Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T00:07:07.913Z Has data issue: false hasContentIssue false
  • English
  • Français

Genetic and environmental influences on the relationship between adult ADHD symptoms and self-reported problem drinking in 6024 Dutch twins

Published online by Cambridge University Press:  03 March 2014

E. M. Derks ,
J. M. Vink ,
G. Willemsen ,
W. van den Brink  and
D. I. Boomsma
E. M. Derks*
Affiliation:
Department of Psychiatry, Academic Medical Centre, The Netherlands
J. M. Vink
Affiliation:
Department of Biological Psychology, The Netherlands Twin Register, VU University Amsterdam, The Netherlands Neuroscience Campus Amsterdam, The Netherlands
G. Willemsen
Affiliation:
Department of Biological Psychology, The Netherlands Twin Register, VU University Amsterdam, The Netherlands EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam, The Netherlands
W. van den Brink
Affiliation:
Department of Psychiatry, Academic Medical Centre, The Netherlands
D. I. Boomsma
Affiliation:
Department of Biological Psychology, The Netherlands Twin Register, VU University Amsterdam, The Netherlands Neuroscience Campus Amsterdam, The Netherlands EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam, The Netherlands
*
*Address for correspondence: Dr E. M. Derks, Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cross-sectional and longitudinal studies have shown a positive association between attention deficit hyperactivity disorder (ADHD) and problematic alcohol use in adults. To what extent this association is explained by genetic and environmental factors is largely unknown.

Method

Data on ADHD and alcohol consumption were collected by self-report in 6024 adult Dutch twins. ADHD symptoms were assessed by three subscales of the Conners' Adult ADHD Rating Scales – Self-Report: Screening Version (CAARS–S:SV): inattentiveness, hyperactivity and the ADHD index (ADHD-I). Problem drinking was defined as at least two self-reported alcohol-related problems on the CAGE questionnaire. Structural equation modelling was applied to the bivariate twin data to estimate genetic and environmental influences.

Results

Heritability of ADHD symptoms ranged between 32% and 40% and heritability of problem drinking was 50%. The positive correlation between ADHD symptoms and problem drinking was confirmed in this general population sample, with phenotypic correlations between 0.20 and 0.28 and genetic correlations between 0.39 and 0.50. Phenotypic correlations are primarily (61–100%) explained by genetic influences with non-shared environmental influences explaining the remaining covariance. No significant quantitative or qualitative gender differences in covariance structure were found.

Conclusions

This study convincingly shows that ADHD symptoms and problem drinking are moderately but significantly correlated in adults and that genetic correlations are primarily underlying this association. This suggests that early interventions are required to prevent adolescents with ADHD from developing problematic levels of alcohol use. Furthermore, clinicians who treat alcohol-dependent patients should be aware that the patient may have a co-morbid condition of ADHD; integrated interventions are required.

Keywords

ADHDalcohol usebivariateexternalizing disordersgeneticheritabilityproblem drinkingtwins
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 12 , September 2014 , pp. 2673 - 2683
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agrawal, A, Lynskey, MT (2008). Are there genetic influences on addiction: evidence from family, adoption and twin studies. Addiction 103, 1069–1081.Google Scholar
Biederman, J, Wilens, T, Mick, E, Milberger, S, Spencer, TJ, Faraone, SV (1995). Psychoactive substance use disorders in adults with attention deficit hyperactivity disorder (ADHD): effects of ADHD and psychiatric comorbidity. American Journal of Psychiatry 152, 1652–1658.Google Scholar
Bisson, J, Nadeau, L, Demers, A (1999). The validity of the CAGE scale to screen for heavy drinking and drinking problems in a general population survey. Addiction 94, 715–722.Google Scholar
Boomsma, DI, Saviouk, V, Hottenga, JJ, Distel, MA, de Moor, MH, Vink, JM, Geels, LM, van Beek, JH, Bartels, M, De Geus, EJ, Willemsen, G (2010). Genetic epidemiology of attention deficit hyperactivity disorder (ADHD index) in adults. PLoS One 5, e10621.Google Scholar
Conners, CK, Erhardt, D, Sparrow, E (1999). Conners’ Adult ADHD Rating Scales (CAARS). Multi-Health Systems: North Tonawanda, NY.Google Scholar
Derks, EM, Dolan, CV, Boomsma, DI (2004). Effects of censoring on parameter estimates and power in genetic modeling. Twin Research 7, 659–669.Google Scholar
Derks, EM, Hudziak, JJ, Boomsma, DI (2007). Why more boys than girls with ADHD receive treatment: a study of Dutch twins. Twin Research and Human Genetics 10, 765–770.Google Scholar
Disney, ER, Elkins, IJ, McGue, M, Iacono, WG (1999). Effects of ADHD, conduct disorder, and gender on substance use and abuse in adolescence. American Journal of Psychiatry 156, 1515–1521.Google Scholar
Distel, MA, Ligthart, L, Willemsen, G, Nyholt, DR, Trull, TJ, Boomsma, DI (2007). Personality, health and lifestyle in a questionnaire family study: a comparison between highly cooperative and less cooperative families. Twin Research and Human Genetics 10, 348–353.Google Scholar
Edwards, AC, Kendler, KS (2012). Twin study of the relationship between adolescent attention-deficit/hyperactivity disorder and adult alcohol dependence. Journal of Studies on Alcohol and Drugs 73, 185–194.Google Scholar
Elkins, IJ, McGue, M, Iacono, WG (2007). Prospective effects of attention-deficit/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Archives of General Psychiatry 64, 1145–1152.Google Scholar
Franke, B, Faraone, SV, Asherson, P, Buitelaar, J, Bau, CH, Ramos-Quiroga, JA, Mick, E, Grevet, EH, Johansson, S, Haavik, J, Lesch, KP, Cormand, B, Reif, A (2012). The genetics of attention deficit/hyperactivity disorder in adults, a review. Molecular Psychiatry 17, 960–987.Google Scholar
Franke, B, Vasquez, AA, Johansson, S, Hoogman, M, Romanos, J, Boreatti-Hummer, A, Heine, M, Jacob, CP, Lesch, KP, Casas, M, Ribases, M, Bosch, R, Sanchez-Mora, C, Gomez-Barros, N, Fernandez-Castillo, N, Bayes, M, Halmoy, A, Halleland, H, Landaas, ET, Fasmer, OB, Knappskog, PM, Heister, AJ, Kiemeney, LA, Kooij, JJ, Boonstra, AM, Kan, CC, Asherson, P, Faraone, SV, Buitelaar, JK, Haavik, J, Cormand, B, Ramos-Quiroga, JA, Reif, A (2010). Multicenter analysis of the SLC6A3/DAT1 VNTR haplotype in persistent ADHD suggests differential involvement of the gene in childhood and persistent ADHD. Neuropsychopharmacology 35, 656–664.Google Scholar
Friedrichs, B, Igl, W, Larsson, H, Larsson, JO (2012). Coexisting psychiatric problems and stressful life events in adults with symptoms of ADHD – a large Swedish population-based study of twins. Journal of Attention Disorders 16, 13–22.Google Scholar
Geels, LM, Vink, JM, van Beijsterveldt, CE, Bartels, M, Boomsma, DI (2013). Developmental prediction model for early alcohol initiation in Dutch adolescents. Journal of Studies on Alcohol and Drugs 74, 59–70.Google Scholar
Gizer, IR, Ficks, C, Waldman, ID (2009). Candidate gene studies of ADHD: a meta-analytic review. Human Genetics 126, 51–90.Google Scholar
Kan, KJ, Dolan, CV, Nivard, MG, Middeldorp, CM, van Beijsterveldt, CE, Willemsen, G, Boomsma, DI (2013). Genetic and environmental stability in attention problems across the lifespan: evidence from the Netherlands Twin Register. Journal of the American Academy of Child and Adolescent Psychiatry 52, 12–25.Google Scholar
Kendler, KS, Gardner, C, Dick, DM (2011). Predicting alcohol consumption in adolescence from alcohol-specific and general externalizing genetic risk factors, key environmental exposures and their interaction. Psychological Medicine 41, 1507–1516.Google Scholar
Kendler, KS, Schmitt, E, Aggen, SH, Prescott, CA (2008). Genetic and environmental influences on alcohol, caffeine, cannabis, and nicotine use from early adolescence to middle adulthood. Archives of General Psychiatry 65, 674–682.Google Scholar
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163, 716–723.Google Scholar
Knop, J, Penick, EC, Nickel, EJ, Mortensen, EL, Sullivan, MA, Murtaza, S, Jensen, P, Manzardo, AM, Gabrielli, WF Jr. (2009). Childhood ADHD and conduct disorder as independent predictors of male alcohol dependence at age 40. Journal of Studies on Alcohol and Drugs 70, 169–177.Google Scholar
Knopik, VS, Heath, AC, Bucholz, KK, Madden, PA, Waldron, M (2009 a). Genetic and environmental influences on externalizing behavior and alcohol problems in adolescence: a female twin study. Pharmacology Biochemistry and Behavior 93, 313–321.Google Scholar
Knopik, VS, Heath, AC, Jacob, T, Slutske, WS, Bucholz, KK, Madden, PA, Waldron, M, Martin, NG (2006). Maternal alcohol use disorder and offspring ADHD: disentangling genetic and environmental effects using a children-of-twins design. Psychological Medicine 36, 1461–1471.Google Scholar
Knopik, VS, Jacob, T, Haber, JR, Swenson, LP, Howell, DN (2009 b). Paternal alcoholism and offspring ADHD problems: a children of twins design. Twin Research and Human Genetics 12, 53–62.Google Scholar
Larsson, H, Asherson, P, Chang, Z, Ljung, T, Friedrichs, B, Larsson, JO, Lichtenstein, P (2013). Genetic and environmental influences on adult attention deficit hyperactivity disorder symptoms: a large Swedish population-based study of twins. Psychological Medicine 43, 197–207.Google Scholar
Lynch, M, Walsh, B (1998). Genetics and Analysis of Quantitative Traits. Sinauer Associates: Sunderland, MA.Google Scholar
Murthy, P, Chand, P (2012). Treatment of dual diagnosis disorders. Current Opinion in Psychiatry 25, 194–200.Google Scholar
Neale, BM, Medland, SE, Ripke, S, Asherson, P, Franke, B, Lesch, KP, Faraone, SV, Nguyen, TT, Schafer, H, Holmans, P, Daly, M, Steinhausen, HC, Freitag, C, Reif, A, Renner, TJ, Romanos, M, Romanos, J, Walitza, S, Warnke, A, Meyer, J, Palmason, H, Buitelaar, J, Vasquez, AA, Lambregts-Rommelse, N, Gill, M, Anney, RJ, Langely, K, O'Donovan, M, Williams, N, Owen, M, Thapar, A, Kent, L, Sergeant, J, Roeyers, H, Mick, E, Biederman, J, Doyle, A, Smalley, S, Loo, S, Hakonarson, H, Elia, J, Todorov, A, Miranda, A, Mulas, F, Ebstein, RP, Rothenberger, A, Banaschewski, T, Oades, RD, Sonuga-Barke, E, McGough, J, Nisenbaum, L, Middleton, F, Hu, X, Nelson, S (2010). Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry 49, 884–897.Google Scholar
Neale, M, Booker, S, Xie, G, Maes, H (2003). Mx: Statistical Modeling. Department of Psychiatry: Richmond, VA.Google Scholar
Nikolas, MA, Burt, SA (2010). Genetic and environmental influences on ADHD symptom dimensions of inattention and hyperactivity: a meta-analysis. Journal of Abnormal Psychology 119, 1–17.Google Scholar
Plomin, R, DeFries, JC, McClearn, GE, McGuffin, P (2008). Behavioral Genetics. Worth Publishers: New York.Google Scholar
Poelen, EA, Derks, EM, Engels, RC, van Leeuwe, JF, Scholte, RH, Willemsen, G, Boomsma, DI (2008). The relative contribution of genes and environment to alcohol use in early adolescents: are similar factors related to initiation of alcohol use and frequency of drinking? Alcoholism: Clinical and Experimental Research 32, 975–982.Google Scholar
Rietschel, M, Treutlein, J (2013). The genetics of alcohol dependence. Annals of the New York Academy of Sciences 1282, 39–70.Google Scholar
Schumann, G, Coin, LJ, Lourdusamy, A, Charoen, P, Berger, KH, Stacey, D, Desrivieres, S, Aliev, FA, Khan, AA, Amin, N, Aulchenko, YS, Bakalkin, G, Bakker, SJ, Balkau, B, Beulens, JW, Bilbao, A, de Boer, RA, Beury, D, Bots, ML, Breetvelt, EJ, Cauchi, S, Cavalcanti-Proenca, C, Chambers, JC, Clarke, TK, Dahmen, N, De Geus, EJ, Dick, D, Ducci, F, Easton, A, Edenberg, HJ, Esko, T, Fernandez-Medarde, A, Foroud, T, Freimer, NB, Girault, JA, Grobbee, DE, Guarrera, S, Gudbjartsson, DF, Hartikainen, AL, Heath, AC, Hesselbrock, V, Hofman, A, Hottenga, JJ, Isohanni, MK, Kaprio, J, Khaw, KT, Kuehnel, B, Laitinen, J, Lobbens, S, Luan, J, Mangino, M, Maroteaux, M, Matullo, G, McCarthy, MI, Mueller, C, Navis, G, Numans, ME, Nunez, A, Nyholt, DR, Onland-Moret, CN, Oostra, BA, O'Reilly, PF, Palkovits, M, Penninx, BW, Polidoro, S, Pouta, A, Prokopenko, I, Ricceri, F, Santos, E, Smit, JH, Soranzo, N, Song, K, Sovio, U, Stumvoll, M, Surakk, I, Thorgeirsson, TE, Thorsteinsdottir, U, Troakes, C, Tyrfingsson, T, Tonjes, A, Uiterwaal, CS, Uitterlinden, AG, van der Harst, P, van der Schouw, YT, Staehlin, O, Vogelzangs, N, Vollenweider, P, Waeber, G, Wareham, NJ, Waterworth, DM, Whitfield, JB, Wichmann, EH, Willemsen, G, Witteman, JC, Yuan, X, Zhai, G, Zhao, JH, Zhang, W, Martin, NG, Metspalu, A, Doering, A, Scott, J, Spector, TD, Loos, RJ, Boomsma, DI, Mooser, V, Peltonen, L, Stefansson, K, van Duijn, CM, Vineis, P, Sommer, WH, Kooner, JS, Spanagel, R, Heberlein, UA, Jarvelin, MR, Elliott, P (2011). Genome-wide association and genetic functional studies identify autism susceptibility candidate 2 gene (AUTS2) in the regulation of alcohol consumption. Proceedings of the National Academy of Sciences USA 108, 7119–7124.Google Scholar
Shaw, M, Hodgkins, P, Caci, H, Young, S, Kahle, J, Woods, AG, Arnold, LE (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Medicine 10, 99.Google Scholar
Shekim, WO, Asarnow, RF, Hess, E, Zaucha, K, Wheeler, N (1990). A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Comprehensive Psychiatry 31, 416–425.Google Scholar
Simon, V, Czobor, P, Balint, S, Meszaros, A, Bitter, I (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. British Journal of Psychiatry 194, 204–211.Google Scholar
Tuithof, M, ten Have, M, van den Brink, W, Vollebergh, W, de Graaf, R (2012). The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study–2. Drug and Alcohol Dependence 123, 115–121.Google Scholar
van den Berg, SM, Willemsen, G, de Geus, EJ, Boomsma, DI (2006). Genetic etiology of stability of attention problems in young adulthood. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 141B, 55–60.Google Scholar
van der Zwaluw, CS, Scholte, RH, Vermulst, AA, Buitelaar, JK, Verkes, RJ, Engels, RC (2008). Parental problem drinking, parenting, and adolescent alcohol use. Journal of Behavioral Medicine 31, 189–200.Google Scholar
van Emmerik-van Oortmerssen, K, Vedel, E, Koeter, MW, de Bruijn, K, Dekker, JJ, van den Brink, W, Schoevers, RA (2013). Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial. BMC Psychiatry 13, 132.Google Scholar
Volkow, ND, Wang, GJ, Kollins, SH, Wigal, TL, Newcorn, JH, Telang, F, Fowler, JS, Zhu, W, Logan, J, Ma, Y, Pradhan, K, Wong, C, Swanson, JM (2009). Evaluating dopamine reward pathway in ADHD: clinical implications. Journal of the American Medical Association 302, 1084–1091.Google Scholar
Wilens, TE, Martelon, M, Joshi, G, Bateman, C, Fried, R, Petty, C, Biederman, J (2011). Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 50, 543–553.Google Scholar
Young, SE, Stallings, MC, Corley, RP, Krauter, KS, Hewitt, JK (2000). Genetic and environmental influences on behavioral disinhibition. American Journal of Medical Genetics 96, 684–695.Google Scholar
Zucker, RA (2008). Anticipating problem alcohol use developmentally from childhood into middle adulthood: what have we learned? Addiction 103 (Suppl. 1), 100–108.Google Scholar
Supplementary material: File

Derks Supplementary Material

Tables

Download Derks Supplementary Material(File)
File 78.3 KB