The Role of Parental Responsiveness in the Development of Co-occurring ADHD and Anxiety Symptoms: Interplay of Genotype and Environment

Abstract

Using a novel index of co-occurring psychopathology, this study aims to clarify three research questions: (1) Is co-occurring ADHD-anxiety in school years a continuation of these problems in preschool period? (2) Is parental unresponsiveness in the early years of life a risk factor in the development of co-occurring ADHD and anxiety problems in preschool and school age? (3) Does genetic risk moderate the effect of parental unresponsiveness on ADHD-anxiety co-occurrence? Participants included 361 families from the Early Growth and Development Study (EGDS), which employs a prospective adoption design. In each family unit, data were collected from the child adopted at birth, the adoptive mother and father, and the biological mother. For the present study, adoptive parent’s responsiveness was assessed at child age of 9, 18, and 27 months; biological parent ADHD symptoms were assessed at 56 months; child ADHD and anxiety symptoms were assessed when children are at 41/2 and 6 years of age. Path analyses were conducted for maternal and paternal responsiveness, separately. In both models, ADHD-anxiety co-occurrence at age 41/2 years significantly predicted ADHD-anxiety co-occurrence at 6 years. Neither maternal responsiveness, nor paternal responsiveness had a main effect on child co-occurrence of ADHD-anxiety at 41/2 years. There were significant interactions between genetic risk and maternal/paternal responsiveness in infancy predicting co-occurring ADHD-anxiety problems at 41/2 years. Findings highlight the importance of attending to excessively high parental responsiveness in the context of genetic risk, which is associated with higher co-occurring ADHD and anxiety problems around ages 41/2 and 6.