Psychological Medicine



Contributions of parental alcoholism, prenatal substance exposure, and genetic transmission to child ADHD risk: a female twin study


VALERIE S. KNOPIK a1c1, ELIZABETH P. SPARROW a2, PAMELA A. F. MADDEN a3, KATHLEEN K. BUCHOLZ a3, JAMES J. HUDZIAK a4, WENDY REICH a3, WENDY S. SLUTSKE a5, JULIA D. GRANT a3, TARA L. McLAUGHLIN a6, ALEXANDRE TODOROV a3, RICHARD D. TODD a3 and ANDREW C. HEATH a3
a1 Center for Alcohol and Addiction Studies, Department of Community Health, Brown University Medical School, Providence, RI, USA
a2 Kennedy Krieger Institute, Baltimore, MD, USA
a3 Missouri Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
a4 Department of Psychiatry, University of Vermont, VT, USA
a5 Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
a6 Hartford Hospital Research Program, Hartford, CT, USA

Article author query
knopik vs   [PubMed][Google Scholar] 
sparrow ep   [PubMed][Google Scholar] 
madden pa   [PubMed][Google Scholar] 
bucholz kk   [PubMed][Google Scholar] 
hudziak jj   [PubMed][Google Scholar] 
reich w   [PubMed][Google Scholar] 
slutske ws   [PubMed][Google Scholar] 
grant jd   [PubMed][Google Scholar] 
mclaughlin tl   [PubMed][Google Scholar] 
todorov a   [PubMed][Google Scholar] 
todd rd   [PubMed][Google Scholar] 
heath ac   [PubMed][Google Scholar] 

Abstract

Background. Genetic influences have been shown to play a major role in determining the risk of attention-deficit hyperactivity disorder (ADHD). In addition, prenatal exposure to nicotine and/or alcohol has also been suggested to increase risk of the disorder. Little attention, however, has been directed to investigating the roles of genetic transmission and prenatal exposure simultaneously.

Method. Diagnostic telephone interview data from parents of Missouri adolescent female twin pairs born during 1975–1985 were analyzed. Logistic regression models were fitted to interview data from a total of 1936 twin pairs (1091 MZ and 845 DZ pairs) to determine the relative contributions of parental smoking and drinking behavior (both during and outside of pregnancy) as risk factors for DSM-IV ADHD. Structural equation models were fitted to determine the extent of residual genetic and environmental influences on ADHD risk while controlling for effects of prenatal and parental predictors on risk.

Results. ADHD was more likely to be diagnosed in girls whose mothers or fathers were alcohol dependent, whose mothers reported heavy alcohol use during pregnancy, and in those with low birth weight. Controlling for other risk factors, risk was not significantly increased in those whose mothers smoked during pregnancy. After allowing for effects of prenatal and childhood predictors, 86% of the residual variance in ADHD risk was attributable to genetic effects and 14% to non-shared environmental influences.

Conclusions. Prenatal and parental risk factors may not be important mediators of influences on risk with much of the association between these variables and ADHD appearing to be indirect.


Correspondence:
c1 Center for Alcohol and Addiction Studies, Department of Community Health, Brown University Medical School, Box G-BH, Providence, RI 02912, USA. (Email: valerie_knopik@Brown.edu)


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