Persistence of childhood ADHD symptoms into adolescence and adulthood is common. However, persistence is not simply a continuation of early high severity ADHD. Rather, it is the product of influences from individual‐level genetic liability, one's environmental context, and their interplay. The field has often focused on cross‐sectional ADHD severity and genetic load. However, environments – such as one's socioeconomic context – exert their own influence over development independently of genetics, as well as modulate genetic influences. Importantly, these genetic and environmental effects vary significantly between inattention and hyperactivity/impulsivity symptom domains, emphasizing the need to consider these domains separately when studying persistence risk. This article outlines a unifying persistence framework reflecting the changing contributions of genes, environmental context, and their interaction over time, offering a path to a more complete understanding of risk for symptom persistence.
Thomson et al. (Tue,) studied this question.