SWAN scale for ADHD trait-based genetic research: a validity and polygenic risk study

Christie L Burton; Leah Wright; Janet Shan; Bowei Xiao; Annie Dupuis; Tara Goodale; S-M Shaheen; Elizabeth C Corfield; Paul D Arnold; Russell J Schachar; Jennifer Crosbie

doi:10.1111/jcpp.13032

SWAN scale for ADHD trait-based genetic research: a validity and polygenic risk study

J Child Psychol Psychiatry. 2019 Sep;60(9):988-997. doi: 10.1111/jcpp.13032. Epub 2019 Mar 25.

Authors

Christie L Burton¹, Leah Wright¹, Janet Shan¹, Bowei Xiao², Annie Dupuis^{3

4}, Tara Goodale¹, S-M Shaheen^{5

6}, Elizabeth C Corfield^{1

7}, Paul D Arnold^{2

5

6}, Russell J Schachar^{1

7

8}, Jennifer Crosbie^{1

7}

Affiliations

¹ Neurosciences and Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada.
² Genetics and Genome Biology Program, Hospital for Sick Children, Toronto, ON, Canada.
³ Clinical Research Services, Hospital for Sick Children, Toronto, ON, Canada.
⁴ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁵ Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada.
⁶ Departments of Psychiatry & Medical Genetics, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁷ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁸ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

PMID: 30908652
DOI: 10.1111/jcpp.13032

Abstract

Background: Population-based samples with valid, quantitative and genetically informative trait measures of psychopathology could be a powerful complement to case/control genetic designs. We report the convergent and predictive validity of the parent- and self-report versions of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scale (SWAN). We tested if SWAN scores were associated with ADHD diagnosis, ADHD polygenic risk, as well as traits and polygenic risk for disorders that co-occur with ADHD: anxiety and obsessive-compulsive disorder (OCD).

Methods: We collected parent- and self-report SWAN scores in a sample of 15,560 children and adolescents (6-17 years) recruited at a science museum (Spit for Science sample). We established age and sex norms for the SWAN. Sensitivity-specificity analyses determined SWAN cut-points that discriminated those with and without a reported ADHD diagnosis. These cut-points were validated in a clinic sample (266 ADHD cases; 36 controls). Convergent validity was established using the Conners' parent- and self-report scales. Using Spit for Science participants with genome-wide data (n = 5,154), we tested if low, medium and high SWAN scores were associated with polygenic risk for ADHD, OCD and anxiety disorders.

Results: Parent- and self-report SWAN scores showed high convergent validity with Conners' scales and distinguished ADHD participants with high sensitivity and specificity in the Spit for Science sample. In a clinic sample, the Spit for Science cut-points discriminated ADHD cases from controls with a sensitivity of 84% and specificity of 92%. High SWAN scores and scores above the Spit for Science cut-points were significantly associated with polygenic risk for ADHD. SWAN scores were not associated with polygenic risk for OCD or anxiety disorders.

Conclusions: Our study supports the validity of the parent- and self-report SWAN scales and their potential in ADHD population-based genetic research.

Keywords: ADHD; SWAN; polygenic risk score; psychometric validity; standardized norms.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity / genetics*
Attention Deficit Disorder with Hyperactivity / physiopathology*
Behavior Rating Scale / standards*
Child
Female
Genetic Predisposition to Disease*
Humans
Male
Multifactorial Inheritance*
Parents
Reproducibility of Results
Self Report
Sensitivity and Specificity

Abstract

Publication types

MeSH terms

Grants and funding