A longitudinal twin study of the direction of effects between ADHD symptoms and IQ

Abstract

While the negative association between ADHD symptoms and IQ is well documented, our knowledge about the direction and aetiology of this association is limited. Here, we examine the association of ADHD symptoms with verbal and performance IQ longitudinally in a population-based sample of twins. In a population-based sample of 4,771 twin pairs, DSM-IV ADHD symptoms were obtained from the Conners' Parent Rating Scale-Revised. Verbal (vocabulary) and performance (Raven's Progressive Matrices) IQ were assessed online. ADHD symptom ratings and IQ scores were obtained at ages 12, 14 and 16 years. Making use of the genetic sensitivity and time-ordered nature of our data, we use a cross-lagged model to examine the direction of effects, while modelling the aetiologies of the association between ADHD symptoms with vocabulary and Raven's scores over time. Although time-specific aetiological influences emerged for each trait at ages 14 and 16 years, the aetiological factors involved in the association between ADHD symptoms and IQ were stable over time. ADHD symptoms and IQ scores significantly predicted each other over time. ADHD symptoms at age 12 years were a significantly stronger predictor of vocabulary and Raven's scores at age 14 years than vice versa, whereas no differential predictive effects emerged from age 14 to 16 years. The results suggest that ADHD symptoms may put adolescents at risk for decreased IQ scores. Persistent genetic influences seem to underlie the association of ADHD symptoms and IQ over time. Early intervention is likely to be key to reducing ADHD symptoms and the associated risk for lower IQ.

Fig 1. Cross-lagged twin model.

Circles represent latent genetic (A), shared environmental (C) and non-shared environmental (E) factors for ADHD symptoms and IQ at time 1 (age 12), time 2 (age 14) and time 3 (age 16). Paths from the latent A, C, E factors to the observed variables (a1–a6, c1–c6, e1–e6) represent genetic and environmental contributions to ADHD symptoms and IQ scores. The environmental and genetic correlations between ADHD symptoms and IQ for each time point are indicated below the arrows connecting the respective circles (rE, rC, rA). Stability paths (b₁₁, b₂₂, b₃₃, b₄₄) connect the same traits across time. Cross-lagged paths (b₁₂, b₂₁, b₃₄, b₄₃) connect different traits across time.

Fig 2. Cross-lagged path model of vocabulary and ADHD symptom scores.

95% confidence intervals are provided in brackets. Values in square brackets [] represent time-specific genetic and environmental contributions to ADHD symptoms and vocabulary scores. Asterisks indicate the significantly greater path at the p = 0.05 level. Non-significant paths are indicated by dashed lines.

Fig 3. Cross-lagged path model of Raven’s and ADHD symptom scores.

95% confidence intervals are provided in brackets. Values in square brackets [] represent time-specific genetic and environmental contributions to ADHD symptoms and Raven’s Progressive Matrices Scores. Asterisks indicate the significantly greater path at the p = 0.05 level. Non-significant paths are indicated by dashed lines.