A Causal and Mediation Analysis of the Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD)

• Published in: Journal of autism and developmental disorders Vol. 47; no. 6; pp. 1595 - 1604
• Main Authors: Sokolova, Elena, Oerlemans, Anoek M., Rommelse, Nanda N., Groot, Perry, Hartman, Catharina A., Glennon, Jeffrey C., Claassen, Tom, Heskes, Tom, Buitelaar, Jan K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2017; Springer; Springer Nature B.V
• Subjects: Adolescent; Age Factors; Attention Control; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Attention Deficit Hyperactivity Disorder; Autism; Autism Spectrum Disorder - diagnosis; Autism Spectrum Disorder - epidemiology; Autism Spectrum Disorder - psychology; Autistic children; Behavior Problems; Behavioral Science and Psychology; Causal Models; Child; Child and School Psychology; Children; Comorbidity; Comprehension; Discovery; Female; Humans; Hyperactivity; Impulsive behavior; Impulsivity; Intelligence Quotient; Intelligence tests; Internationality; Interpersonal Competence; Male; Mediation Theory; Neurosciences; Original Paper; Pediatrics; Pervasive Developmental Disorders; Physiology; Psychology; Public Health; Repetition; Repetitive behaviour; Self Control; Sex Factors; Siblings; Siblings - psychology; Social interaction; Statistics as Topic - methods; Stereotyped behavior; Stereotyped Behavior - physiology; Stereotypes; Structural Equation Models; Symptoms (Individual Disorders); Understanding; Verbal Ability; ADHD; ASD; Inattention; Social interaction; Comorbidity
• ISSN: 0162-3257; 1573-3432
• DOI: 10.1007/s10803-017-3083-7

Autism spectrum disorder (ASD) and Attention-deficit/hyperactivity disorder (ADHD) are often comorbid. The purpose of this study is to explore the relationships between ASD and ADHD symptoms by applying causal modeling. We used a large phenotypic data set of 417 children with ASD and/or ADHD, 562 affected and unaffected siblings, and 414 controls, to infer a structural equation model using a causal discovery algorithm. Three distinct pathways between ASD and ADHD were identified: (1) from impulsivity to difficulties with understanding social information, (2) from hyperactivity to stereotypic, repetitive behavior, (3) a pairwise pathway between inattention, difficulties with understanding social information, and verbal IQ. These findings may inform future studies on understanding the pathophysiological mechanisms behind the overlap between ASD and ADHD.