Journal of Abnormal Child Psychology

, Volume 37, Issue 2, pp 153–167

A Common Genetic Factor Explains the Covariation Among ADHD ODD and CD Symptoms in 9–10 Year Old Boys and Girls

  • Catherine Tuvblad
  • Mo Zheng
  • Adrian Raine
  • Laura A. Baker


Previous studies examining the covariation among Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) have yielded inconsistent results. Some studies have concluded that the covariation among these symptoms is due to common genetic influences, whereas others have found a common environmental overlap. The present study investigated the genetic and environmental correlations among these three childhood disorders, based on a sample of 1,219 twins, age 9–10 years. A latent externalizing behavior factor was found to explain the covariance among ADHD, ODD and CD symptoms. Genetic influences explained more than half of the variance in this externalizing factor in both boys and girls. There were also unique genetic and environmental influences in each set of symptoms, suggesting some etiological independence of the three disorders. Our findings have implications for molecular genetic studies trying to identify susceptibility genes for these disorders.


ADHD CD ODD Covariation Genetic influences Twins 


  1. Akaike, A. C. (1987). Factor analysis and AIC. Psychometrika, 52, 317–332.CrossRefGoogle Scholar
  2. American Psychiatric Association. (2004). American Psychiatric Association DSM-IV-TR Diagnostic and Statistical Manual of Mental Disoders. Washington, DC.Google Scholar
  3. Anckarsäter, H., Stahlberg, O., Larson, T., Hakansson, C., Jutblad, S. B., Niklasson, L., et al. (2006). The impact of ADHD and autism spectrum disorders on temperament, character, and personality development. American Journal of Psychiatry, 163, 1239–1244.PubMedCrossRefGoogle Scholar
  4. Angold, A., Costello, J. E., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.PubMedCrossRefGoogle Scholar
  5. Baker, L. A., Barton, M., Lozano, D. I., Raine, A., & Fowler, J. H. (2006). The Southern California Twin Register at the University of Southern California: II. Twin Research and Human Genetics, 9, 933–940.PubMedCrossRefGoogle Scholar
  6. Baker, L. A., Jacobson, K. C., Raine, A., Lozano, D. I., & Bezdjian, S. (2007). Genetic and environmental bases of childhood antisocial behavior: A multi-informant twin study. Journal of Abnormal Psychology, 116, 219–235.PubMedCrossRefGoogle Scholar
  7. Bartels, M., Hudziak, J. J., van den Oord, E. J. C. G., van Beijsterveldt, C. E. M., Rietveld, M. J. H., Boomsma, D., et al. (2003). Co-occurrence of aggressive behavior and rule-breaking behavior at age 12: multi-rater analyses. Behavior Genetics, 33, 607–621.PubMedCrossRefGoogle Scholar
  8. Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal Psychiatry, 148, 564–577.Google Scholar
  9. Biederman, J., & Faraone, S. V. (2006). The effects of attention-deficit/hyperactivity disorder on employment and household income. Medscape General Medicine, 18, 3–12.Google Scholar
  10. Biederman, J., Faraone, S. V., Milberger, S., Jetton, J. G., Chen, L., Mick, E., et al. (1996). Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. Journal of the American Academy Child and Adolescent Psychiatry, 35, 1193–1204.Google Scholar
  11. Brown, R. T., Freeman, W. S., Perrin, J. M., Stein, M. T., Amler, R. W., Feldman, H. M., et al. (2001). Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings. Pediatrics, 107, E43.PubMedCrossRefGoogle Scholar
  12. Burt, A. S., Krueger, R. F., McGue, M., & Iacono, W. G. (2001). Sources of covariation among attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder: The importance of shared environment. Journal of Abnormal Psychology, 110, 516–525.PubMedCrossRefGoogle Scholar
  13. Burt, A. S., Krueger, R., McGue, M., & Iacono, W. G. (2003). Parent-child conflict and the comorbidity among childhood externalizing disorders. Archives of General Psychiatry, 60, 505–513.PubMedCrossRefGoogle Scholar
  14. Burt, S. A., McGue, M., Krueger, R. F., & Iacono, W. G. (2005). Sources of covariation among the child-externalizing disorders: informant effects and the shared environment. Psychological Medicine, 35, 1133–1144.PubMedCrossRefGoogle Scholar
  15. Caspi, A., McClay, J., Moffitt, T. E., Mill, J., Martin, J., Craig, I. W., et al. (2002). Role of genotype in the cycle of violence in maltreated children. Science, 297, 851–854.PubMedCrossRefGoogle Scholar
  16. Davis, O. S. P., Kovas, Y., Harlaar, N., Busfield, P., McMillan, A., Frances, J., et al. (2007). Generalist genes and the internet generation: etiology of learning abilities by web testing at age 10. Genes, Brain and Behavior, Epub ahead of print, 1–25.Google Scholar
  17. Derks, E. M., Dolan, C. V., Hudziak, J. J., Neale, M. C., & Boomsma, D. I. (2007). Assessment and etiology of attention deficit hyperactivity disorder and oppositional defiant disorder in boys and girls. Behavior Genetics, 37, 559–566.PubMedCrossRefGoogle Scholar
  18. Derks, E. M., Hudziak, J. J., Dolan, C. V., van Beijsterveldt, T. C., Verhulst, F. C., Boomsma, D. I., et al. (2008). Genetic and environmental influences on the relation between attention problems and attention deficit hyperactivity disorder. Behavior Genetics, 38, 11–23.PubMedCrossRefGoogle Scholar
  19. Dick, D. M., Viken, R. J., Kaprio, J., Pulkkinen, L., & Rose, R. J. (2005). Understanding the covariaton among childhood externalizing symptoms: genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology, 33, 219–229.PubMedCrossRefGoogle Scholar
  20. Dick, D. M., Aliev, F., Wang, J. C., Grucza, R. A., Schuckit, M., Kuperman, S., et al. (2008). Using dimensional models of externalizing psychopathology to aid in gene identification. Archives of General Psychiatry, 65, 310–318.PubMedCrossRefGoogle Scholar
  21. Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457.CrossRefGoogle Scholar
  22. Faraone, S. V., Biederman, J., Jetton, J. G., & Tsuang, M. (1997). Attention deficit hyperactivity disorder and conduct disorder: longitudinal evidence for a familial subtype. Psychological Medicine, 27, 291–300.PubMedCrossRefGoogle Scholar
  23. Faraone, S. V., Biederman, J., Mennin, D., Russell, R., & Tsuang, M. T. (1998a). Familial subtypes of attention deficit hyperactivity disorder: a 4-year follow-up study of children from antisocial-ADHD families. Journal of Child Psychology and Psychiatry, 39, 1045–1053.PubMedCrossRefGoogle Scholar
  24. Faraone, S. V., Biederman, J., Weber, W., & Russell, R. (1998b). Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: results from a clinically referred sample. Journal of American Academy of Child and Adolescent Psychiatry, 37, 185–193.CrossRefGoogle Scholar
  25. Feehan, M., McGee, R., Raja, S. N., & Williams, S. M. (1994). DSM-III-R disorders in New Zealand 18-year-olds. Aust N Z J Psychiatry, 28, 87–99.PubMedCrossRefGoogle Scholar
  26. Fergusson, D. M., & Horwood, L. J. (1998). Early conduct problems and later life opportunities. Journal of Child Psychology and Psychiatry, 39, 1097–1108.PubMedCrossRefGoogle Scholar
  27. Haberstick, B. C., Timberlake, D., Hopfer, C. J., Lessem, J. M., Ehringer, M. A., & Hewitt, J. K. (2008). Genetic and environmental contributions to retrospectively reported DSM-IV childhood attention deficit hyperactivity disorder. Psychological Medicine, 38, 1057–1066.PubMedCrossRefGoogle Scholar
  28. Jacobson, K. C., Prescott, C. A., & Kendler, K. (2002). Sex differences in the genetic and environmental influences on the development of antisocial behavior. Developmental Psychology, 14, 395–416.Google Scholar
  29. Kendler, K., Heath, A. C., Martin, N. G., & Eaves, L. (1987). Symptoms of anxiety and symptoms of depression. Archives of General Psychiatry, 44, 451–457.PubMedGoogle Scholar
  30. Kendler, K., Prescott, C. A., Myers, J., & Neale, M. C. (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry, 60, 929–937.PubMedCrossRefGoogle Scholar
  31. Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60, 709–717.PubMedCrossRefGoogle Scholar
  32. Krueger, R. F., Hicks, B. M., Patrick, C. J., Carlson, S. R., Iacono, W. G., & McGue, M. (2002). Etiologoc connections among substance dependence, antisocial behavior, and personality: modeling the externalizing spectrum. Journal of Abnormal Psychology, 111, 411–424.PubMedCrossRefGoogle Scholar
  33. Krueger, R. F., Markon, K. E., Patrick, C. J., & Iacono, W. G. (2005). Externalizing psychopathology in adulthood: A dimensional-spectrum conceptualization and its implications for DSM-V. Journal of Abnormal Psychology, 114, 537–550.PubMedCrossRefGoogle Scholar
  34. Krueger, R. F., Markon, K. E., Patrick, C. J., Benning, S. D., & Kramer, M. D. (2007). Linking antisocial behavior, substance use, and personality: an integrative quantitative model of the adult externalizing spectrum. Journal of Abnormal Psychology, 116, 645–666.PubMedCrossRefGoogle Scholar
  35. Kuperman, S., Schlosser, S. S., Lidral, J., & Reich, W. (1999). Relationship of child psychopathology to parental alcoholism and antisocial personality disorder. Journal of the American Academy Child and Adolescent Psychiatry, 38, 686–692.Google Scholar
  36. Kuperman, S., Schlosser, S. S., Kramer, J. R., Bucholz, K., Hesselbrock, V., Reich, T., & Reich, W. (2001). Developmental sequence from disruptive behavior diagnosis to adolescent alcohol dependence. American Journal of Psychiatry, 158, 2022–2026.PubMedCrossRefGoogle Scholar
  37. Lahey, B. B., Schwab-Stoen, M., Goodman, S. H., Waldman, I. D., Canino, G., Rathouz, P. J., et al. (2000). Age and gender differences in oppositional behaviour and conduct problems: a cross-sectional household study of middle childhood and adolescence. Journal of Abnormal Psychology, 109, 488–503.PubMedCrossRefGoogle Scholar
  38. Larsson, J. O., Larsson, H., & Lichtenstein, P. (2004). Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study. Journal of the American Academy Child and Adolescent Psychiatry, 43, 1267–1275.CrossRefGoogle Scholar
  39. Loeber, R., Burke, J. D., Lahey, B. B., Winters, A., & Zera, M. (2000). Oppositional defiant and conduct disorder: a review of the past 10 years, part I. Journal of the American Academy Child and Adolescent Psychiatry, 39, 1468–1484.CrossRefGoogle Scholar
  40. Maughan, B., Rowe, R., Messer, J., Goodman, R., & Meltzer, H. (2004). Conduct Disorder and Oppositional Defiant Disorder in a national sample: developmental epidemiology. Journal of Child Psychology and Psychiatry, 45, 609–621.PubMedCrossRefGoogle Scholar
  41. McArdle, J. J., & Goldsmith, H. H. (1990). Alternative common factor models for multivariate biometric analyses. Behavior Genetics, 20, 569–608.PubMedCrossRefGoogle Scholar
  42. Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674−701.PubMedCrossRefGoogle Scholar
  43. Nadder, T. S., Rutter, M., Silberg, J., Maes, H., & Eaves, L. (2002). Genetic effects on the variation and covariation of attention deficit-hyperactivity disorder (ADHD) and oppositional-defiant disorder/conduct disorder (ODD/CD) symptomatologies across informant and occasion of measurement. Psychological Medicine, 32, 39–53.PubMedCrossRefGoogle Scholar
  44. Neale, M. C., & Cardon, L. R. (1992). Methodology for genetic studies of twins and families. Dordrecht, The Netherlands: Kluwer Academic Publications.Google Scholar
  45. Neale, M. C., Boker, S. M., Xie, G., & Maes, H. (2003). Mx: Statistical modeling. Richmond, VA: Department of Psychiatry, Medical College of Virginia.Google Scholar
  46. Posthuma, D., Beem, A. L., de Geus, E. J. C., van Baal, C. M., von Hjelmborg, J. B., Iachine, I., et al. (2003). Theory and practice in quantitative genetics. Twin Research and Human Genetics, 6, 361–376.CrossRefGoogle Scholar
  47. Raftery, A. E. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111–163.CrossRefGoogle Scholar
  48. Rettew, D. C., Copeland, W., Stanger, C., & Hudziak, J. J. (2004). Associations between temperament and DSM-IV externalizing disorders in children and adolescents. Journal of Developmental and Behavioral Pediatrics, 25, 383–391.PubMedCrossRefGoogle Scholar
  49. Rhee, S. H., Waldman, I. D., Hay, D. A., & Levy, F. (1999). Sex differences in genetic and environmental influences on DSM-III-R attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology, 108, 24–41.PubMedCrossRefGoogle Scholar
  50. Rhee, S. H., Willcutt, E. G., Hartman, C. A., Pennington, B. F. & DeFries, J. C. (2007). Test of alternative hypotheses explaining the comorbidity between attention-deficit/hyperactivity disorder and conduct disorder. Journal of Abnormal Child Psychology, Epub ahead of print.Google Scholar
  51. Rietveld, M. J., Hudziak, J. J., Bartels, M., van Beijsterveldt, C. E., & Boomsma, D. I. (2003). Heritability of attention problems in children: I. cross-sectional results from a study of twins, age 3-12 years. American Journal of Medical Genetics Part B (Neuropsychiatric Genetics), 117, 102–113.CrossRefGoogle Scholar
  52. Robins, L. N. (1966). Deviant children grown up. Baltimore, MD: Wiliams & Wilkins.Google Scholar
  53. Rose, R. J., Dick, D. M., Viken, R. J., Pulkkinen, L., & Kaprio, J. (2004). Genetic and environmental effects on conduct disorder and alcohol dependence symptoms and their covariation at age 14. Alcoholism: Clinical and Experimental Research, 28, 1541–1548.CrossRefGoogle Scholar
  54. Rowe, R., Maughan, B., Pickles, A., Costello, E. J., & Angold, A. (2002). The relationship between DSM-IV oppositional defiant disorder and conduct disorder: findings from the Great Smoky Mountains Study. Journal of Child Psychology and Psychiatry, 43, 365–373.PubMedCrossRefGoogle Scholar
  55. Rutter, M., Giller, H., & Hagell, A. (1998). Antisocial Behavior by Young People. Cambridge, UK: Cambridge University Press.Google Scholar
  56. Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997). Neighbourhoods and violent crime: A multilevel study of collective efficacy. Science, 277, 918–924.PubMedCrossRefGoogle Scholar
  57. Schachar, R., & Tannock, R. (1995). Test of four hypotheses for the comorbidity of attention-deficit hyperactivity disorder and conduct disorder. Journal of the American Academy Child and Adolescent Psychiatry, 34, 639–648.CrossRefGoogle Scholar
  58. Shaffer, D., Fisher, P., Lucas, C., & Comer, J. (2000). Diagnostic Interview Schedule for Children - DISC IV. NY: Columbia University.Google Scholar
  59. Silberg, J., Rutter, M., Meyer, J., Maes, H., Hewitt, J. K., Simonoff, E., et al. (1996). Genetic and environmental influences on the covariation between hyperactivity and conduct disturbance in juvenile twins. Journal of Child Psychology and Psychiatry, 37, 803–816.PubMedCrossRefGoogle Scholar
  60. Simonoff, E., Pickles, A., Hervas, A., Silberg, J. L., Rutter, M., & Eaves, L. (1998). Genetic influences on childhood hyperactivity: contrast effects imply parental rating bias, not sibling interaction. Psychological Medicine, 28, 825–837.PubMedCrossRefGoogle Scholar
  61. Subbarao, A., Rhee, S. H., Young, S. E., Ehringer, M. A., Corley, R. P., Hewitt, J. K., et al. (2008). Common genetic and environmental influences on major depressive disorder and conduct disorder. Journal of Abnormal Child Psychology, 36, 433–444.PubMedCrossRefGoogle Scholar
  62. Thapar, A., Harrington, H., Ross, K., & McGuffin, P. (2000). Does the definition of ADHD affect heritabiity? Journal of the American Academy Child and Adolescent Psychiatry, 39, 1528–1536.CrossRefGoogle Scholar
  63. Thapar, A., Harrington, R., & McGuffin, P. (2001). Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design. British Journal of Psychiatry, 179, 224–229.PubMedCrossRefGoogle Scholar
  64. Vierikko, E., Pulkkinen, L., Kaprio, J., Viken, R. J., & Rose, R. J. (2003). Sex differences in genetic and environmental effects on aggression. Aggressive Behavior, 29, 55–68.CrossRefGoogle Scholar
  65. White, H. R., Xie, M., Thompson, W., Loeber, R., & Stouthamer-Loeber, M. (2001). Psychopathology as a predictor of adolescent drug use trajectories. Psychology of Addictive Behaviors, 15, 210–218.PubMedCrossRefGoogle Scholar
  66. Young, S. E., Stallings, M. C., Corley, R. P., Krauter, K. S., & Hewitt, J. K. (2000). Genetic and environmental influences on behavioral disinhibition. American Journal of Medical Genetics (Neuropsychiatric Genetics), 96, 684–695.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Catherine Tuvblad
    • 1
  • Mo Zheng
    • 1
  • Adrian Raine
    • 2
  • Laura A. Baker
    • 1
  1. 1.Department of PsychologyUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Departments of Criminology, Psychiatry, and PsychologyUniversity of PennsylvaniaLos AngelesUSA

Personalised recommendations