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Cited by 29Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentAutism Spectrum Disorder Research

Decline in attention-deficit hyperactivity disorder traits over the life course in the general population: trajectories across five population birth cohorts spanning ages 3 to 45 years

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Wootton, Robyn E, Riglin, Lucy, Blakey, Rachel, Agnew-Blais, Jessica, Caye, Arthur, Cadman, Tim, Havdahl, Alexandra, Gonçalves, Helen +11 more·2022·International Journal of Epidemiology
DOI 10.1093/ije/dyac049PMC PMC9189965
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Abstract

Background: Trajectories of attention-deficit hyperactivity disorder (ADHD) traits spanning early childhood to mid-life have not been described in general populations across different geographical contexts. Population trajectories are crucial to better understanding typical developmental patterns. Methods: We combined repeated assessments of ADHD traits from five population-based cohorts, spanning ages 3 to 45 years. We used two measures: (i) the Strengths and Difficulties Questionnaire (SDQ) hyperactive-inattentive subscale (175 831 observations, 29 519 individuals); and (ii) scores from DSM-referenced scales (118 144 observations, 28 685 individuals). Multilevel linear spline models allowed for non-linear change over time and differences between cohorts and raters (parent/teacher/self). Results: Patterns of age-related change differed by measure, cohort and country: overall, SDQ scores decreased with age, most rapidly declining before age 8 years (-0.157, 95% CI: -0.170, -0.144 per year). The pattern was generally consistent using DSM scores, although with greater between-cohort variation. DSM scores decreased most rapidly between ages 14 and 17 years (-1.32%, 95% CI: -1.471, -1.170 per year). Average scores were consistently lower for females than males (SDQ: -0.818, 95% CI: -0.856, -0.780; DSM: -4.934%, 95% CI: -5.378, -4.489). This sex difference decreased over age for both measures, due to an overall steeper decrease for males. Conclusions: ADHD trait scores declined from childhood to mid-life, with marked variation between cohorts. Our results highlight the importance of taking a developmental perspective when considering typical population traits. When interpreting changes in clinical cohorts, it is important to consider the pattern of expected change within the general population, which is influenced by cultural context and measurement.

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  • The rate of both childhood and adulthood ADHD symptoms (2.6%) is consistent with current empirical knowledge and confirms the hypothesis of a continuous decrease of ADHD symptomatology with increasing age.

    “Both, clinically relevant symptoms in childhood as well as in adulthood were reported by 2.6% of our sample, a rate which goes well with the current empirical knowledge about the course of ADHD along the lifespan and confirms our hypothesis of a continuous decrease of ADHD symptomatology with increasing age (Wootton et al. 2022).”

    From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Wootton et al. 2022

    The Introduction gives a 2.6% estimated prevalence for adults, not for people reporting clinically relevant symptoms in both childhood and adulthood. The Discussion reports an overall decrease in ADHD traits with age, but the Results describe a small increase in measured scores from ages 17 to 21, so the paper does not establish a strictly continuous decrease. (LLM, conf=0.87)

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Authors
Wootton, R. E., Riglin, L., Blakey, R., Agnew-Blais, J., Caye, A., Cadman, T., Havdahl, A., Gonçalves, H., Menezes, A. M. B., Wehrmeister, F. C., Rimfeld, K., Davey Smith, G., Eley, T. C., Rohde, L. A., Arseneault, L., Moffitt, T. E., Stergiakouli, E., Thapar, A., & Tilling, K.
Affiliations
  • University of Bristol (GB)
  • Cardiff University (GB)
  • Department of Psychology, School of Biological and Chemical Science, Queen Mary University of London, London, UK
  • Universidade Federal do Rio Grande do Sul (BR)
  • Norwegian Institute of Public Health (NO)
  • Universidade Federal de Pelotas (BR)
  • King's College London (GB)
  • MRC Integrative Epidemiology Unit, University of Bristol , Bristol, UK
  • National Institute of Developmental Psychiatry for Children and Adolescents , Brazil
  • Duke University (US)
Corresponding author
Wootton, Robyn E
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2022-04-11
Volume
51
Issue
3
Pages
919-930
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/dyac049
PMC
PMC9189965
OpenAlex
W4223631522
Cited by
29
References
11
Citations by year
2026: 4 · 2025: 7 · 2024: 7 · 2023: 10 · 2022: 1
FWCI
4.07
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Epidemiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, cc-by)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
Funders
  • The UK Medical Research Council and Wellcome (217065/Z/19/Z)
  • University of Bristol provide core support for ALSPAC
  • NIH (5R01MH073842-04)
  • Wellcome Trust and MRC (076467/Z/05/Z)
  • Wellcome Trust (204895/Z/16/Z)
  • UK Medical Research Council (MR/V012878/1, G0901245, G1002190)
  • US National Institutes of Health (AG046938)
  • US National Institute of Child Health and Development (HD077482)
  • Klaus J. Jacobs Foundation
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, ADHD traits, life course, developmental trajectories, general population, birth cohort, sex differences, Strengths and Difficulties Questionnaire, age-related changes, cultural context, measurement variability
MeSH terms
Birth Cohort, Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Humans, Life Change Events, Male, Middle Aged, Phenotype, Cohort Studies, Young Adult

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