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Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls

Journal article
Authors E. N. Selinus
Y. Molero
P. Lichtenstein
Henrik Anckarsäter
Sebastian Lundström
M. Bottai
C. H. Gumpert
Published in Acta Psychiatrica Scandinavica
Volume 134
Issue 6
Pages 533-545
ISSN 0001-690X
Publication year 2016
Published at Gillberg Neuropsychiatry Centre
Centre for Ethics, Law, and Mental Health
Pages 533-545
Language en
Keywords attention deficit hyperactivity disorder, child and adolescent psychiatry, comorbidity, gender, comorbidities a-tac, substance use disorders, age-dependent decline, prospective follow-up, deficit/hyperactivity disorder, autism-tics, telephone interview, gender-differences, difficulties questionnaire, functional impairments
Subject categories Neurosciences


ObjectiveTo examine the association between different levels of childhood attention deficit hyperactivity disorder (ADHD) symptoms and sex differences in psychosocial outcomes during adolescence. MethodSwedish children (n = 4635) were screened for neuropsychiatric symptoms at age 9 or 12. ADHD symptoms were divided into three levels: screen-negative, screen-intermediate, and screen-positive. At follow-up (age 15), parents and teenagers filled out questionnaires regarding (i) hyperactivity/inattention, (ii) peer problems, (iii) school problems, (iv) internalizing problems, (v) antisocial behaviour, (vi) alcohol misuse, and (vii) drug misuse. All outcomes were controlled for symptoms of diagnostic categories other than ADHD. ResultsIncreasing levels of ADHD symptoms in childhood were associated with higher proportions of adolescents who displayed negative psychosocial outcomes. More girls than boys reported internalizing problems (all levels) and risky drug use (screen-intermediate and screen-positive only). More boys reported antisocial behaviour at the screen-negative and screen-intermediate levels, but at the screen-positive level, similar proportions of girls and boys displayed antisocial behaviour. ConclusionThe findings support the view that ADHD symptoms, as well as their negative outcomes, are dimensionally distributed in the population and that adolescent girls and boys display different risk profiles. The findings confirm that ADHD symptoms are associated with higher risk of drug misuse in girls.

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