The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.
Attention-Deficit Hyperactivity Disorder: A Category or a Continuum? Genetic Analysis of a Large-Scale Twin Study
Abstract
Objective To investigate heritability and continuum versus categorical approaches to attention-deficit hyperactivity disorder (ADHD), using a large-scale twin sample.Method A cohort of 1,938 families with twins and siblings aged 4 to 12 years, recruited from the Australian National Health and Medical Research Council Twin Registry, was assessed for ADHD using a DSM-III-R-based maternal rating scale. Probandwise concordance rates and correlations in monozygotic and dizygotic twins and siblings were calculated, and heritability was examined using the De Fries and Fulker regression technique.Results There was a narrow (additive) heritability of 0.75 to 0.91 which was robust across familial relationships (twin, sibling, and twin-sibling) and across definitions of ADHD as part of a continuum or as a disorder with various symptom cutoffs. There was no evidence for nonadditive genetic variation or for shared family environmental effects.Conclusions These findings suggest that ADHD is best viewed as the extreme of a behavior that varies genetically throughout the entire population rather than as a disorder with discrete determinants. This has implications for the classification of ADHD and for the identification of genes for this behavior, as well as implications for diagnosis and treatment.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Family, twin and adoption studies show that ADHD is a familial disorder with high heritability, indicating that a significant genetic component influences risk for the disorder [46-54].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [54]
In the citing paper
“although ADHD is typically discussed as a categorical diagnosis, symptoms of ADHD can be considered from a dimensional perspective (Frazier, Youngstrom, & Naugle, 2007; Levy, Hay, McStephen, Wood, & Waldman, 1997).”
From Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions (2015) · cites this paper as Levy, Hay, McStephen, Wood, & Waldman, 1997
In the citing paper
“Etiologically, twin studies have supported high levels of heritability (Levy et al, 1997) for ADHD, indicating a strong genetic basis for the disorder.”
From Deviations from the expectable environment in early childhood and emerging psychopathology (2015) · cites this paper as Levy et al, 1997
Citations
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 109,845
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603
(1991) · Medical Entomology and Zoology · Cited by 8,071
Methodology for Genetic Studies of Twins and Families
Neale, M. C., & Cardon, L. R. (1992) · doi:10.1007/978-94-015-8018-2 · Cited by 4,005
Education, health, and behaviour
Rutter, M. E. (1970) · Medical Entomology and Zoology · Cited by 3,236
Ebstein, R. P., Novick, O., Umansky, R., Priel, B., Osher, Y., Blaine, D., Bennett, E. R., Nemanov, L., Katz, M., & Belmaker, R. H. (1996) · Nature Genetics · doi:10.1038/ng0196-78 · Cited by 1,475
Benjamin, J., Li, L., Patterson, C. A., Greenberg, B. D., Murphy, D. L., & Hamer, D. H. (1996) · Nature Genetics · doi:10.1038/ng0196-81 · Cited by 1,191
Diagnostic and Statistical Manual of Mental Disorders
Preedy, V., & Watson, R. (2010) · Springer eBooks · doi:10.1007/978-0-387-78665-0_5485 · Cited by 1,146
The Genetic Basis of Complex Human Behaviors
Plomin, R. J., Owen, M. J., & McGuffin, P. (1994) · Science · doi:10.1126/science.8209254 · Cited by 1,033
Association of attention-deficit disorder and the dopamine transporter gene.
Cook, E. H., Stein, M. A., Krasowski, M. D., Cox, N. J., Olkon, D. M., Kieffer, J. E., & LEVENTHAL, B. L. (1995) · PubMed · Cited by 995
Biederman, J. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820090056010 · Cited by 771
Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder.
LaHoste, G. J., Swanson, J. M., Wigal, S. B., Glabe, C. G., Wigal, T. L., King, N., & Kennedy, J. L. (1996) · PubMed · Cited by 678
Multiple regression analysis of twin data
DeFries, J. C., & Fulker, D. W. (1985) · Behavior Genetics · doi:10.1007/bf01066239 · Cited by 660
Attention-Deficit Hyperactivity Disorder
Hinshaw, S. P., & Zalecki, C. A. (2001) · Elsevier eBooks · doi:10.1016/b978-008043362-2/50006-8 · Cited by 585
Quantitative Trait Locus for Reading Disability on Chromosome 6
Cardon, L. R., Smith, S. D., Fulker, D. W., Kimberling, W. J., Pennington, B. F., & DeFries, J. C. (1994) · Science · doi:10.1126/science.7939663 · Cited by 533
Plomin, R. J., & McClearn, G. E. (1993) · American Psychological Association eBooks · doi:10.1037/10131-000 · Cited by 486
Family-Genetic and Psychosocial Risk Factors in DSM-III Attention Deficit Disorder
BIEDERMAN, J., FARAONE, S. V., KEENAN, K., KNEE, D., & TSUANG, M. T. (1990) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199007000-00004 · Cited by 478
Goodman, R., & Stevenson, J. (1989) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1989.tb00782.x · Cited by 363
A Twin Study of Competence and Problem Behavior in Childhood and Early Adolescence
EDELBROCK, C. S., Rende, R., Plomin, R. J., & Thompson, L. A. (1995) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1995.tb01328.x · Cited by 323
Multiple Regression Analysis of Twin Data: Etiology of Deviant Scores versus Individual Differences
DeFries, J. C., & Fulker, D. W. (1988) · Acta geneticae medicae et gemellologiae · doi:10.1017/s0001566000003810 · Cited by 304
Genetic Factors in Child Psychiatric Disorders—II. Empirical Findings
Rutter, M. L., Macdonald, H., Couteur, A. S. L., Harrington, R., Bolton, P., & Bailey, A. J. (1990) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1990.tb02273.x · Cited by 241
(2005) · CRC Press eBooks · doi:10.1201/b14615 · Cited by 226
The Epidemiology of Childhood Hyperactivity
Garralda, M. E. (1992) · Archives of Disease in Childhood · doi:10.1136/adc.67.8.1060-b · Cited by 217
Gjone, H., Stevenson, J., & Sundet, J. M. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199605000-00013 · Cited by 208
Reliably Separating Identical From Fraternal Twins
Cohen, D. J. (1975) · Archives of General Psychiatry · doi:10.1001/archpsyc.1975.01760290039004 · Cited by 204
Evidence for a genetic etiology in hyperactivity in children
Stevenson, J. (1992) · Behavior Genetics · doi:10.1007/bf01066665 · Cited by 182
Attention deficit disorder in reading-disabled twins: Evidence for a genetic etiology
Gillis, J. J., Gilger, J. W., Pennington, B. F., & DeFries, J. C. (1992) · Research on Child and Adolescent Psychopathology · doi:10.1007/bf00916694 · Cited by 175
Biederman, J., Münir, K., & Knee, D. (1987) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198709000-00018 · Cited by 171
Activity Level and Hyperactivity in Twins
Willerman, L. (1973) · Child Development · doi:10.2307/1128049 · Cited by 165
van den Oord, E. J. C. G., Boomsma, D. I., & Verhulst, F. C. (1994) · Behavior Genetics · doi:10.1007/bf01067187 · Cited by 158
Thapar, A., Amaia Hervas, G., & McGuffin, P. (1995) · Behavior Genetics · doi:10.1007/bf02327577 · Cited by 151
Segregation analysis of attention deficit hyperactivity disorder
Faraone, S. V., Biederman, J., Chen, W. J., Lehman, B. K., Keenan, K. E., Moore, C. S., Sprich, S. E., & Tsuang, M. T. (1992) · Psychiatric Genetics · doi:10.1097/00041444-199210000-00004 · Cited by 142
Twin‐Sibling Differences in Parental Reports of ADHD, Speech, Reading and Behaviour Problems
Lévy, F., McLaughlin, M., Wood, C., Hay, D. A., & Waldman, I. D. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01443.x · Cited by 134
Self-citationResolving genetic models for the transmission of schizophrenia
McGue, M. K., Gottesman, I. I., Rao, D. C., & Spence, M. A. (1985) · Genetic Epidemiology · doi:10.1002/gepi.1370020110 · Cited by 130
Genetic Epidemiology in Psychiatry: Taking Both Genes and Environment Seriously
Kendler, K. S. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950230009003 · Cited by 126
Scales, Diagnoses, and Child Psychopathology: I. CBCL and DISC Relationships
Jensen, P. S., Salzberg, A. D., Richters, J. E., & Watanabe, H. K. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199303000-00022 · Cited by 124
Multiple pregnancy. Epidemiology, gestation and perinatal outcome
Eskes, T. K. A. B. (1996) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0301-2115(96)90000-7 · Cited by 119
Quantitative Trait Locus for Reading Disability: Correction
Cardon, L. R., Smith, S. D., Fulker, D. W., Kimberling, W. J., Pennington, B. F., & DeFries, J. C. (1995) · Science · doi:10.1126/science.7777847 · Cited by 118
Zahn‐Waxler, C., Schmitz, S., Fulker, D. W., Robinson, J. L., & Emde, R. N. (1996) · Development and Psychopathology · doi:10.1017/s0954579400006994 · Cited by 89
A familial factor in minimal brain dysfunction
Safer, D. J. (1973) · Behavior Genetics · doi:10.1007/bf01067657 · Cited by 83
Importance of Nonshared Environmental Factors for Childhood and Adolescent Psychopathology
Pike, A., & Plomin, R. J. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199605000-00010 · Cited by 71
Genetic and neurobiological aspects of attention deficit hyperactive disorder: a review.
Hechtman, L. T. (1994) · PubMed Central · Cited by 60
Rodgers, J. L., & McGue, M. K. (1994) · Behavior Genetics · doi:10.1007/bf01067192 · Cited by 54
Nature, nurture, and psychopathology: A new look at an old topic
Rutter, M. L. (1991) · Development and Psychopathology · doi:10.1017/s0954579400000031 · Cited by 53
The epidemiology of multiple births in Europe
Thiéry, M. (1996) · Ghent University Academic Bibliography (Ghent University) · Cited by 52
Hay, D. A., & O'Brien, P. J. (1983) · Child Development · doi:10.1111/j.1467-8624.1983.tb03875.x · Cited by 43
Self-citationHay, D. A., & O'Brien, P. J. (1983) · Child Development · doi:10.2307/1129694 · Cited by 41
Self-citationDo they grow out of it? : long-term outcomes of childhood disorders
Hechtman, L. T. (1996) · Medical Entomology and Zoology · Cited by 39
Eaves, L. J., Silberg, J. L., Hewitt, J. K., Meyer, J. M., Rutter, M. L., Simonoff, E. A., Neale, M. C., & Pickles, A. R. (1993) · American Psychological Association eBooks · doi:10.1037/10131-014 · Cited by 36
PREDICTION OF READING DISABILITY TWIN BOYS
Johnston, C., Prior, M. R., & Hay, D. A. (1984) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1984.tb04496.x · Cited by 30
Self-citationReading Disability, Attention-Deficit Hyperactivity Disorder, and the Immune System
Warren, R. P., Odell, J. D., Warren, W. L., Burger, R. A., Maciulis, A., Daniels, W. W., & Torres, A. (1995) · Science · doi:10.1126/science.7605493 · Cited by 18
The Differential Diagnosis of ADHD
Hay, D. A., & Lévy, F. (1996) · The Australian Educational and Developmental Psychologist · doi:10.1017/s0816512200027425 · Cited by 11
Self-citationThe epidemiology of multiple births
Derom, J. O. A. E. R. (2006) · CRC Press eBooks · doi:10.3109/9781439814697-168 · Cited by 8
Use of siblings, twins, and cousins in the study of child and adolescent psychopathology
Todd, R. D. (1994) · Current Opinion in Psychiatry · doi:10.1097/00001504-199407000-00007 · Cited by 7
Gershon, E. S. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950230014004 · Cited by 2
Research works printed but not linked: 1
- Rhee SH, Waldman ID, Hay DA, Levy F (in press), Sex differences in genetic and environmental influences on DSM-III-R attention-deficit-hyperactivity disorder (ADHD). J Abnorm Psychol
Cited by
Sorted by citations
Molecular genetics of attention-deficit/hyperactivity disorder
Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M. A., & Sklar, P. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.11.024 · Cited by 2,357
The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review
Willcutt, E. G. (2012) · Neurotherapeutics · doi:10.1007/s13311-012-0135-8 · Cited by 2,160
Genetics of attention deficit hyperactivity disorder
Faraone, S. V., & Larsson, H. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0070-0 · Cited by 1,338
Temperament and developmental psychopathology
Nigg, J. T. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01612.x · Cited by 971
Kooij, S. J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugué, M., Carpentier, P. J., Edvinsson, D., Fayyad, J., Foeken, K., Fitzgerald, M., et al. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-67 · Cited by 928
“Family, twin and adoption studies show that ADHD is a familial disorder with high heritability, indicating that a significant genetic component influences risk for the disorder [46-54].”
Metadata
- Authors
- LEVY, F., HAY, D. A., McSTEPHEN, M., WOOD, C., & WALDMAN, I.
- Affiliations
- Emory University (US)
- UNSW Sydney (AU)
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 1997-06
- Volume
- 36
- Issue
- 6
- Pages
- 737-744
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W1989251017
- Cited by
- 956
- References
- 55
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 9 · 2023: 16 · 2022: 11 · 2021: 14 · 2020: 21 · 2019: 22 · 2018: 17 · 2017: 32 · 2016: 48 · 2015: 36 · 2014: 29 · 2013: 29 · 2012: 50
- FWCI
- 24.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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, heritability, monozygotic twins, dizygotic twins, additive genetic effects, shared family environment, ADHD classification, gene identification
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Family Health, Female, Humans, Male, Twins, Dizygotic, Twins, Monozygotic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review