ADHD symptoms across adolescence: the role of the family and school climate and the DRD4 and 5-HTTLPR genotype

Djûke M Brinksma,Barbara J Van Den Hoofdakker,Annelies De Bildt,Catharina A Hartman,Pieter J Hoekstra,Andrea Dietrich,Jan K Buitelaar

doi:10.1007/s00787-019-01424-3

Abstract

We examined bidirectional relations between attention-deficit/hyperactivity disorder (ADHD) symptoms and family and school climate, and the possible role of DRD4 and/or 5-HTTLPR genotypes herein. Three-wave longitudinal data of 1860 adolescents (mean ages 11, 13.5, and 16 years) from the general population and clinic-referred cohort of TRacking Adolescents’ Individual Lives Survey were used. Using a multigroup Random Intercept Cross-Lagged Panel Model, we tested between-person (i.e., stable trait levels) and within-person (i.e., causal processes) associations across ADHD symptoms, family and school climate, and the extent to which these depended on genotype. Findings indicated no influence of genotype. Results did show significant between-person differences (ADHD symptoms with family climate r = .38; and school climate r = .23, p values < .001), indicating that higher stable levels of ADHD symptoms were associated with a less favorable family and school climate. Regarding within-person causal processes, ADHD symptoms predicted a less favorable family climate in early adolescence (β = .16, p < .01), while ADHD symptoms predicted a more favorable family climate in the later phase of adolescence (β = − .11, p < .01), a finding which we explain by normative developmental changes during adolescence. Overall, this study showed that negative associations between ADHD symptoms and both family and school climate are largely explained by stable between-person differences. We recommend applying the Random Intercept Cross-Lagged Path Model to developmental data to tease stable associations and change processes apart.

Highlights

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood [1]
A similar effect has been found for the association between teacher–student dissatisfaction and rule-breaking behaviors which was stronger for adolescents without the 7-repeat DRD4 non-long carriers [39]. Together these findings suggest that the prospective associations between family and school climate and ADHD studied here may be moderated by DRD4 genotype
The current study examined whether bidirectional associations between ADHD symptoms and the family and school climate were moderated by the plasticity genes DRD4 and 5-HTTLPR across adolescence in a large pooled population and clinic-referred sample

Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood [1]. European Child & Adolescent Psychiatry (2020) 29:1049–1061 relations, have shown in (pre-)school aged boys that a less optimal family environment predicted higher ADHD levels [14]. One longitudinal study found that higher levels of parental involvement predicted reduced symptoms of ADHD symptoms in young children [18]. A more optimal family environment predicted lower ADHD symptoms [19, 20]. There has been more attention for (prospective) associations between ADHD symptoms and family functioning, but those studies often focused on parental ADHD symptoms rather than the broader family environment (e.g., [21, 22]). Prospective associations between adolescents’ ADHD symptoms and the socio-emotional quality of family functioning, which we here refer to as the family climate, are an understudied topic

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Conclusion