Variation in Latent Classes of Adult Attention-Deficit Hyperactivity Disorder by Sex and Environmental Adversity

Objective: The findings of genetic, imaging and neuropsychological studies of attention-deficit hyperactivity disorder (ADHD) are mixed. To understand why this might be the case we use both dimensional and categorical symptom measurement to provide alternate and detailed perspectives of symptom expression. Method: Interviewers collected ADHD, conduct problems (CP) and sociodemographic data from 3793 twins and their siblings aged 22 to 49 (M = 32.6). We estimate linear weighting of symptoms across ADHD and CP items. Latent class analyses and regression describe associations between measured variables, environmental risk factors and subsequent disadvantage. Additionally, the clinical relevance of each class was estimated. Results: Five classes were found for women and men; few symptoms, hyperactive-impulsive, CP, inattentive, combined symptoms with CP. Women within the inattentive class reported more symptoms and reduced emotional health when compared to men and to women within other latent classes. Women and men with combined ADHD symptoms reported comorbid conduct problems but those with either inattention or hyperactivity-impulsivity only did not. Conclusion: The dual perspective of dimensional and categorical measurement of ADHD provides important detail about symptom variation across sex and with environmental covariates.