors may be useful for reducing ADHD symptoms, especially considering that environmental factors are generally modifiable.…”

Insights into attention-deficit/hyperactivity disorder from recent genetic studies

“…Thus, many conclusions from twin research may not extend to other populations. For example, a recent study of ADHD traits in Chinese adolescent twins found smaller genetic and larger shared environmental influences compared to previously reported estimates in North American and European populations (Zheng, Pingault, Unger, & Rijsdijk, 2020), highlighting the necessity of collecting samples from diverse populations and suggesting that the contribution of environmental influences to ADHD may vary by societal and contextual factors.…”

“…For example, a recent study of ADHD traits in Chinese adolescent twins found smaller genetic and larger shared environmental influences than previously reported in Western populations (Zheng et al, 2020), highlighting the necessity of collecting globally representative samples and suggesting that the contribution of environmental influences to ADHD may vary by societal/contextual factors.…”

Impact of Perceived Social Support on the Relationship between ADHD and Depressive Symptoms among First Year Medical Students: A Structural Equation Model Approach

“…In fact, in older age participants such as in the present study, other sources of support, especially friends, should come into play, but this was not the case. The reason perceived as to why family support prevailed, despite the participants being emerging adults, may have been the fact that the participants live in a collectivistic society and are influenced by Thai family tradition; this influence is present in many cultures, especially in Asian countries [ 50 , 51 , 52 ]. Compared with medical students from Western cultures, the role of the family is distinctively predominant [ 53 ].…”