Decline in attention deficit hyperactivity disorder traits over the life-course in the general population: Trajectories across five population birth cohorts spanning ages 3 to 45 years

Robyn E Wootton, Lucy Riglin, Rachel Blakey, Jessica C. Agnew-blais, Arthur Caye, Tim Cadman, Alexandra Havdahl, Helen Gonçalves, Ana Menezes, Fernando Wehrmeister, Kaili Rimfeld, George Davey Smith, Thalia Eley, Luis Augusto Rohde, Louise Arseneault, Terrie Moffitt, Evangelia Stergiakouli, A Thapar, K Tilling

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12 Citations (Scopus)
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Abstract

Background: Trajectories of attention-deficit hyperactivity disorder (ADHD) traits spanning early childhood to mid-life have not been described in general populations across different geographical contexts. Population trajectories are crucial to better understanding typical developmental patterns. Methods: We combined repeated assessments of ADHD traits from five population-based cohorts, spanning ages 3 to 45 years. We used two measures: (i) the Strengths and Difficulties Questionnaire (SDQ) hyperactive-inattentive subscale (175831 observations, 29519 individuals); and (ii) scores from DSM-referenced scales (118144 observations, 28685 individuals). Multilevel linear spline models allowed for non-linear change over time and differences between cohorts and raters (parent/teacher/self). Results: Patterns of age-related change differed by measure, cohort and country: overall, SDQ scores decreased with age, most rapidly declining before age 8 years (-0.157, 95% CI:-0.170,-0.144 per year). The pattern was generally consistent using DSM scores, although with greater between-cohort variation. DSM scores decreased most rapidly between ages 14 and 17 years (-1.32%, 95% CI:-1.471,-1.170 per year). Average scores were consistently lower for females than males (SDQ:-0.818, 95% CI:-0.856,-0.780; DSM:-4.934%, 95% CI:-5.378,-4.489). This sex difference decreased over age for both measures, due to an overall steeper decrease for males. Conclusions: ADHD trait scores declined from childhood to mid-life, with marked variation between cohorts. Our results highlight the importance of taking a developmental perspective when considering typical population traits. When interpreting changes in clinical cohorts, it is important to consider the pattern of expected change within the general population, which is influenced by cultural context and measurement.

Original languageEnglish
Pages (from-to)919-930
Number of pages12
JournalInternational Journal of Epidemiology
Volume51
Issue number3
Early online date11 Apr 2022
DOIs
Publication statusPublished - 1 Jun 2022

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