King's College London, Medical Research Council (MRC) Social Genetic and Developmental Psychiatry Centre, London, UK; University of Bath, Bath, UK.
King's College London, Medical Research Council (MRC) Social Genetic and Developmental Psychiatry Centre, London, UK; University of Southampton, Division of Clinical Neuroscience, School of Medicine, Southampton, UK.
J Am Acad Child Adolesc Psychiatry. 2014 Feb;53(2):209-220.e4. doi: 10.1016/j.jaac.2013.11.006. Epub 2013 Nov 26.
Emotional lability is recognized as an associated feature of attention-deficit/hyperactivity disorder (ADHD). However, the degree of phenotypic and etiologic overlap between emotional lability and the ADHD dimensions of hyperactivity-impulsivity and inattention remains unclear. The present study examines these associations in a large, community twin sample.
Structural equation models were fit to data from 1,920 child and adolescent twin pairs (age range, 5-18 years). Symptoms of hyperactivity-impulsivity (HI) and inattention (IA) were assessed using a modified version of the DuPaul rating scale, completed by parents. Symptoms of emotional lability (EL) were assessed using the parent-rated Conners 10-item scale.
There were moderate to strong phenotypic correlations between HI, IA, and EL. Multivariate twin modeling revealed that a common pathway model best accounted for the covariance among these dimensions, represented by a highly heritable latent factor. Ad hoc analyses confirmed that all additive genetic influences on HI, IA, and EL were shared, and identified a significantly stronger association of EL with the latent ADHD factor in older than in younger individuals.
Emotional lability was phenotypically and genetically associated with hyperactivity-impulsivity and inattention in children and adolescents. The finding that a single, heritable, latent factor accounted for covariation among these phenotypes indicates that their co-occurrence is primarily the result of overlapping genetic effects. These data support the hypothesis that emotional lability is etiologically relevant to the core ADHD phenotype, and that it should be targeted in assessment and treatment in clinical practice.
情绪不稳被认为是注意力缺陷多动障碍（ADHD）的一个相关特征。然而，情绪不稳与 ADHD 的多动冲动和注意力不集中维度之间的表型和病因重叠程度尚不清楚。本研究在一个大型社区双胞胎样本中研究了这些关联。
使用结构方程模型对 1920 对儿童和青少年双胞胎（年龄范围为 5-18 岁）的数据进行拟合。使用家长评定的康纳斯 10 项量表评估多动冲动（HI）和注意力不集中（IA）症状。使用家长评定的 Conners 10 项量表评估情绪不稳（EL）症状。
HI、IA 和 EL 之间存在中度到高度的表型相关性。多变量双胞胎模型表明，共同途径模型最能解释这些维度之间的协方差，由一个高度遗传的潜在因素表示。专门分析证实，HI、IA 和 EL 的所有加性遗传影响都是共享的，并确定在年龄较大的个体中，EL 与潜在的 ADHD 因子的关联更强。
情绪不稳与儿童和青少年的多动冲动和注意力不集中在表型和遗传上相关。发现一个单一的、可遗传的、潜在的因素可以解释这些表型之间的协变，这表明它们的共同发生主要是重叠遗传效应的结果。这些数据支持了情绪不稳与核心 ADHD 表型具有病因学相关性的假设，并且在临床实践中应该在评估和治疗中针对它。
