ArticleJournal of the American Academy of Child and Adolescent Psychiatry2016
Is There a Female Protective Effect Against Attention-Deficit/Hyperactivity Disorder? Evidence From Two Representative Twin Samples.
Article in Journal of the American Academy of Child and Adolescent Psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
37 citing papers in PubMed, 70 citations in OpenAlex.
- Review
- Sex Bias in the Clinical Diagnosis of ADHD: A Critical Review.Journal of clinical medicine · 2026Review
- ADHD and Student Grades in Children from the ABCD StudyBehavior genetics · 2026Article
- Sex and tissue resolved co-expression networks reveal a female placental-brain axis protective against prenatal PCB exposure.Genome biology · 2026Article
- The inactive X chromosome as a female protector in autism and beyond.Nature genetics · 2026Review
- Medicaid Expansion and Medication Use Among U.S. Children with ASD or ADHD: A Repeated Cross-Sectional Analysis Comparing Before and During the COVID-19 Periods.Healthcare (Basel, Switzerland) · 2026Article
- Prevalence of and factors associated with multiple neurodevelopmental disorders among children and adolescents: a nationwide cross-sectional study.Frontiers in public health · 2026Article
- The inactive X chromosome as a female protector in autism and beyond.Research square · 2025Article
- Transcriptomic sex differences in postmortem brain samples from patients with psychiatric disorders.Science translational medicine · 2024Article
- Differences in genetic risk score profiles for drug use disorder, major depression, and ADHD as a function of sex, age at onset, recurrence, mode of ascertainment, and treatment.Psychological medicine · 2023Article
- Genetics in the ADHD Clinic: How Can Genetic Testing Support the Current Clinical Practice?Frontiers in psychology · 2022Review
- Sex differences in anxiety and depression in children with attention deficit hyperactivity disorder: Investigating genetic liability and comorbidity.American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics · 2021Article
- Sex differences in parent-offspring recurrence of attention-deficit/hyperactivity disorder.Journal of child psychology and psychiatry, and allied disciplines · 2021Article
- The Polygenic Nature and Complex Genetic Architecture of Specific Learning Disorder.Brain sciences · 2021Review
- Integration of brain and behavior measures for identification of data-driven groups cutting across children with ASD, ADHD, or OCD.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2021Article
- Do borderline personality disorder and attention-deficit/hyperactivity disorder co-aggregate in families? A population-based study of 2 million Swedes.Molecular psychiatry · 2021Article
- Article
- Using the tools of genetic epidemiology to understand sex differences in neuropsychiatric disorders.Genes, brain, and behavior · 2020Review
- Differential implications of persistent, remitted, and late-onset ADHD symptoms for substance abuse in women and men: A twin study from ages 11 to 24.Drug and alcohol dependence · 2020Article
- Genetic landscape of autism spectrum disorder in Vietnamese children.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveAttention-deficit/hyperactivity disorder (ADHD) is more frequent in males than in females. The "female protective effect" posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested whether cotwins of females displaying extreme ADHD traits would display more ADHD traits than cotwins of males displaying extreme ADHD traits.
methodParents of approximately 7,000 pairs of nonidentical twins in Sweden, and approximately 4,000 pairs of twins in England and Wales, completed dimensional assessments of ADHD traits. Probands were selected on the basis of scoring within the highest 10% of the distribution in each sample. Dimensional scores of cotwins of probands, as well as the categorical recurrence rate, were investigated by proband sex.
resultsCotwins of female probands displayed higher mean ADHD trait scores (mean = 0.62-0.79) than cotwins of male probands (mean = 0.38-0.55) in both samples. This trend was significant in the Swedish sample (p < .01) and when the 2 samples were merged into a single, larger sample (p < .001). When the samples were merged, there was also a significant association between proband sex and cotwin's categorical status, with more cotwins of female probands also being probands than cotwins of male probands.
conclusionThese findings support a female protective effect against ADHD behaviors, suggesting that females require greater exposure to genetic and environmental factors associated with ADHD in order to develop the condition.
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Registered trials
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