Neurosciences and Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada.
Genetics and Genome Biology Program, Hospital for Sick Children, Toronto, ON, Canada.
J Child Psychol Psychiatry. 2019 Sep;60(9):988-997. doi: 10.1111/jcpp.13032. Epub 2019 Mar 25.
Population-based samples with valid, quantitative and genetically informative trait measures of psychopathology could be a powerful complement to case/control genetic designs. We report the convergent and predictive validity of the parent- and self-report versions of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scale (SWAN). We tested if SWAN scores were associated with ADHD diagnosis, ADHD polygenic risk, as well as traits and polygenic risk for disorders that co-occur with ADHD: anxiety and obsessive-compulsive disorder (OCD).
We collected parent- and self-report SWAN scores in a sample of 15,560 children and adolescents (6-17 years) recruited at a science museum (Spit for Science sample). We established age and sex norms for the SWAN. Sensitivity-specificity analyses determined SWAN cut-points that discriminated those with and without a reported ADHD diagnosis. These cut-points were validated in a clinic sample (266 ADHD cases; 36 controls). Convergent validity was established using the Conners' parent- and self-report scales. Using Spit for Science participants with genome-wide data (n = 5,154), we tested if low, medium and high SWAN scores were associated with polygenic risk for ADHD, OCD and anxiety disorders.
Parent- and self-report SWAN scores showed high convergent validity with Conners' scales and distinguished ADHD participants with high sensitivity and specificity in the Spit for Science sample. In a clinic sample, the Spit for Science cut-points discriminated ADHD cases from controls with a sensitivity of 84% and specificity of 92%. High SWAN scores and scores above the Spit for Science cut-points were significantly associated with polygenic risk for ADHD. SWAN scores were not associated with polygenic risk for OCD or anxiety disorders.
Our study supports the validity of the parent- and self-report SWAN scales and their potential in ADHD population-based genetic research.
具有有效、定量和遗传信息丰富的精神病理学特征测量的基于人群的样本，可以成为病例对照遗传设计的有力补充。我们报告了注意力缺陷多动障碍症状和正常行为评定量表（SWAN）的父母报告和自我报告版本的会聚和预测效度。我们测试了 SWAN 评分是否与 ADHD 诊断、ADHD 多基因风险以及与 ADHD 共病的障碍（焦虑和强迫症）的特征和多基因风险相关。
我们在科学博物馆（Spit for Science 样本）招募的 15560 名儿童和青少年（6-17 岁）样本中收集了父母报告和自我报告的 SWAN 评分。我们为 SWAN 建立了年龄和性别规范。敏感性特异性分析确定了区分有和没有报告 ADHD 诊断的 SWAN 切点。这些切点在诊所样本（266 例 ADHD 病例；36 例对照）中得到验证。使用 Conners 的父母报告和自我报告量表确立了会聚效度。使用 Spit for Science 参与者的全基因组数据（n=5154），我们测试了低、中、高 SWAN 评分是否与 ADHD、强迫症和焦虑障碍的多基因风险相关。
父母报告和自我报告的 SWAN 评分与 Conners 量表具有高度的会聚效度，并在 Spit for Science 样本中以高灵敏度和特异性区分 ADHD 参与者。在诊所样本中，Spit for Science 切点以 84%的敏感性和 92%的特异性区分 ADHD 病例和对照组。高 SWAN 评分和高于 Spit for Science 切点的评分与 ADHD 的多基因风险显著相关。SWAN 评分与强迫症或焦虑障碍的多基因风险无关。
我们的研究支持父母报告和自我报告的 SWAN 量表的有效性及其在 ADHD 基于人群的遗传研究中的潜力。
