Is There a Female Protective Effect Against Attention-Deficit/Hyperactivity Disorder? Evidence From Two Representative Twin Samples.
Is There a Female Protective Effect Against Attention-Deficit/Hyperactivity Disorder? Evidence From Two Representative Twin Samples.
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DOI：
10.1016/j.jaac.2016.04.004
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发表时间：
2016-06
影响因子：
13.3
通讯作者：
Ronald A
中科院分区：
文献类型：
--
作者：
Taylor MJ;Lichtenstein P;Larsson H;Anckarsäter H;Greven CU;Ronald A
注意缺陷多动障碍(ADHD)在男性中比在女性中更常见。“女性保护效应”假设，为了患上多动症，女性比男性更容易受到病因因素的影响，从而预测女性多动症的亲属会表现出更多的多动症行为。因此，我们测试了表现出极端多动症特征的女性双胞胎是否会比表现出极端多动症特征的男性双胞胎表现出更多的ADHD特征。在瑞典，大约有7000对异卵双胞胎的父母，在英格兰和威尔士，大约有4000对双胞胎的父母完成了ADHD特征的维度评估。先证者是根据每个样本中最高10%的分布范围内的得分来选择的。先证者的双胞胎维度得分，以及分类复发率，通过先证者的性别进行调查。在两个样本中，女性先证者的同卵双胞胎的平均多动症特质得分(平均−=0.62−0.79)都高于男性先证者的同卵双生子(平均F=0.38 GMT=0.55)。这一趋势在瑞典样本(P<；.01)以及将两个样本合并为一个更大的样本(P&L；.001)时非常明显。当样本合并时，先证者和性别之间也存在显著的关联，同卵双胞胎的分类地位也是如此，女性先证者的同卵双胞胎也比男性先证者的同卵双胞胎更多。这些发现支持女性对ADHD行为的保护作用，表明女性需要更多地接触与ADHD相关的遗传和环境因素才能患上这种疾病。
Attention-deficit/hyperactivity disorder (ADHD) is more frequent in males than in females. The “female protective effect” posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested whether cotwins of females displaying extreme ADHD traits would display more ADHD traits than cotwins of males displaying extreme ADHD traits. Parents of approximately 7,000 pairs of nonidentical twins in Sweden, and approximately 4,000 pairs of twins in England and Wales, completed dimensional assessments of ADHD traits. Probands were selected on the basis of scoring within the highest 10% of the distribution in each sample. Dimensional scores of cotwins of probands, as well as the categorical recurrence rate, were investigated by proband sex. Cotwins of female probands displayed higher mean ADHD trait scores (mean = 0.62−0.79) than cotwins of male probands (mean = 0.38−0.55) in both samples. This trend was significant in the Swedish sample (p < .01) and when the 2 samples were merged into a single, larger sample (p < .001). When the samples were merged, there was also a significant association between proband sex and cotwin’s categorical status, with more cotwins of female probands also being probands than cotwins of male probands. These findings support a female protective effect against ADHD behaviors, suggesting that females require greater exposure to genetic and environmental factors associated with ADHD in order to develop the condition.