Twin Study of Child and Adolescent Development - TCHAD

In the longitudinal Swedish Twin study of Child and Adolescent Development (TCHAD) we have followed 1,500 twin pairs from age 8 to age 26. Twins and parents have responded to 5 waves of questionnaires (1994, 1999, 2002, 2006, 2013). We have also collected biological samples for DNA-extraction. 

A paper that describes the study was published in 2007 (Lichtenstein, Tuvblad, Larsson, Carlström, 2007, Twin Research and Human Genetics). At least 15 PhD theses and more than 50 papers/reports have been published based on data from this study.

Project description

We have studied how genetic and environmental effects contribute to the development of mental health problems over time. For example, we have identified persistent “combined” and subtype-specific genetic influences (i.e., “hyperactive-impulsive” and “inattentive”) suggesting a genetic basis for the DSM-IV classification of ADHD (Larsson, Lichtenstein et al. 2006) and that genetic effects are more stable for ADHD (Chang, Lichtenstein et al. 2013) compared to internalizing problems (e.g., fears, anxiety) (Kendler, Gardner et al. 2008).

With the large population-based sample of twins, followed prospectively from childhood to emerging adulthood, the study is unique also in an international perspective. The data include a broad spectrum of measures of environments as well as internalizing and externalizing problems behaviors from both twins and parents. The study is designed to address the interplay between genes and environments, comorbidity, and the development into adult psychopathology. We will continue our studies of antisocial behavior, ADHD, eating problems, fears and phobias, and relationships.

Project leader


Paul Lichtenstein

Phone: +46-(0)8-524 874 24
Organizational unit: C8.MEB.Lichtenstein


Inst för barn- och ungdomspsykiatri, Astrid Lindgrens Barnsjukhus, Karolinska Sjukhuset; Inst of Psychiatry, London; Centre for Violence Prevention, Karolinska Institutet, Center for developmental studies, Örebro universitet; Center for Family Research, George Washington University, Washington.

Main financing: Vetenskapsrådet, FAS, FORTE


  1. Illicit Drug Use, Cigarette Smoking, and Eating Disorder Symptoms: Associations in an Adolescent Twin Sample.
    Baker J, Johnson N, Munn-Chernoff M, Lichtenstein P, Larsson H, Maes H, et al
    J Stud Alcohol Drugs 2018 Sep;79(5):720-724
  2. Associations Between Alcohol Involvement and Drive for Thinness and Body Dissatisfaction in Adolescent Twins: A Bivariate Twin Study.
    Baker J, Brosof L, Munn-Chernoff M, Lichtenstein P, Larsson H, Maes H, et al
    Alcohol. Clin. Exp. Res. 2018 Nov;42(11):2214-2223
  3. Association Between Childhood to Adolescent Attention Deficit/Hyperactivity Disorder Symptom Trajectories and Late Adolescent Disordered Eating.
    Yilmaz Z, Javaras K, Baker J, Thornton L, Lichtenstein P, Bulik C, et al
    J Adolesc Health 2017 Aug;61(2):140-146
  4. Education in Twins and Their Parents Across Birth Cohorts Over 100 years: An Individual-Level Pooled Analysis of 42-Twin Cohorts.
    Silventoinen K, Jelenkovic A, Latvala A, Sund R, Yokoyama Y, Ullemar V, et al
    Twin Res Hum Genet 2017 10;20(5):395-405
  5. A Genetic Epidemiological Mega Analysis of Smoking Initiation in Adolescents.
    Maes H, Prom-Wormley E, Eaves L, Rhee S, Hewitt J, Young S, et al
    Nicotine Tob. Res. 2017 Apr;19(4):401-409
  6. Predictive validity of parent- and self-rated ADHD symptoms in adolescence on adverse socioeconomic and health outcomes.
    Du Rietz E, Kuja-Halkola R, Brikell I, Jangmo A, Sariaslan A, Lichtenstein P, et al
    Eur Child Adolesc Psychiatry 2017 Jul;26(7):857-867
  7. Shared familial risk between bulimic symptoms and alcohol involvement during adolescence.
    Baker J, Munn-Chernoff M, Lichtenstein P, Larsson H, Maes H, Kendler K
    J Abnorm Psychol 2017 Jul;126(5):506-518
  8. Relative Immaturity in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms From Childhood to Early Adulthood: Exploring Genetic and Environmental Overlap Across Development.
    Brikell I, Kuja-Halkola R, Larsson J, Lahey B, Kuntsi J, Lichtenstein P, et al
    J Am Acad Child Adolesc Psychiatry 2016 10;55(10):886-95
  9. The CODATwins Project: The Cohort Description of Collaborative Project of Development of Anthropometrical Measures in Twins to Study Macro-Environmental Variation in Genetic and Environmental Effects on Anthropometric Traits.
    Silventoinen K, Jelenkovic A, Sund R, Honda C, Aaltonen S, Yokoyama Y, et al
    Twin Res Hum Genet 2015 Aug;18(4):348-60
  10. A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms.
    Savage J, Verhulst B, Copeland W, Althoff R, Lichtenstein P, Roberson-Nay R
    J Am Acad Child Adolesc Psychiatry 2015 May;54(5):377-84
  11. Is Physical Activity Causally Associated With Symptoms of Attention-Deficit/Hyperactivity Disorder?
    Rommel A, Lichtenstein P, Rydell M, Kuja-Halkola R, Asherson P, Kuntsi J, et al
    J Am Acad Child Adolesc Psychiatry 2015 Jul;54(7):565-70
  12. Longitudinal Stability of Genetic and Environmental Influences on Irritability: From Childhood to Young Adulthood.
    Roberson-Nay R, Leibenluft E, Brotman M, Myers J, Larsson H, Lichtenstein P, et al
    Am J Psychiatry 2015 Jul;172(7):657-64
  13. Risk for self-reported anorexia or bulimia nervosa based on drive for thinness and negative affect clusters/dimensions during adolescence: A three-year prospective study of the TChAD cohort.
    Peñas-Lledó E, Bulik C, Lichtenstein P, Larsson H, Baker J
    Int J Eat Disord 2015 Sep;48(6):692-9
  14. Codevelopment of ADHD and externalizing behavior from childhood to adulthood.
    Kuja-Halkola R, Lichtenstein P, D'Onofrio B, Larsson H
    J Child Psychol Psychiatry 2015 Jun;56(6):640-7
  15. Zygosity Differences in Height and Body Mass Index of Twins From Infancy to Old Age: A Study of the CODATwins Project.
    Jelenkovic A, Yokoyama Y, Sund R, Honda C, Bogl L, Aaltonen S, et al
    Twin Res Hum Genet 2015 Oct;18(5):557-70
  16. Accounting for genetic and environmental confounds in associations between parent and child characteristics: a systematic review of children-of-twins studies.
    McAdams T, Neiderhiser J, Rijsdijk F, Narusyte J, Lichtenstein P, Eley T
    Psychol Bull 2014 Jul;140(4):1138-73
  17. Psychotic experiences as a predictor of the natural course of suicidal ideation: a Swedish cohort study.
    Kelleher I, Cederlöf M, Lichtenstein P
    World Psychiatry 2014 Jun;13(2):184-8
  18. Genetic innovation and stability in externalizing problem behavior across development: a multi-informant twin study.
    Wichers M, Gardner C, Maes H, Lichtenstein P, Larsson H, Kendler K
    Behav. Genet. 2013 May;43(3):191-201
  19. Genetic and environmental risk factors in males for self-report externalizing traits in mid-adolescence and criminal behavior through young adulthood.
    Kendler K, Patrick C, Larsson H, Gardner C, Lichtenstein P
    Psychol Med 2013 Oct;43(10):2161-8
  20. Developmental twin study of attention problems: high heritabilities throughout development.
    Chang Z, Lichtenstein P, Asherson P, Larsson H
    JAMA Psychiatry 2013 Mar;70(3):311-8
  21. Variation in the oxytocin receptor gene is associated with pair-bonding and social behavior.
    Walum H, Lichtenstein P, Neiderhiser J, Reiss D, Ganiban J, Spotts E, et al
    Biol. Psychiatry 2012 Mar;71(5):419-26
  22. Genetic and environmental influences on the association between pubertal maturation and internalizing symptoms.
    Marceau K, Neiderhiser J, Lichtenstein P, Reiss D
    J Youth Adolesc 2012 Sep;41(9):1111-26
  23. Genetic and environmental contributions to weight, height, and BMI from birth to 19 years of age: an international study of over 12,000 twin pairs.
    Dubois L, Ohm Kyvik K, Girard M, Tatone-Tokuda F, Pérusse D, Hjelmborg J, et al
    PLoS ONE 2012 ;7(2):e30153
  24. Genetic variance of body mass index from childhood to early adulthood.
    Dellava J, Lichtenstein P, Kendler K
    Behav. Genet. 2012 Jan;42(1):86-95
  25. The effects of childhood ADHD symptoms on early-onset substance use: a Swedish twin study.
    Chang Z, Lichtenstein P, Larsson H
    J Abnorm Child Psychol 2012 Apr;40(3):425-35
  26. Pubertal development predicts eating behaviors in adolescence.
    Baker J, Thornton L, Lichtenstein P, Bulik C
    Int J Eat Disord 2012 Nov;45(7):819-26
  27. Shared genetic effects between age at menarche and disordered eating.
    Baker J, Thornton L, Bulik C, Kendler K, Lichtenstein P
    J Adolesc Health 2012 Nov;51(5):491-6
  28. The genetic and environmental etiology of antisocial behavior from childhood to emerging adulthood.
    Tuvblad C, Narusyte J, Grann M, Sarnecki J, Lichtenstein P
    Behav. Genet. 2011 Sep;41(5):629-40
  29. Parental criticism and externalizing behavior problems in adolescents: the role of environment and genotype-environment correlation.
    Narusyte J, Neiderhiser J, Andershed A, D'Onofrio B, Reiss D, Spotts E, et al
    J Abnorm Psychol 2011 May;120(2):365-76
  30. Association between childhood asthma and ADHD symptoms in adolescence--a prospective population-based twin study.
    Mogensen N, Larsson H, Lundholm C, Almqvist C
    Allergy 2011 Sep;66(9):1224-30
  31. Internalizing behavior in adolescent girls affects parental emotional overinvolvement: a cross-lagged twin study.
    Moberg T, Lichtenstein P, Forsman M, Larsson H
    Behav. Genet. 2011 Mar;41(2):223-33
  32. Developmental trajectories of DSM-IV symptoms of attention-deficit/hyperactivity disorder: genetic effects, family risk and associated psychopathology.
    Larsson H, Dilshad R, Lichtenstein P, Barker E
    J Child Psychol Psychiatry 2011 Sep;52(9):954-63
  33. The impact of environmental experiences on symptoms of anxiety and depression across the life span.
    Kendler K, Eaves L, Loken E, Pedersen N, Middeldorp C, Reynolds C, et al
    Psychol Sci 2011 Oct;22(10):1343-52
  34. Early environmental influences contribute to covariation between internalizing symptoms and alcohol intoxication frequency across adolescence.
    Edwards A, Larsson H, Lichtenstein P, Kendler K
    Addict Behav 2011 Mar;36(3):175-82
  35. Study on the possible association of brain-derived neurotrophic factor polymorphism with the developmental course of symptoms of attention deficit and hyperactivity.
    Bergman O, Westberg L, Lichtenstein P, Eriksson E, Larsson H
    Int. J. Neuropsychopharmacol. 2011 Nov;14(10):1367-76
  36. Sex differences and developmental stability in genetic and environmental influences on psychoactive substance consumption from early adolescence to young adulthood.
    Baker J, Maes H, Larsson H, Lichtenstein P, Kendler K
    Psychol Med 2011 Sep;41(9):1907-16
  37. Heritability of dental fear.
    Ray J, Boman U, Bodin L, Berggren U, Lichtenstein P, Broberg A
    J. Dent. Res. 2010 Mar;89(3):297-301
  38. A longitudinal twin study of the direction of effects between psychopathic personality and antisocial behaviour.
    Forsman M, Lichtenstein P, Andershed H, Larsson H
    J Child Psychol Psychiatry 2010 Jan;51(1):39-47
  39. High sense of coherence in adolescence is a protective factor in the longitudinal development of ADHD symptoms.
    Edbom T, Malmberg K, Lichtenstein P, Granlund M, Larsson J
    Scand J Caring Sci 2010 Sep;24(3):541-7
  40. Genetic risk factors for disordered eating in adolescent males and females.
    Baker J, Maes H, Lissner L, Aggen S, Lichtenstein P, Kendler K
    J Abnorm Psychol 2009 Aug;118(3):576-86
  41. Intrauterine testosterone exposure and risk for disordered eating.
    Baker J, Lichtenstein P, Kendler K
    Br J Psychiatry 2009 Apr;194(4):375-6
  42. Testing different types of genotype-environment correlation: an extended children-of-twins model.
    Narusyte J, Neiderhiser J, D'Onofrio B, Reiss D, Spotts E, Ganiban J, et al
    Dev Psychol 2008 Nov;44(6):1591-603
  43. ADHD and Disruptive Behavior scores - associations with MAO-A and 5-HTT genes and with platelet MAO-B activity in adolescents.
    Malmberg K, Wargelius H, Lichtenstein P, Oreland L, Larsson J
    BMC Psychiatry 2008 Apr;8():28
  44. A developmental twin study of symptoms of anxiety and depression: evidence for genetic innovation and attenuation.
    Kendler K, Gardner C, Lichtenstein P
    Psychol Med 2008 Nov;38(11):1567-75
  45. A longitudinal twin study of fears from middle childhood to early adulthood: evidence for a developmentally dynamic genome.
    Kendler K, Gardner C, Annas P, Neale M, Eaves L, Lichtenstein P
    Arch. Gen. Psychiatry 2008 Apr;65(4):421-9
  46. The development of fears from early adolesence to young adulthood: a multivariate study.
    Kendler K, Gardner C, Annas P, Lichtenstein P
    Psychol Med 2008 Dec;38(12):1759-69
  47. Genetic effects explain the stability of psychopathic personality from mid- to late adolescence.
    Forsman M, Lichtenstein P, Andershed H, Larsson H
    J Abnorm Psychol 2008 Aug;117(3):606-17
  48. Aggression as a mediator of genetic contributions to the association between negative parent-child relationships and adolescent antisocial behavior.
    Narusyte J, Andershed A, Neiderhiser J, Lichtenstein P
    Eur Child Adolesc Psychiatry 2007 Mar;16(2):128-37
  49. The Swedish Twin study of CHild and Adolescent Development: the TCHAD-study.
    Lichtenstein P, Tuvblad C, Larsson H, Carlström E
    Twin Res Hum Genet 2007 Feb;10(1):67-73
  50. A common genetic factor explains the association between psychopathic personality and antisocial behavior.
    Larsson H, Tuvblad C, Rijsdijk F, Andershed H, Grann M, Lichtenstein P
    Psychol Med 2007 Jan;37(1):15-26
  51. Birth weight and attention-deficit/hyperactivity symptoms in childhood and early adolescence: a prospective Swedish twin study.
    Hultman C, Torrång A, Tuvblad C, Cnattingius S, Larsson J, Lichtenstein P
    J Am Acad Child Adolesc Psychiatry 2007 Mar;46(3):370-7
  52. Forsman M, Larsson H, Andershed H, Lichtenstein P. The association between persistent disruptive childhood behaviour and the psychopathic personality constellation in adolescence: A twin study. Brit J Dev Psychol. 2007;25:383-98.
  53. Heritability for adolescent antisocial behavior differs with socioeconomic status: gene-environment interaction.
    Tuvblad C, Grann M, Lichtenstein P
    J Child Psychol Psychiatry 2006 Jul;47(7):734-43
  54. Genetic contributions to the development of ADHD subtypes from childhood to adolescence.
    Larsson H, Lichtenstein P, Larsson J
    J Am Acad Child Adolesc Psychiatry 2006 Aug;45(8):973-81
  55. A genetic factor explains most of the variation in the psychopathic personality.
    Larsson H, Andershed H, Lichtenstein P
    J Abnorm Psychol 2006 May;115(2):221-30
  56. Long-term relationships between symptoms of Attention Deficit Hyperactivity Disorder and self-esteem in a prospective longitudinal study of twins.
    Edbom T, Lichtenstein P, Granlund M, Larsson J
    Acta Paediatr. 2006 Jun;95(6):650-7
  57. The development of antisocial behaviour from childhood to adolescence. A longitudinal twin study.
    Tuvblad C, Eley T, Lichtenstein P
    Eur Child Adolesc Psychiatry 2005 Jul;14(4):216-25
  58. Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study.
    Larsson J, Larsson H, Lichtenstein P
    J Am Acad Child Adolesc Psychiatry 2004 Oct;43(10):1267-75
  59. Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study.
    Larsson J, Larsson H, Lichtenstein P
    J Am Acad Child Adolesc Psychiatry 2004 Oct;43(10):1267-75
  60. A longitudinal behavioral genetic analysis of the etiology of aggressive and nonaggressive antisocial behavior.
    Eley T, Lichtenstein P, Moffitt T
    Dev. Psychopathol. 2003 ;15(2):383-402
  61. Genetic and environmental influences on problematic masturbatory behavior in children: a study of same-sex twins.
    Långström N, Grann M, Lichtenstein P
    Arch Sex Behav 2002 Aug;31(4):343-50
  62. Heritability and prevalence of specific fears and phobias in childhood.
    Lichtenstein P, Annas P
    J Child Psychol Psychiatry 2000 Oct;41(7):927-37
  63. Parents' perception of mental development and behavioural problems in 8 to 9-year-old children.
    Larsson J, Lichtenstein P, Fried I, El-Sayed E, Rydelius P
    Acta Paediatr. 2000 Dec;89(12):1469-73
  64. Genetic and environmental influences on recurrent headaches in eight to nine-year-old twins.
    Svensson D, Larsson B, Bille B, Lichtenstein P
    Cephalalgia 1999 Dec;19(10):866-72
  65. Steffensson B, Larsson JO, Fried I, El-Sayed E, Rydelius PA, Lichtenstein P. Genetic disposition for global maturity: An explanation for genetic effects on parental report on ADHD. International Journal of Behavioral Development. 1999;23(2):357-74.
  66. Sex differences in the etiology of aggressive and nonaggressive antisocial behavior: results from two twin studies.
    Eley T, Lichtenstein P, Stevenson J
    Child Dev ;70(1):155-68
  67. Lichtenstein P, Svartengren M. Genes, environments, and sex: factors of importance in atopic diseases in 7-9-year-old Swedish twins. Allergy 1997;52:1079-86.


Twin research