ADHD symptoms in the adult general population are associated with factors linked to ADHD in adult patients
Open accessAbstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children and adults. It is characterized by inappropriate levels of inattention (IA) and/or hyperactivity and impulsivity (HI). The ADHD diagnosis is hypothesized to represent the extreme of a continuous distribution of ADHD symptoms in the general population. In this study, we investigated whether factors linked to adult ADHD as a disorder are associated with adult ADHD symptoms in the general population. Our population-based sample included 4987 adults (mean age 56.1 years; 53.8% female) recruited by the Nijmegen Biomedical Study (NBS). Participants completed the Dutch ADHD DSM-IV Rating Scale for current and childhood ADHD symptoms, the Symptom Check List-90-R (SCL-90-R) anxiety subscale, and the Eysenk Personality Questionnaire (EPQR-S). Partial Spearman correlation and Hurdle negative binomial regression analysis were used to assess how age, sex, childhood ADHD symptoms, anxiety symptoms, and personality traits (neuroticism, extraversion, and psychoticism) are associated with current IA and HI symptoms. Increasing age was associated with a lower proportion of participants reporting HI symptoms and with reduced levels of HI; IA levels remained fairly stable over the age-range, but the probability of reporting IA symptoms increased throughout middle/late adulthood. Females were more likely to report IA symptoms than males. Childhood ADHD symptoms, neuroticism, and psychoticism were positively associated with current IA and HI symptoms, while extraversion had an opposite association with these symptom domains. Anxiety symptoms affected HI symptoms in females. Our results indicate that factors associated with categorical ADHD are also correlated with ADHD symptoms in the adult population.
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Extraversion and agreeableness tend to be lower in ADHD, though the associations are less strong.
“Though the associations between ADHD and extraversion and agreeableness are less strong, both traits tend to be lower in ADHD (20, 21, 23–26).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [26]
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
An Introduction to the Five‐Factor Model and Its Applications
McCrae, R. R., & John, O. P. (1992) · Journal of Personality · doi:10.1111/j.1467-6494.1992.tb00970.x · Cited by 6,835 · see citing works
The worldwide prevalence of ADHD: a systematic review and metaregression analysis
Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.6.942 · Cited by 5,346 · see citing works
Prevalence and development of psychiatric disorders in childhood and adolescence
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.8.837 · Cited by 4,035 · see citing works
Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.4.716 · Cited by 3,886 · see citing works
International Statistical Classification of Diseases and Related Health Problems
Eisfeld, J. (2014) · TSQ Transgender Studies Quarterly · doi:10.1215/23289252-2399740 · Cited by 3,570 · see citing works
A revised version of the Psychoticism scale
Eysenck, S. B. G., Eysenck, H. J., & Barrett, P. (1985) · Personality and Individual Differences · doi:10.1016/0191-8869(85)90026-1 · Cited by 3,094 · see citing works
Regression Models for Count Data in R
Zeileis, A., Kleiber, C., & Jackman, S. D. (2008) · Journal of Statistical Software · doi:10.18637/jss.v027.i08 · Cited by 2,353 · see citing works
FARAONE, S. V., BIEDERMAN, J., & MICK, E. (2006) · Psychological Medicine · doi:10.1017/s003329170500471x · Cited by 2,267 · see citing works
ADHD Working Group of the Psychiatric Genomics Consortium (PGC), Demontis, D., Early Lifecourse & Genetic Epidemiology (EAGLE) Consortium, 23andMe Research Team, Walters, R. K., Martin, J., Mattheisen, M., Als, T. D., Agerbo, E., Baldursson, G., et al. (2019) · Nature Genetics · doi:10.1038/s41588-018-0269-7 · Cited by 2,203 · see citing works
Self-citationPrevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis
Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015) · Pediatrics · doi:10.1542/peds.2014-3482 · Cited by 1,976 · see citing works
Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis
Simon, V., Czobor, P., Bálint, S., Mészáros, Á., & Bitter, I. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.048827 · Cited by 1,601 · see citing works
Biederman, J. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.5.816 · Cited by 1,498 · see citing works
Attention-deficit/hyperactivity disorder
Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J. S., Tannock, R., & Franke, B. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.20 · Cited by 1,479 · see citing works
Self-citationGender Differences in ADHD: A Meta-Analysis and Critical Review
GAUB, M., & CARLSON, C. L. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199708000-00011 · Cited by 1,117 · see citing works
Positive affect increases the breadth of attentional selection
Rowe, G., Hirsh, J. B., & Anderson, A. K. (2007) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0605198104 · Cited by 1,051 · see citing works
LEVY, F., HAY, D. A., McSTEPHEN, M., WOOD, C., & WALDMAN, I. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199706000-00009 · Cited by 956 · see citing works
Gender Differences in ADHD: A Meta-Analysis and Critical Review
Gaub, M., & Carlson, C. L. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199708000-00023 · Cited by 871 · see citing works
Biederman, J., Mick, E., Faraone, S. V., Braaten, E., Doyle, A., Spencer, T., Wilens, T. E., Frazier, E., & Johnson, M. A. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.36 · Cited by 863 · see citing works
Ramtekkar, U. P., Reiersen, A. M., Todorov, A. A., & Todd, R. D. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2009.11.011 · Cited by 480 · see citing works
Handbook of Psychological Assessment in Primary Care Settings
(2000) · Routledge eBooks · doi:10.4324/9781315827346 · Cited by 471 · see citing works
SANDRA KOOIJ, J. J., BUITELAAR, J. K., van den OORD, E. J., FURER, J. W., TH. RIJNDERS, C. A., & HODIAMONT, P. P. G. (2005) · Psychological Medicine · doi:10.1017/s003329170400337x · Cited by 468 · see citing works
Self-citationSymptom profiles in children with ADHD: effects of comorbidity and gender.
Newcorn, J. H., Halperin, J., Jensen, P. S., Abikoff, H., Arnold, L. E., Cantwell, D., Conners, C., Elliott, G., Epstein, J. N., Greenhill, L. L., et al. (2001) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/00004583-200102000-00008 · Cited by 442 · see citing works
Lara, C., Fayyad, J., de Graaf, R., Kessler, R. C., Aguilar-Gaxiola, S., Angermeyer, M., Demytteneare, K., de Girolamo, G., Haro, J. M., Jin, R., et al. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.10.005 · Cited by 420 · see citing works
Eysenck, H. J. (1990) · Journal of Personality · doi:10.1111/j.1467-6494.1990.tb00915.x · Cited by 409 · see citing works
ADHD With Comorbid Anxiety: A Review of the Current Literature
Schatz, D. B., & Rostain, A. L. (2006) · Journal of Attention Disorders · doi:10.1177/1087054706286698 · Cited by 407 · see citing works
The SCL-90-R and Brief Symptom Inventory (BSI) in Primary Care
Savitz, L. R. D. A. K. L. (2000) · Routledge eBooks · doi:10.4324/9781315827346-11 · Cited by 384 · see citing works
Coghill, D., & Sonuga‐Barke, E. J. S. (2012) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02511.x · Cited by 355 · see citing works
Zero-Truncated and Zero-Inflated Models for Count Data
Zuur, A. F., Ieno, E. N., Walker, N. J., et al. (2009) · Statistics for biology and health · doi:10.1007/978-0-387-87458-6_11 · Cited by 339 · see citing works
Sex differences in <scp>ADHD</scp> symptom severity
Arnett, A. B., Pennington, B. F., Willcutt, E. G., DeFries, J. C., & Olson, R. K. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12337 · Cited by 333 · see citing works
Regression Models for Count Data in R
Kleiber, C., Zeileis, A., & Jackman, S. D. (2008) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 322 · see citing works
Big five dimensions and ADHD symptoms: links between personality traits and clinical symptoms
Nigg, J. T., John, O. P., Blaskey, L. G., Huang-Pollock, C. L., Willcutt, E. G., Hinshaw, S. P., & Pennington, B. (2002) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.83.2.451 · Cited by 315 · see citing works
Quinn, P. O., & Madhoo, M. (2014) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.13r01596 · Cited by 264 · see citing works
Larsson, H., Anckarsater, H., Råstam, M., Chang, Z., & Lichtenstein, P. (2012) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02467.x · Cited by 254 · see citing works
Gender differences in adults with attention-deficit/hyperactivity disorder: A narrative review
Williamson, D., & Johnston, C. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.05.005 · Cited by 226 · see citing works
Riglin, L., Collishaw, S., Thapar, A. K., Dalsgaard, S., Langley, K., Smith, G. D., Stergiakouli, E., Maughan, B., O’Donovan, M. C., & Thapar, A. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.2817 · Cited by 161 · see citing works
ADHD and personality: a meta-analytic review
Gomez, R., & Corr, P. J. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.05.002 · Cited by 151 · see citing works
The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17 770 twins
Polderman, T. J. C., Hoekstra, R. A., Posthuma, D., & Larsson, H. (2014) · Translational Psychiatry · doi:10.1038/tp.2014.84 · Cited by 131 · see citing works
Middeldorp, C. M., Hammerschlag, A. R., Ouwens, K. G., Groen‐Blokhuis, M. M., Pourcain, B. S., Greven, C. U., Pappa, I., Tiesler, C. M. T., Ang, W., Nolte, I. M., et al. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.05.025 · Cited by 123 · see citing works
Untreated ADHD in Adults: Are There Sex Differences in Symptoms, Comorbidity, and Impairment?
Rasmussen, K., & Levander, S. (2009) · Journal of Attention Disorders · doi:10.1177/1087054708314621 · Cited by 100 · see citing works
Ghirardi, L., Pettersson, E., Taylor, M. J., Freitag, C. M., Franke, B., Asherson, P., Larsson, H., & Kuja-Halkola, R. (2019) · Psychological Medicine · doi:10.1017/s003329171800243x · Cited by 99 · see citing works
Self-citationADHD symptoms and personality: relationships with the five-factor model
Parker, J. D. A., Majeski, S. A., & Collin, V. T. (2004) · Personality and Individual Differences · doi:10.1016/s0191-8869(03)00166-1 · Cited by 97 · see citing works
Cortese, S., Faraone, S. V., Bernardi, S., Wang, S., & Blanco, C. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09630 · Cited by 97 · see citing works
Stergiakouli, E., Martin, J., Hamshere, M. L., Langley, K., Evans, D. M., St Pourcain, B., Timpson, N. J., Owen, M. J., O'Donovan, M., Thapar, A., et al. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.01.010 · Cited by 94 · see citing works
Childhood attention deficit/hyperactivity disorder in adults with anxiety disorders
MANCINI, C., VAN AMERINGEN, M., OAKMAN, J. M., & FIGUEIREDO, D. (1999) · Psychological Medicine · doi:10.1017/s0033291798007697 · Cited by 87 · see citing works
Personality Characteristics Associated with Persistent ADHD in Late Adolescence
Miller, C. J., Miller, S. R., Newcorn, J. H., & Halperin, J. M. (2007) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-007-9167-7 · Cited by 82 · see citing works
Adult Attention Deficit Hyperactivity Disorder in an Anxiety Disorders Population
Ameringen, M. V., Mancini, C., Simpson, W. S., & Patterson, B. A. (2010) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2010.00148.x · Cited by 69 · see citing works
Behavioral and ERP evidence of greater distractor processing in old age
de Fockert, J. W., Ramchurn, A., van Velzen, J. L., et al. (2009) · Brain Research · doi:10.1016/j.brainres.2009.05.060 · Cited by 68 · see citing works
Cohort Profile: The Nijmegen Biomedical Study (NBS)
Galesloot, T., Vermeulen, S., Swinkels, D., de Vegt, F., Franke, B., den Heijer, M., de Graaf, J., Verbeek, A., & Kiemeney, L. (2016) · International Journal of Epidemiology · doi:10.1093/ije/dyw268 · Cited by 51 · see citing works
Self-citationMelegari, M. G., Bruni, O., Sacco, R., Barni, D., Sette, S., & Donfrancesco, R. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.10.078 · Cited by 46 · see citing works
Gudjonsson, G. H., Sigurðsson, J. F., Young, S., Newton, A. K., & Peersen, M. (2009) · Personality and Individual Differences · doi:10.1016/j.paid.2009.01.048 · Cited by 45 · see citing works
Tuning major gene variants conditioning human behavior: the anachronism of ADHD
Arcos‐Burgos, M., & Acosta, M. T. (2007) · Current Opinion in Genetics & Development · doi:10.1016/j.gde.2007.04.011 · Cited by 45 · see citing works
Emotional reactions in adults with symptoms of attention deficit hyperactivity disorder
Braaten, E. B., & Rosén, L. A. (1997) · Personality and Individual Differences · doi:10.1016/s0191-8869(96)00217-6 · Cited by 43 · see citing works
Pinto, R., Rijsdijk, F. V., Ronald, A., Asherson, P. J., & Kuntsi, J. (2015) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-015-0037-4 · Cited by 42 · see citing works
Hahn, S., Buttaccio, D. R., Hahn, J., & Lee, T. (2015) · Quarterly Journal of Experimental Psychology · doi:10.1080/17470218.2015.1032986 · Cited by 40 · see citing works
Haring, A. E., Zhuravleva, T. Y., Alperin, B. R., Rentz, D. M., Holcomb, P. J., & Daffner, K. R. (2013) · Brain Research · doi:10.1016/j.brainres.2013.01.003 · Cited by 34 · see citing works
Knouse, L. E., Traeger, L. N., O’Cleirigh, C. M., & Safren, S. A. (2013) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3182a5bf33 · Cited by 31 · see citing works
Huang, C. L.-C., Weng, S., & Ho, C. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.08.023 · Cited by 27 · see citing works
Evren, C., Dalbudak, E., Ozen, S., & Evren, B. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.04.039 · Cited by 25 · see citing works
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Haijen, E. C. H. M., Hurks, P. P. M., & Kuypers, K. P. C. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1233585 · Cited by 7 · see citing works
- Authors
- Li, T., Mota, N. R., Galesloot, T. E., Bralten, J., Buitelaar, J. K., IntHout, J., AriasVasquez, A., & Franke, B.
- Affiliations
- Radboud University Medical Center (NL)
- Radboud University Nijmegen (NL)
- Corresponding author
- Franke, Barbara
- ORCID
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 29
- Issue
- 10
- Pages
- 1117-1126
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2966085314
- Cited by
- 45
- References
- 59
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 8 · 2023: 7 · 2022: 7 · 2021: 6 · 2020: 4
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- OSF Preprints (OSF Preprints) (submittedVersion, public-domain)
- OSF Preprints (OSF Preprints) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- China Scholarship Council (201507720006)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016\u2013130\u2013669)
- National Institute of Mental Health (R01MH106655)
- European Commission (643051, 667302)
- Seventh Framework Programme (602805, 602450, 278948)
- European College of Neuropsychopharmacology
- Chiropractic and Osteopathic College of Australasia
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, ADHD symptoms, inattention, hyperactivity/impulsivity, general population, childhood ADHD symptoms, anxiety symptoms, personality traits, neuroticism, extraversion, psychoticism, age differences, sex differences
- MeSH terms
- Age Factors, Attention, Attention Deficit Disorder with Hyperactivity, Female, Humans, Hyperkinesis, Impulsive Behavior, Male, Middle Aged, Personality, Psychiatric Status Rating Scales, Sex Factors, Self Report, Healthy Volunteers
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