Attention-deficit hyperactivity disorder dimensions: A twin study of inattention and impulsivity-hyperactivity

Objective: This study used a model-fitting strategy to estimate genetic and environmental contributions to the core behavioral dimensions associated with attention-deficit hyperactivity disorder (ADHD) in 576 twin boys, aged 11 and 12 years. Method: Teacher ratings and maternal structured interview reports composed of behavioral items including DSM-III and DSM-III-R criteria for ADHD were obtained for 194 pairs of monozygotic and 94 pairs of dizygotic twins. Factor analysis of these measures yielded two ADHD-related dimensions, inattention and impulsivity-hyperactivity. Scales representing these dimensions were used in the genetic analyses. Results: Univariate analyses supported a substantial contribution of genetic factors in the expression of inattention and impulsivity-hyperactivity and smaller contributions of shared and nonshared environmental factors. Results varied according to informant source, with mothers' reports suggestive of rater bias effects. Bivariate analyses indicated that the correlation between these two ADHD dimensions was also genetically mediated. Conclusions: Genetic factors are etiologically important in the expression of the separate dimensions of ADHD and in the covariation between them. However, it is important to obtain reports from more than one informant because rater bias effects may be operative, particularly in maternal reports.