2025

Ketvel, Laila; Vuoksimaa, Eero; Pulkkinen, Lea; Rose, Richard J.; Vedenkannas, Ulla; Rapeli, Pekka; Raevuori, Anu; Latvala, Antti

Objective: To investigate associations of executive function (EF) performance in adolescence with dimensional symptoms of inattention and hyperactivity-impulsivity assessed by multiple informants as well as ADHD (attention-deficit/hyperactivity disorder) symptoms based on the Diagnostic and Statistical Manual of Mental Disorders criteria, and whether familial factors and co-occurring symptoms of depressive disorder and conduct disorder explain these associations in a population-based sample. Method: In 14-year-old twins from the population-based FinnTwin12 study (N = 638-1,227), we assessed EF with commonly used neuropsychological tests. Diagnostic and Statistical Manual of Mental Disorders symptoms of ADHD and psychiatric disorders were assessed with a semistructured interview, and dimensional symptoms of inattention and hyperactivity-impulsivity with behavioral ratings made by the twins, their co-twins, and teachers at age 14, and by parents and teachers at age 12, the latter being different from those at age 14. Results: Teacher-rated inattention had the strongest association with poorer EF performance across two measurement points with different teachers; these associations were not affected by adding symptoms of depressive disorder and conduct disorder as covariates. Within-pair analyses suggested that the associations of inattention and hyperactivity-impulsivity with EF were partly explained by familial factors. Conclusion: Even at a subclinical level in a sample of adolescents representing general population, ADHD symptoms are associated with EF performance. Teachers' evaluations appear especially valuable when assessing adolescents' ADHD symptoms. Our findings support the notion of dimensional ADHD symptoms in the population.