Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-44178
Kuntsi, J; Wood, A C; Rijsdijk, F; Johnson, K A; Andreou, P; Albrecht, B; Arias-Vásquez, A; Buitelaar, J K; McLoughlin, G; Rommelse, N N J; Sergeant, J A; Sonuga-Barke, E J; Uebel, H; van der Meere, J J; Banaschewski, T; Gill, M; Manor, I; Miranda, A; Mulas, F; Oades, R D; Roeyers, H; Rothenberger, A; Steinhausen, H C; Faraone, S V; Asherson, P (2010). Separation of cognitive impairments in attention-deficit/hyperactivity disorder into 2 familial factors. Archives of General Psychiatry, 67(11):1159-1167.
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CONTEXT: Attention-deficit/hyperactivity disorder (ADHD) is associated with widespread cognitive impairments, but it is not known whether the apparent multiple impairments share etiological roots or separate etiological pathways exist. A better understanding of the etiological pathways is important for the development of targeted interventions and for identification of suitable intermediate phenotypes for molecular genetic investigations. OBJECTIVES: To determine, by using a multivariate familial factor analysis approach, whether 1 or more familial factors underlie the slow and variable reaction times, impaired response inhibition, and choice impulsivity associated with ADHD. DESIGN: An ADHD and control sibling-pair design. SETTING: Belgium, Germany, Ireland, Israel, Spain, Switzerland, and the United Kingdom. PARTICIPANTS: A total of 1265 participants, aged 6 to 18 years: 464 probands with ADHD and 456 of their siblings (524 with combined-subtype ADHD), and 345 control participants. MAIN OUTCOME MEASURES: Performance on a 4-choice reaction time task, a go/no-go inhibition task, and a choice-delay task. RESULTS: The final model consisted of 2 familial factors. The larger factor, reflecting 85% of the familial variance of ADHD, captured 98% to 100% of the familial influences on mean reaction time and reaction time variability. The second, smaller factor, reflecting 13% of the familial variance of ADHD, captured 62% to 82% of the familial influences on commission and omission errors on the go/no-go task. Choice impulsivity was excluded in the final model because of poor fit. CONCLUSIONS: The findings suggest the existence of 2 familial pathways to cognitive impairments in ADHD and indicate promising cognitive targets for future molecular genetic investigations. The familial distinction between the 2 cognitive impairments is consistent with recent theoretical models--a developmental model and an arousal-attention model--of 2 separable underlying processes in ADHD. Future research that tests the familial model within a developmental framework may inform developmentally sensitive interventions.
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|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > Center for Child and Adolescent Psychiatry|
|Dewey Decimal Classification:||610 Medicine & health|
|Deposited On:||01 Feb 2011 17:33|
|Last Modified:||08 Mar 2013 15:58|
|Publisher:||American Medical Association|
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