Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T05:22:00.277Z Has data issue: false hasContentIssue false
  • English
  • Français

Childhood maltreatment and attention deficit hyperactivity disorder symptoms in adults: a large twin study

Published online by Cambridge University Press:  05 July 2016

A. J. Capusan ,
R. Kuja-Halkola ,
P. Bendtsen ,
E. Viding ,
E. McCrory ,
I. Marteinsdottir  and
H. Larsson
A. J. Capusan*
Affiliation:
Department of Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
R. Kuja-Halkola
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
P. Bendtsen
Affiliation:
Department of Medical specialist and Department of Medical and Health Sciences, Linköping, University, Motala, Sweden
E. Viding
Affiliation:
Developmental Risk and Resilience Unit, University College, London UK
E. McCrory
Affiliation:
Developmental Risk and Resilience Unit, University College, London UK
I. Marteinsdottir
Affiliation:
Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience (CSAN), Linköping University, Linköping, Sweden
H. Larsson
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Medical Sciences, Örebro University, Örebro, Sweden
*
*Address for correspondence: Dr A. J. Capusan, Department of Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, SE-581 83 Linköping, Sweden. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Childhood maltreatment (CM) has been associated with increased risk of attention deficit hyperactivity disorder (ADHD) in children and adults. It is, however, unclear whether this association is causal or due to familial confounding.

Method

Data from 18 168 adult twins, aged 20–46 years, were drawn from the population-based Swedish twin registry. Retrospective self-ratings of CM (emotional and physical neglect, physical and sexual abuse and witnessing family violence), and self-ratings for DSM-IV ADHD symptoms in adulthood were analysed. Possible familial confounding was investigated using a within twin-pair design based on monozygotic (MZ) and dizygotic (DZ) twins.

Results

CM was significantly associated with increased levels of ADHD symptom scores in adults [regression coefficient: 0.40 standard deviations, 95% confidence interval (CI) 0.37–0.43]. Within twin-pair analyses showed attenuated but significant estimates within DZ (0.29, 95% CI 0.21–0.36) and MZ (0.18, 95% CI 0.10–0.25) twin pairs. Similar results emerged for hyperactive/impulsive and inattentive ADHD symptom scores separately in association with CM. We conducted sensitivity analyses for early maltreatment, before age 7, and for abuse and neglect separately, and found similarly reduced estimates in DZ and MZ pairs. Re-traumatization after age 7 did not significantly influence results.

Conclusions

CM was significantly associated with increased ADHD symptoms in adults. Associations were partly due to familial confounding, but also consistent with a causal interpretation. Our findings support cognitive neuroscience studies investigating neural pathways through which exposure to CM may influence ADHD. Clinicians treating adults with ADHD should be aware of the association with maltreatment.

Keywords

Adult ADHDchildhood maltreatmentenvironmental riskfamilial confoundingtwins
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 12 , September 2016 , pp. 2637 - 2646
Copyright
Copyright © Cambridge University Press 2016 

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

Alemany, S, Goldberg, X, Van Winkel, R, Gasto, C, Peralta, V, Fananas, L (2013). Childhood adversity and psychosis: examining whether the association is due to genetic confounding using a monozygotic twin differences approach. European Psychiatry 28, 207–212.Google Scholar
Annerback, EM, Wingren, G, Svedin, CG, Gustafsson, PA (2010). Prevalence and characteristics of child physical abuse in Sweden – findings from a population-based youth survey. Acta Paediatrica 99, 1229–1236.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. DSM-IV-TR, American Psychiatric Association: Washington, DC.Google Scholar
Barkley, RA, Fischer, M, Smallish, L, Fletcher, K (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology 111, 279–289.Google Scholar
Bornovalova, MA, Cummings, JR, Hunt, E, Blazei, R, Malone, S, Iacono, WG (2014). Understanding the relative contributions of direct environmental effects and passive genotype-environment correlations in the association between familial risk factors and child disruptive behavior disorders. Psychological Medicine 44, 831–844.Google Scholar
Briscoe-Smith, AM, Hinshaw, SP (2006). Linkages between child abuse and attention-deficit/hyperactivity disorder in girls: behavioral and social correlates. Child Abuse and Neglect 30, 1239–1255.Google Scholar
Capusan, AJ, Bendtsen, P, Marteinsdottir, I, Kuja-Halkola, R, Larsson, H (2015). Genetic and environmental contributions to the association between attention deficit hyperactivity disorder and alcohol dependence in adulthood: a large population-based twin study. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics. Published online: 25 February 2015. doi:10.1002/ajmg.b.32300.Google Scholar
Cater, AK, Andershed, AK, Andershed, H (2014). Youth victimization in Sweden: prevalence, characteristics and relation to mental health and behavioral problems in young adulthood. Child Abuse and Neglect 38, 1290–1302.Google Scholar
Coughlin, SS (1990). Recall bias in epidemiologic studies. Journal of Clinical Epidemiology 43, 87–91.Google Scholar
Currie, J, Widom, CS (2010). Long-term consequences of child abuse and neglect on adult economic well-being. Childhood Maltreatment 15, 111–120.CrossRefGoogle ScholarPubMed
Durrant, JE (1999). Evaluating the success of Sweden's corporal punishment ban. Child Abuse and Neglect 23, 435–448.Google Scholar
Elton, A, Tripathi, SP, Mletzko, T, Young, J, Cisler, JM, James, GA, Kilts, CD (2014). Childhood maltreatment is associated with a sex-dependent functional reorganization of a brain inhibitory control network. Human Brain Mapping 35, 1654–1667.Google Scholar
Faraone, SV, Mick, E (2010). Molecular genetics of attention deficit hyperactivity disorder. Psychiatric Clinics of North America 33, 159–180.CrossRefGoogle ScholarPubMed
Forsman, M, Langstrom, N (2012). Child maltreatment and adult violent offending: population-based twin study addressing the ‘cycle of violence’ hypothesis. Psychological Medicine 42, 1977–1983.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 Disorder 16, 13–22.CrossRefGoogle ScholarPubMed
Furberg, H, Lichtenstein, P, Pedersen, NL, Thornton, L, Bulik, CM, Lerman, C, Sullivan, PF (2008). The STAGE cohort: a prospective study of tobacco use among Swedish twins. Nicotine & Tobacco Research 10, 1727–1735.Google Scholar
Gilbert, R, Widom, CS, Browne, K, Fergusson, D, Webb, E, Janson, S (2009). Burden and consequences of child maltreatment in high-income countries. Lancet 373, 68–81.CrossRefGoogle ScholarPubMed
Gould, F, Clarke, J, Heim, C, Harvey, PD, Majer, M, Nemeroff, CB (2012). The effects of child abuse and neglect on cognitive functioning in adulthood. Journal of Psychiatric Research 46, 500–506.Google Scholar
Haberstick, BC, Lessem, JM, Hewitt, JK, Smolen, A, Hopfer, CJ, Halpern, CT, Killeya-Jones, LA, Boardman, JD, Tabor, J, Siegler, IC, Williams, RB, Mullan Harris, K (2014). MAOA genotype, childhood maltreatment, and their interaction in the etiology of adult antisocial behaviors. Biological Psychiatry 75, 25–30.CrossRefGoogle ScholarPubMed
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry and Allied Disciplines 45, 260–273.CrossRefGoogle ScholarPubMed
Harold, GT, Leve, LD, Barrett, D, Elam, K, Neiderhiser, JM, Natsuaki, MN, Shaw, DS, Reiss, D, Thapar, A (2013). Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry and Allied Disciplines 54, 1038–1046.Google Scholar
Humphreys, KL, Zeanah, CH (2015). Deviations from the expectable environment in early childhood and emerging psychopathology. Neuropsychopharmacology, 40, 154–170.Google Scholar
Jaffee, SR, Caspi, A, Moffitt, TE, Dodge, KA, Rutter, M, Taylor, A, Tully, LA (2005). Nature x nurture: genetic vulnerabilities interact with physical maltreatment to promote conduct problems. Development and Psychopathology 17, 67–84.Google Scholar
Jaffee, SR, Caspi, A, Moffitt, TE, Polo-Tomas, M, Price, TS, Taylor, A (2004). The limits of child effects: evidence for genetically mediated child effects on corporal punishment but not on physical maltreatment. Developmental Psychology 40, 1047–1058.Google Scholar
Jay Schulz-Heik, R, Rhee, SH, Silvern, L, Lessem, JM, Haberstick, BC, Hopfer, C, Hewitt, JK (2009). Investigation of genetically mediated child effects on maltreatment. Behavior Genetics 39, 265–276.Google Scholar
Kendler, KS & Baker, JH (2007). Genetic influences on measures of the environment: a systematic review. Psychological Medicine 37, 615–626.Google Scholar
Kendler, KS, Bulik, CM, Silberg, J, Hettema, JM, Myers, J, Prescott, CA (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Archives of General Psychiatry 57, 953–959.Google Scholar
Kieling, C, Hutz, MH, Genro, JP, Polanczyk, GV, Anselmi, L, Camey, S, Hallal, PC, Barros, FC, Victora, CG, Menezes, AM & Rohde, LA (2013). Gene-environment interaction in externalizing problems among adolescents: evidence from the Pelotas 1993 Birth Cohort Study. Journal of Child Psychology and Psychiatry and Allied Disciplines 54, 298–304.CrossRefGoogle ScholarPubMed
Kloppen, K, Haugland, S, Svedin, CG, Maehle, M, Breivik, K (2016). Prevalence of child sexual abuse in the Nordic countries: a literature review. Journal of Child Sexual Abuse 25, 37–55.CrossRefGoogle ScholarPubMed
Lansford, JE, Godwin, J, Uribe Tirado, LM, Zelli, A, Al-Hassan, SM, Bacchini, D, Bombi, AS, Bornstein, MH, Chang, L, Deater-Deckard, K, Di Giunta, L, Dodge, KA, Malone, PS, Oburu, P, Pastorelli, C, Skinner, AT, Sorbring, E, Tapanya, S, Pena Alampay, L (2015). Individual, family, and culture level contributions to child physical abuse and neglect: a longitudinal study in nine countries. Development and Psychopathology 27, 1417–1428.CrossRefGoogle ScholarPubMed
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
Lichtenstein, P, Sullivan, PF, Cnattingius, S, Gatz, M, Johansson, S, Carlström, E, Björk, C, Svartengren, M, Wolk, A, Klareskog, L, De Faire, U, Schalling, M, Palmgren, J, Pedersen, NL (2006). The Swedish Twin Registry in the third millennium: an update. Twin Research and Human Genetics 9, 875–882.Google Scholar
Lim, L, Hart, H, Mehta, MA, Simmons, A, Mirza, K, Rubia, K (2015). Neural correlates of error processing in young people with a history of severe childhood abuse: an fMRI study. American Journal of Psychiatry 172, 892–900.Google Scholar
MacDonald, K, Thomas, ML, Sciolla, AF, Schneider, B, Pappas, K, Bleijenberg, G, Bohus, M, Bekh, B, Carpenter, L, Carr, A, Dannlowski, U, Dorahy, M, Fahlke, C, Finzi-Dottan, R, Karu, T, Gerdner, A, Glaesmer, H, Grabe, HJ, Heins, M, Kenny, DT, Kim, D, Knoop, H, Lobbestael, J, Lochner, C, Lauritzen, G, Ravndal, E, Riggs, S, Sar, V, Schafer, I, Schlosser, N, Schwandt, ML, Stein, MB, Subic-Wrana, C, Vogel, M, Wingenfeld, K (2016). Minimization of childhood maltreatment is common and consequential: results from a large, multinational sample using the childhood trauma questionnaire. PLoS ONE 11, e0146058.Google Scholar
Magnusson, A, Lundholm, C, Goransson, M, Copeland, W, Heilig, M, Pedersen, NL (2011). Familial influence and childhood trauma in female alcoholism. Psychological Medicine 42, 381–389.Google Scholar
Martin, J, Hamshere, ML, Stergiakouli, E, O'Donovan, MC, Thapar, A (2014). Genetic risk for attention-deficit/hyperactivity disorder contributes to neurodevelopmental traits in the general population. Biological Psychiatry 76, 664–671.CrossRefGoogle ScholarPubMed
May-Chahal, C, Cawson, P (2005). Measuring child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect. Child Abuse and Neglect 29, 969–984.Google Scholar
McCrory, EJ, Viding, E (2015). The theory of latent vulnerability: reconceptualizing the link between childhood maltreatment and psychiatric disorder. Development and Psychopathology 27, 493–505.Google Scholar
McGee, RA, Wolfe, DA, Yuen, SA, Wilson, SK, Carnochan, J (1995). The measurement of maltreatment: a comparison of approaches. Child Abuse and Neglect 19, 233–249.Google Scholar
McGue, M, Osler, M, Christensen, K (2010). Causal inference and observational research: the utility of twins. Perspectives on Psychological Science 5, 546–556.Google Scholar
Moffitt, TE, Houts, R, Asherson, P, Belsky, DW, Corcoran, DL, Hammerle, M, Harrington, H, Hogan, S, Meier, MH, Polanczyk, GV, Poulton, R, Ramrakha, S, Sugden, K, Williams, B, Rohde, LA Caspi, A (2015). Is adult ADHD a childhood-onset neurodevelopmental disorder? evidence from a four-decade longitudinal cohort study. American Journal of Psychiatry 172, 967–977.Google Scholar
Neiderhiser, JM, Reiss, D, Pedersen, NL, Lichtenstein, P, Spotts, EL, Hansson, K, Cederblad, M, Ellhammer, O (2004). Genetic and environmental influences on mothering of adolescents: a comparison of two samples. Developmental Psychology 40, 335–351.Google Scholar
Nikulina, V, Widom, CS, Czaja, S (2011). The role of childhood neglect and childhood poverty in predicting mental health, academic achievement and crime in adulthood. American Journal of Community Psychology 48, 309–321.Google Scholar
Ouyang, L, Fang, X, Mercy, J, Perou, R, Grosse, SD (2008). Attention-deficit/hyperactivity disorder symptoms and child maltreatment: a population-based study. Journal of Pediatrics 153, 851–856.Google Scholar
Plomin, R, Defries, JC, Knopik, VS, Neiderhiser, JM (2013). Behavioral Genetics. Worth Publishers: New York, pp. 105–118.Google Scholar
Romens, SE, McDonald, J, Svaren, J, Pollak, SD (2015). Associations between early life stress and gene methylation in children. Child Development 86, 303–309.Google Scholar
Roth, TL, Sweatt, JD (2011). Epigenetic marking of the BDNF gene by early-life adverse experiences. Hormones and Behavior 59, 315–320.Google Scholar
Rucklidge, JJ, Brown, DL, Crawford, S, Kaplan, BJ (2006). Retrospective reports of childhood trauma in adults with ADHD. Journal of Attention Disorder 9, 631–641.Google Scholar
Scott, KM, McLaughlin, KA, Smith, DA, Ellis, PM (2012). Childhood maltreatment and DSM-IV adult mental disorders: comparison of prospective and retrospective findings. British Journal of Psychiatry 200, 469–475.Google Scholar
Shadish, WR, Cook, TD, Campbell, DT (2001). Experimental and Quasi-Experimental Designs for Generalized Causal Inference. Houghton Mifflin: Boston.Google Scholar
Shaffer, A, Huston, L, Egeland, B (2008). Identification of child maltreatment using prospective and self-report methodologies: a comparison of maltreatment incidence and relation to later psychopathology. Child Abuse and Neglect 32, 682–692.Google Scholar
Singer, MJ, Humphreys, KL, Lee, SS (2012). Coping self-efficacy mediates the association between child abuse and ADHD in adulthood. Journal of Attention Disorder. Published online: 29 November 2012.Google Scholar
Stevens, SE, Sonuga-Barke, EJ, Kreppner, JM, Beckett, C, Castle, J, Colvert, E, Groothues, C, Hawkins, A, Rutter, M (2008). Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence. Journal of Abnormal Child Psychology 36, 385–398.Google Scholar
Sugaya, L, Hasin, DS, Olfson, M, Lin, KH, Grant, BF, Blanco, C (2012). Child physical abuse and adult mental health: a national study. Journal of Traumatic Stress 25, 384–392.Google Scholar
Thapar, A, Cooper, M (2016). Attention deficit hyperactivity disorder. Lancet 387: 1240–1250.Google Scholar
Whitmore, EA, Kramer, JR, Knutson, JF (1993). The association between punitive childhood experiences and hyperactivity. Child Abuse and Neglect 17, 357–366.Google Scholar
Wolfe, JKR (1997). Gender issues in the assessment of posttraumatic stress disorder. In Assessing Psychological Trauma and PTSD. Guilford Press: New York.Google Scholar
Zeanah, CH, Egger, HL, Smyke, AT, Nelson, CA, Fox, NA, Marshall, PJ, Guthrie, D (2009). Institutional rearing and psychiatric disorders in Romanian preschool children. American Journal of Psychiatry 166, 777–785.Google Scholar