Why do depression, conduct, and hyperactivity symptoms co-occur across adolescence? The role of stable and dynamic genetic and environmental influences

Abstract

Depression, conduct, and hyperactivity symptoms are chronic and frequently co-occur in adolescence. Common genetic and environmental vulnerability to these conditions have previously been demonstrated, however, the manner in which common versus disorder-specific etiological influences operate across development and maintain symptom co-occurrence is unclear. Thus, the current study investigated the role of common genetic and environmental influences in the comorbidity of depression, conduct, and hyperactivity across adolescence. Over 10,000 twins and their parents reported adolescents' symptoms at mean ages 11 and 16 years. Biometric independent pathway models were fitted to estimate genetic and environmental contributions to the continuity of symptom co-occurrence over time, as well as time-and symptom-specific influences. Results found that a common stable genetic factor accounted for the concurrent and longitudinal co-occurrence of depression, conduct, and hyperactivity symptoms. New genetic influences common to these three symptom scales emerged at 16 years, and further contributed to symptom co-occurrence. Conversely, environmental influences largely contributed to the timespecific associations. The findings were generally consistent for self-and parent-reported symptoms. Overall, the results suggest that stable, overlapping genetic influences contribute to the co-occurrence of depression, conduct, and hyperactivity symptoms across adolescence. The results are in line with hierarchical causal models of psychopathology, which posit that much of the developmental co-occurrence between different symptoms is due to common liability. Specifically, current findings indicate that only genetic influences constitute common liability over time. Future studies should identify genetically influenced transdiagnostic risk and maintenance factors to inform prevention and treatment of comorbid internalizing and externalizing symptoms in adolescence.

Adolescent depression and adult labor market marginalization: a longitudinal cohort study

“…However, the findings should be interpreted in the context of some limitations. First, unmeasured factors including genetic vulnerability may account for observed associations [73][74][75], and other forms of residual confounding cannot be ruled out. Second, the study was not without attrition, yet the study retained around 90 percent of the original cohort, with a relatively small proportion of missingness across the follow-up period.…”

Telomere shortening as a stress biomarker in children and adolescents affected by natural disasters

“…In a study with adolescents, common genetic features and liability contributed to the co-occurrence of depression, conduct, and hyperactivity symptoms [29]. Based on twin studies, there are common grounds to say that comorbidities have genetic features [29,32]. Children with externalizing symptoms are more vulnerable to harmful effects related to stressful events.…”

The Five-Factor Model of Personality and the Structure of Psychopathology in Adolescence

“…Regarding structure of psychopathology findings, similar results to those reported by Lahey et al (2011) have been found in more recent studies conducted with adolescents. These studies suggest a stable genetic factor to represent common liability, and to account for the co-occurrence between different symptoms (Waszczuk et al, 2020). Moreover, this general factor and specific externalizing and internalizing dimensions characterize youth psychopathology at both the phenotypic and etiologic levels (Waldman et al, 2016).…”

“…Behavior genetics has supported the structure of psychopathology in adults (Hicks et al, 2004;Kendler et al, 2003;Rosenström et al, 2019), and youths (Cosgrove et al, 2011;Gjone & Stevenson, 1997;Lahey et al, 2011;Marceau & Neiderhiser, 2020;Waldman et al, 2016;Waszczuk et al, 2020;Young et al, 2000). For instance, the findings of Young et al (2000) indicated that a variety of adolescent problem behaviors share a common underlying genetic risk.…”

“…Moreover, this general factor and specific externalizing and internalizing dimensions characterize youth psychopathology at both the phenotypic and etiologic levels (Waldman et al, 2016). Genetic influences apparently to constitute this common liability over time, with minor and specific environmental influences (Waldman et al, 2016.;Waszczuk et al, 2020), and such heritability suggests that the p factor emerges as a valid construct, and not merely as an artifact of measurement error (Waldman et al, 2016). Similarly, studies with twin adults (Rosenström et al, 2019) reveal a joint structure of disorders, and normal and pathological personality traits, including a general risk factor, internalizing problems and traits, and externalizing problems and traits with high heritability estimates, but no significant effects for a shared environment.…”