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

J Autism Dev Disord. 2017 Jun;47(6):1595-1604. doi: 10.1007/s10803-017-3083-7.

Abstract

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.

Keywords: ADHD; ASD; Comorbidity; Inattention; Social interaction.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Age Factors
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Autism Spectrum Disorder / diagnosis*
  • Autism Spectrum Disorder / epidemiology
  • Autism Spectrum Disorder / psychology*
  • Child
  • Comorbidity
  • Female
  • Humans
  • Internationality*
  • Male
  • Sex Factors
  • Siblings / psychology
  • Statistics as Topic / methods*
  • Stereotyped Behavior / physiology