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Peer-reviewedCC BY 4.0Journal of Child Psychology and Psychiatry, and Allied Disciplines

Co‐development of ADHD symptoms and emotional problems from childhood to adulthood: predictors and developmental outcomes

  • Yuan You1
  • Helena M.S. Zavos2
  • Laurie J. Hannigan3,4,5
  • Linlin Zhang6
  • Giacomo Bignardi1
  • Meredith X. Han1,7
  • Elisavet Palaiologou1
  • Christopher Rayner1
  • Tom A. McAdams1
7 affiliations
  1. 1Social, Genetic and Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience, King's College London London UK
  2. 2Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
  3. 3Research Department Lovisenberg Diaconal Hospital Oslo Norway
  4. 4Centre for Genetic Epidemiology and Mental Health Norwegian Institute of Public Health Oslo Norway
  5. 5Population Health Sciences Bristol Medical School, University of Bristol Bristol UK
  6. 6School of Psychology, Capital Normal University Beijing China
  7. 7Department of Paediatrics Yong Loo Lin School of Medicine, National University of Singapore Singapore City Singapore
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Abstract

Background: Attention‐deficit/hyperactivity disorder (ADHD) symptoms and emotional problems frequently co‐occur. Longitudinal data provide opportunities to understand how and why they co‐develop.

Methods: Data were drawn from the Twins Early Development Study, which included 27,890 participants. Emotional problems and ADHD symptoms were parent‐reported using the Strengths and Difficulties Questionnaire and Conners' Parent Rating scales. We modeled the co‐development of ADHD symptoms and emotional problems from ages 4 to 21 using joint trajectory analysis. The predictors included polygenic scores (PGSs) for multiple psychiatric symptoms, maternal depression, family chaos, and socioeconomic status (SES). The outcomes included SES, lifetime psychiatric diagnoses, undergraduate diploma attainment, and entry into parenthood at age 26.

Results: A four‐class joint trajectory model was selected as best fitting and included: ‘Low ADHD, Low emotional problems’, ‘High‐decreasing ADHD, Low emotional problems’, ‘Mid‐decreasing ADHD, Increasing emotional problems’, and ‘Increasing ADHD, Increasing emotional problems’. The consistently low‐symptom group reported lower ADHD and had lower externalizing PGSs, lower maternal depression, higher SES, and less home chaos at baseline, and higher educational attainment and fewer lifetime depression/anxiety diagnoses at 26 than groups with higher symptom levels. Those with high ADHD symptoms in childhood or increasing ADHD symptoms from childhood to adulthood had the lowest educational attainment and SES in adulthood.

Conclusions: Groups characterized by increasing ADHD symptoms also tended to show increases in emotional problems, whereas increases in emotional problems did not necessarily coincide with increases in ADHD symptoms. The trajectories had distinct early‐life predictors and adult outcomes, highlighting potential intervention targets.

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Cite

BibTeXRIS
BibTeX
@article{you2026codevelopment,
  title = {{Co‐development of ADHD symptoms and emotional problems from childhood to adulthood: predictors and developmental outcomes}},
  author = {Yuan You and Helena M.S. Zavos and Laurie J. Hannigan and Linlin Zhang and Giacomo Bignardi and Meredith X. Han and Elisavet Palaiologou and Christopher Rayner and Tom A. McAdams},
  journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines},
  year = {2026},
  month = jun,
  doi = {10.1111/jcpp.70196},
  url = {https://doi.org/10.1111/jcpp.70196},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Co‐development of ADHD symptoms and emotional problems from childhood to adulthood: predictors and developmental outcomes
AU  - Yuan You
AU  - Helena M.S. Zavos
AU  - Laurie J. Hannigan
AU  - Linlin Zhang
AU  - Giacomo Bignardi
AU  - Meredith X. Han
AU  - Elisavet Palaiologou
AU  - Christopher Rayner
AU  - Tom A. McAdams
PY  - 2026
DA  - 2026/06/30
JO  - Journal of Child Psychology and Psychiatry, and Allied Disciplines
DO  - 10.1111/jcpp.70196
UR  - https://doi.org/10.1111/jcpp.70196
AB  - Background: Attention‐deficit/hyperactivity disorder (ADHD) symptoms and emotional problems frequently co‐occur. Longitudinal data provide opportunities to understand how and why they co‐develop.  Methods: Data were drawn from the Twins Early Development Study, which included 27,890 participants. Emotional problems and ADHD symptoms were parent‐reported using the Strengths and Difficulties Questionnaire and Conners' Parent Rating scales. We modeled the co‐development of ADHD symptoms and emotional problems from ages 4 to 21 using joint trajectory analysis. The predictors included polygenic scores (PGSs) for multiple psychiatric symptoms, maternal depression, family chaos, and socioeconomic status (SES). The outcomes included SES, lifetime psychiatric diagnoses, undergraduate diploma attainment, and entry into parenthood at age 26.  Results: A four‐class joint trajectory model was selected as best fitting and included: ‘Low ADHD, Low emotional problems’, ‘High‐decreasing ADHD, Low emotional problems’, ‘Mid‐decreasing ADHD, Increasing emotional problems’, and ‘Increasing ADHD, Increasing emotional problems’. The consistently low‐symptom group reported lower ADHD and had lower externalizing PGSs, lower maternal depression, higher SES, and less home chaos at baseline, and higher educational attainment and fewer lifetime depression/anxiety diagnoses at 26 than groups with higher symptom levels. Those with high ADHD symptoms in childhood or increasing ADHD symptoms from childhood to adulthood had the lowest educational attainment and SES in adulthood.  Conclusions: Groups characterized by increasing ADHD symptoms also tended to show increases in emotional problems, whereas increases in emotional problems did not necessarily coincide with increases in ADHD symptoms. The trajectories had distinct early‐life predictors and adult outcomes, highlighting potential intervention targets.
SN  - 0021-9630
SN  - 1469-7610
ER  -