Cited by 106Attention Deficit Hyperactivity DisorderAutism Spectrum Disorder ResearchNeurotransmitter Receptor Influence on Behavior

The Separation of ADHD Inattention and Hyperactivity-Impulsivity Symptoms: Pathways from Genetic Effects to Cognitive Impairments and Symptoms

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Kuntsi, Jonna, Pinto, Rebecca, Price, Thomas S., van der Meere, Jaap J., Frazier-Wood, Alexis C., Asherson, Philip·2014·Journal of Abnormal Child Psychology

Abstract

Both shared and unique genetic risk factors underlie the two symptom domains of attention deficit hyperactivity disorder (ADHD): inattention and hyperactivity-impulsivity. The developmental course and relationship to co-occurring disorders differs across the two symptom domains, highlighting the importance of their partially distinct etiologies. Familial cognitive impairment factors have been identified in ADHD, but whether they show specificity in relation to the two ADHD symptom domains remains poorly understood. We aimed to investigate whether different cognitive impairments are genetically linked to the ADHD symptom domains of inattention versus hyperactivity-impulsivity. We conducted multivariate genetic model fitting analyses on ADHD symptom scores and cognitive data, from go/no-go and fast tasks, collected on a population twin sample of 1,312 children aged 7-10. Reaction time variability (RTV) showed substantial genetic overlap with inattention, as observed in an additive genetic correlation of 0.64, compared to an additive genetic correlation of 0.31 with hyperactivity-impulsivity. Commission errors (CE) showed low additive genetic correlations with both hyperactivity-impulsivity and inattention (genetic correlations of 0.17 and 0.11, respectively). The additive genetic correlation between RTV and CE was also low and non-significant at -0.10, consistent with the etiological separation between the two indices of cognitive impairments. Overall, two key cognitive impairments phenotypically associated with ADHD symptoms, captured by RTV and CE, showed different genetic relationships to the two ADHD symptom domains. The findings extend a previous model of two familial cognitive impairment factors in combined subtype ADHD by separating pathways underlying inattention and hyperactivity-impulsivity symptoms.

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  • Most cases of ADHD arise from a 'pool' of genetic and environmental risk factors.

    “These approaches have received clear support from aetiological studies indicating that most cases of ADHD arise from a 'pool' of genetic and environmental risk factors.”

    From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [33]

    The Introduction and Discussion describe shared and distinct genetic influences on ADHD symptom domains. The Methods also consider environmental influences in the twin models, but the paper does not establish that most ADHD cases arise from a pool of genetic and environmental risk factors; its findings concern variation in symptoms and cognitive impairments, not the causes of most diagnosed cases. (LLM, conf=0.82)

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  • Neurocognitive, neuroimaging and genetic theories of ADHD have shifted from single-cause or single-pathway models to models that delineate causes that lead to ADHD through several molecular, neural and neurocognitive pathways.

    “Neurocognitive, neuroimaging and genetic theories of ADHD have shifted from single-cause or singlepathway models to models that delineate causes that lead to ADHD through several molecular, neural and neurocognitive pathways 33,98-102 .”

    From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [33]

    The Discussion (page unavailable) highlights shared and unique etiological pathways and different genetic relationships between cognitive impairments and the two ADHD symptom domains. This supports a multiple-pathway account, but the paper does not establish the claimed historical shift across neurocognitive, neuroimaging, and genetic theories or delineate molecular and neural pathways. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • Family and twin studies have demonstrated that genetic influences are shared between ADHD and a wide range of other neurodevelopmental and psychopathological traits and disorders, including conduct disorder and problems, cognitive performance, autism spectrum disorders and mood disorders.

    “Family and twin studies have also demonstrated that genetic influences are shared between ADHD and a wide range of other neurodevelopmental and psycho pathological traits and disorders, including conduct disorder and problems 32 , cognitive performance 33 , autism s pectrum disorders 34 and mood disorders 35,36 .”

    From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [33]

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  1. American Psychiatric Association (APA) Diagnostic and statistical manual of mental disorders, 4 edition, text revision 2000 APA Washington 4th ed.

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Authors
Kuntsi, J., Pinto, R., Price, T. S., van der Meere, J. J., Frazier-Wood, A. C., & Asherson, P.
Affiliations
King's College London (GB)
Corresponding author
Kuntsi, Jonna
Venue
Journal of Abnormal Child Psychology
Published
2013-07-10
Volume
42
Issue
1
Pages
127-136
ISSN
  • 0091-0627 (ISSN-L)
  • 1573-2835
OpenAlex
W2012675790
Cited by
106
References
46
Citations by year
2026: 3 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 13 · 2019: 8 · 2018: 13 · 2017: 1 · 2016: 11 · 2015: 9 · 2014: 9
FWCI
6.84
Type
journal article
Language
en
Open access
Locations
  • Research on Child and Adolescent Psychopathology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • Research Portal (King's College London) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Funders
Wellcome Trust (GR070345MF, 070345)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
attention deficit hyperactivity disorder, inattention, hyperactivity/impulsivity, genetic correlation, reaction time variability, commission errors, cognitive impairment, twin studies, children, go/no-go task
MeSH terms
Attention, Attention Deficit Disorder with Hyperactivity, Child, Cognition Disorders, Female, Humans, Impulsive Behavior, Male, Psychiatric Status Rating Scales, Reaction Time, Risk Factors, Twins, Comorbidity, Multivariate Analysis, Genetic Predisposition to Disease

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