Adolescent Caffeine Use, ADHD, and Cigarette Smoking

Using caffeine as a chemical means to induce flow states

Flow is an intrinsically rewarding state characterised by positive affect and total task absorption. Because cognitive and physical performance are optimal in flow, chemical means to facilitate this state are appealing. Caffeine, a non-selective adenosine receptor antagonist, has been emphasized as a potential flow-inducer. Thus, we review the psychological and biological effects of caffeine that, conceptually, enhance flow. Caffeine may facilitate flow through various effects, including: i) upregulation of dopamine D1/D2 receptor affinity in reward-associated brain areas, leading to greater energetic arousal and 'wanting'; ii) protection of dopaminergic neurons; iii) increases in norepinephrine release and alertness, which offset sleep-deprivation and hypoarousal; iv) heightening of parasympathetic high frequency heart rate variability, resulting in improved cortical stress appraisal, v) modification of striatal endocannabinoid-CB1 receptor-signalling, leading to enhanced stress tolerance; and vi) changes in brain network activity in favour of executive function and flow. We also discuss the application of caffeine to treat attention deficit hyperactivity disorder and caveats. We hope to inspire studies assessing the use of caffeine to induce flow.

Adolescent endocrine disrupting chemical exposure and academic achievement

BACKGROUND

Epidemiologic studies support associations of exposure to endocrine disrupting chemicals (EDCs), such as some phthalates, phenols, and parabens with a wide range of cognitive and behavioral traits. While many of these traits are associated with academic achievement, the relationship of EDC exposure specifically with academic achievement in adolescence has not yet been studied.

OBJECTIVE

We assessed the association of urinary biomarker concentrations of EDCs with academic achievement in adolescents as well as the potential for psychosocial factors to modify associations.

METHODS

We quantified urinary concentrations of select EDCs in 205 adolescent participants from the New Bedford Cohort (NBC), a prospective birth cohort of children born to mothers residing near the New Bedford Harbor Superfund site in Massachusetts, and estimated associations between EDCs and adolescent academic achievement assessed with the Wide Range Achievement Test (WRAT). Measures of socioeconomic status and the home environment were used to estimate psychosocial stress.

RESULTS

Urinary concentrations of antiandrogenic phthalates were inversely associated with Math Computation scores. For example, each doubling of the concentration of antiandrogenic phthalate metabolites in urine was associated with a 1.94 point decrease (95% CI: 3.84, -0.05) in Math Computation scores, indicating poorer performance. For the most part, associations were stronger in adolescents with more, as compared to less, social disadvantage, but most of these differences did not achieve statistical significance.

CONCLUSION

Our findings support the potential for adolescents' exposure to antiandrogenic phthalates to correlate with poorer academic achievement in math, particularly among participants with greater psychosocial stress.

Quantum chemical calculations of nicotine and caffeine molecule in gas phase and solvent using DFT methods

In this study, the molecular structures of nicotine and caffeine molecule have been generated using the 6-311++G(d,p) basis set in the DFT/B3LYP method. The molecules were optimized on the same basis set and their minimum stable energy was calculated. The HOMO-LUMO energies were calculated to establish the kinetic stability and chemical reactivity of the chosen compounds. The variation of energy and its gap were closely studied for both nicotine and caffeine in the presence of solvent water as well. Similarly, vibrational spectroscopy was studied at the most prominent region in both gas phase and solvent water with their respective TED assignments. The shifting of frequency clearly indicates the impact of solvent water and isotopic substitution of carbon atoms.

Impact of a Behavioral Sleep Intervention in Adolescents With ADHD: Feasibility, Acceptability, and Preliminary Effectiveness From a Pilot Open Trial

OBJECTIVE

An open trial tested the feasibility, acceptability, and preliminary effectiveness of a behavioral sleep intervention in adolescents with ADHD.

METHOD

Fourteen adolescents (ages 13-17 years; 50% male) with ADHD and co-occurring sleep problems received the cognitive-behavioral-based Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C). Adolescent, parent, and teacher ratings, actigraphy, and daily sleep diaries were collected at pre-intervention, post-intervention, and 3-month follow-up.

RESULTS

Adolescents experienced moderate to large improvements in sleep, mental health symptoms, and daily life executive functioning from pre-treatment to post-treatment, and improvements were generally maintained at 3 months. Pre-intervention, 71.4% of adolescents were classified as poor sleepers and this was reduced to 21.4% and 28.6% at post-treatment and follow-up, respectively.

CONCLUSION

This study provides strong preliminary evidence that TranS-C improves sleep and associated outcomes in adolescents with ADHD and co-occurring sleep problems. A randomized controlled trial is needed to rigorously test the efficacy of TranS-C in this population.

Caffeine-related genes influence anxiety disorders in children and adults with ADHD

Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders (AD) frequently co-occur, increasing morbidity and challenging treatment. Caffeine is a central nervous system stimulant and acts in the brain through adenosine receptors, influencing attention, alertness, and anxiety. In the present study, we performed a gene-set analysis to verify if genes related to caffeine response are associated with anxiety disorders in 240 children and 406 adults with ADHD. We demonstrated an association between the gene-set with AD in children (P = 0.0054) and with the number of anxiety disorders in adults (P = 0.0197). In order to test if this effect is a result of anxiety in general or is related to AD comorbid with ADHD, we evaluated the association between caffeine gene-set with AD in an adult control sample. The gene-set was neither associated with the AD presence (P = 0.3008) nor with the number of AD (P = 0.5594) in this control sample. We also test this gene set with ADHD (n = 55,374) and AD (n = 18,186) GWAS summary statistics, and we did not observe significant results with ADHD (P = 0.5587) or AD (P = 0.3930). These findings suggest the caffeine-related genes play a role in the etiology of an anxiety disorder phenotype present in children and adults with ADHD.

Self-Medication of ADHD Symptoms: Does Caffeine Have a Role?

OBJECTIVE

Stimulants are the most effective treatment for Attention Deficit/ Hyperactivity disorder (ADHD). In addition, studies have shown that nicotine dependence in patients with ADHD is probably best explained by self-medication. The question is whether this is also true for caffeine use and caffeine dependence. The aim of our study was, therefore, to examine the relationship of ADHD symptoms, caffeine consumption, caffeine use disorder (CUD) and well-being. We hypothesized that those who have more ADHD symptoms and regularly consume caffeine have higher psychological well-being than those who have more ADHD symptoms, but do not consume caffeine.

METHODS

A general population sample (N = 2,259, 70.5% male, mean age 34.0) filled out the 10-item Caffeine Use Disorder Questionnaire (CUDQ), the Adult ADHD Self-report Scale (ASRS) and the WHO-5 Well-Being Index (WHO-5) and were asked about their caffeine consumption habits in an online survey.

RESULTS

There were no associations between ADHD and coffee, tea, energy drink or cola consumption or daily caffeine consumption. However, the results of the path analysis showed that the level of ADHD symptoms was positively associated with the level of CUD (β = 0.350) and negatively with the WHO-5 (β = -0.259).

CONCLUSIONS

Caffeine consumption was not associated with ADHD symptom severity and thus not likely to represent self-medication. On the contrary, caffeine use disorder severity is associated with more ADHD symptoms and both caffeine use disorder and ADHD are associated with lower well-being.

Patterns of Caffeine Use and Validation of Assessment in Psychiatric Population: An Implication in Primary Care Setting

Background:

Caffeine use and abuse is a concern among treatment seekers for psychological problems. This aspect has not been documented an Indian context as well as its relevance in primary care setting. The aim of the present study was to explore and compare the caffeine intake and prevalence in Indian psychiatric patients and healthy subjects.

Materials and Methods:

Caffeine analysis in urine samples was carried out using a gold technique, gas chromatograph and mass selective detectors. This analytical technique is highly sensitive for identification of unambiguous compound. Two hundred and forty-three subjects having psychiatric disorders, along with forty-two healthy subjects were included in the study. They were assessed by using structured interview for caffeine use and screened for substance dependence as well.

Results:

One hundred twenty-eight subjects had history of substance use along with other comorbid psychiatric problems The mean of caffeine values was 1459 ± 1140 ng/mL, Whereas 42 subjects in control group (male 26, female 16) in the age group of 21–60 years had the mean caffeine levels of 1023 ± 788.8 ng/mL. The Caffeine use was significantly higher (P ≥ 0.84) in the subjects with psychiatric problems in comparison to the healthy subjects.

Conclusions:

It implies the need to enable and sensitize the primary care physicians in screening and educating treatment seekers with psychiatric morbidities for the management of caffeine use.

Association of Exposure to Endocrine-Disrupting Chemicals During Adolescence With Attention-Deficit/Hyperactivity Disorder-Related Behaviors

IMPORTANCE

Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurobehavioral disorder. Studies suggest that prenatal and early childhood exposure to endocrine-disrupting chemicals may be associated with ADHD, but the association during adolescence has not been studied to date.

OBJECTIVE

To evaluate the association between exposure to select endocrine-disrupting chemicals during adolescence and ADHD-related behaviors.

DESIGN, SETTING, AND PARTICIPANTS

For this cross-sectional analysis, data were collected from 205 adolescents in the New Bedford Cohort, an ongoing prospective birth cohort, between June 18, 2011, and June 10, 2014. The adolescents provided spot urine samples and underwent neurodevelopmental testing. Statistical analyses performed from January 15 to December 31, 2019, used a repeated-measures analysis with multivariate modified Poisson models to estimate the adjusted relative risk of ADHD-related behaviors associated with exposure to endocrine-disrupting chemicals.

EXPOSURES

Urinary biomarker concentrations of endocrine-disrupting chemicals or their metabolites, including phthalates, parabens, phenols, and triclocarban, were quantified. Summary exposure measures were created, combining biomarker concentrations of chemicals with a shared mechanism of action, exposure pathway, or chemical class.

MAIN OUTCOMES AND MEASURES

Behaviors related to ADHD were assessed with up to 14 indices from self-, parent-, and teacher-completed behavioral checklists using validated and standardized instruments; specifically, the Conners Attention Deficit Scale and the Behavior Assessment System for Children, Second Edition. Scores on each index were dichotomized to identify those with evidence of a significant behavioral problem, defined by each scale's interpretive guidelines.

RESULTS

Among the 205 participants, the mean (SD) age at assessment was 15.3 (0.7) years, with 112 girls (55%) and 124 non-Hispanic White participants (61%). The median urine concentrations were 0.45 μmol/L of Σantiandrogenic phthalates, 0.13 μmol/L of ΣDEHP metabolites, 0.49 μmol/L of Σpersonal care product phthalates, 0.35 μmol/L of Σparabens, 0.02 μmol/L of Σbisphenols, and 0.02 μmol/L of Σdichlorophenols. A total of 82 (40%) had scores consistent with a significant behavioral problem, whereas 39 (19%) had an ADHD diagnosis. Each 2-fold increase in the sum of antiandrogenic phthalate concentrations was associated with a 1.34 (95% CI, 1.00-1.79) increase in the risk of significant ADHD-related behavior problems, whereas a 2-fold increase in the sum of dichlorophenols was associated with a 1.15 (95% CI, 1.01-1.32) increased risk. These associations tended to be stronger in male participants, but comparisons of sex-specific differences were imprecise.

CONCLUSIONS AND RELEVANCE

Endocrine-disrupting chemicals are used in a wide variety of consumer products resulting in ubiquitous exposure. The study findings suggest that exposure to some of these chemicals, particularly certain phthalates, during adolescence may be associated with behaviors characteristic of ADHD.

Caffeine Use and Associations With Sleep in Adolescents With and Without ADHD

OBJECTIVE

The objective of this study was to compare caffeine consumption in the morning, afternoon, and evening in adolescents with and without attention-deficit/hyperactivity disorder (ADHD) and examine associations with sleep functioning.

METHODS

Participants were 302 adolescents (ages 12-14) with (N = 140) and without (N = 162) ADHD. Adolescents wore actigraph watches to assess total sleep time and wake after sleep onset and reported on sleep-wake problems and the number of caffeinated beverages consumed per day in the morning, afternoon, and evening. Parents reported on adolescents' difficulties initiating and maintaining sleep. Chi-square tests, odds ratios, and path analyses were conducted.

RESULTS

Analyses controlled for sex, medication status, and pubertal development. Adolescents with ADHD were 2.47 times more likely to consume caffeine in the afternoon and evening than adolescents without ADHD. Path analyses indicated significant associations between afternoon caffeine use and more self-reported sleep problems for adolescents with and without ADHD, and an association between evening caffeine use and self-reported sleep problems only in adolescents with ADHD. Afternoon caffeine use was associated with parent-reported sleep problems in adolescents with ADHD only. Caffeine use was not associated with actigraphy-assessed sleep.

CONCLUSION

This is the first study to show that adolescents with ADHD consume more caffeine than peers during later times of the day. Additionally, caffeine use is more consistently associated with poorer subjective sleep functioning in adolescents with ADHD. Pediatricians and mental health professionals should assess for caffeine use in adolescents with ADHD and co-occurring sleep problems.

Social, demographic, and economic correlates of food and chemical consumption measured by wastewater-based epidemiology

Wastewater is a potential treasure trove of chemicals that reflects population behavior and health status. Wastewater-based epidemiology has been employed to determine population-scale consumption of chemicals, particularly illicit drugs, across different communities and over time. However, the sociodemographic or socioeconomic correlates of chemical consumption and exposure are unclear. This study explores the relationships between catchment specific sociodemographic parameters and biomarkers in wastewater generated by the respective catchments. Domestic wastewater influent samples taken during the 2016 Australian census week were analyzed for a range of diet, drug, pharmaceutical, and lifestyle biomarkers. We present both linear and rank-order (i.e., Pearson and Spearman) correlations between loads of 42 biomarkers and census-derived metrics, index of relative socioeconomic advantage and disadvantage (IRSAD), median age, and 40 socioeconomic index for area (SEIFA) descriptors. Biomarkers of caffeine, citrus, and dietary fiber consumption had strong positive correlations with IRSAD, while tramadol, atenolol, and pregabalin had strong negative correlation with IRSAD. As expected, atenolol and hydrochlorothiazide correlated positively with median age. We also found specific SEIFA descriptors such as occupation and educational attainment correlating with each biomarker. Our study demonstrates that wastewater-based epidemiology can be used to study sociodemographic influences and disparities in chemical consumption.

The Relationships between Addiction to Highly Caffeinated Drinks, Burnout, and Attention-Deficit/ Hyperactivity Disorder

Objectives:

This study aimed to evaluate the addiction to highly caffeinated drinks among university students, and we investigated the relationships between smartphone addiction, depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), burnout, self-esteem, impulsiveness in high caffeine drink addiction risk group (high caffeine group). We also compared these mental health factors differences between the high caffeine group and the control group; and, investigated the relative risk between the independent variables of the high caffeine group.

Methods:

This study was conducted in Korea, from June 2015 to July 2016. A set of questionnaires was administered on 511 college students.

Results:

The participants who belonged to the high caffeine group were more likely to demonstrate the symptoms of ADHD and higher levels of burnout and impulsiveness. Further, the results of logistic regression analysis confirmed the association between the high caffeine group and burnout.

Conclusion:

These behaviors among university students addicted to highly caffeinated drinks suggests the need for timely and effective interventions for those at risk of addiction.

Demographic, developmental and psychosocial predictors of the development of anxiety in adults with ADHD

The purpose of this research was to investigate potential demographic, developmental and psychosocial predictors of anxiety in the context of ADHD. Participants included 267 adults with a diagnosis of ADHD (168 males:99 females) and an age range of 18-70 years (M = 31 years; SD = 10.03 years). A background interview, parent questionnaire and rating scales were used to gather participant information. Correlations, independent t tests and one-way analysis of variances were used to identify variables associated with anxiety, and a stepwise multiple regression was used to identify potential predictors of anxiety. Variables associated with anxiety included childhood aggression, employment status, difficulties making friends, number of children and caffeine intake. Childhood aggression and caffeine intake were the potential predictors. Clinicians should be aware of these potential predictors of anxiety in the context of ADHD in order to minimise the likelihood of the development or maintenance of comorbid anxiety. Future research is needed in order to draw any conclusions on cause and effect.

Energy drinks and youth self-reported hyperactivity/inattention symptoms

OBJECTIVE

To describe patterns in sweetened beverage consumption by race/ethnicity and sex, documenting both the amount and types of sweetened beverages consumed; and to examine the association of sweetened beverage consumption with hyperactivity/inattention symptoms among middle school students in a single urban school district.

METHODS

Middle school students (n = 1649; 47% Hispanic and 38% black, non-Hispanic) from 12 schools, randomly selected out of 27 district schools, completed health behavior surveys in fall 2011. Students reported quantity and types of sweetened beverages consumed in the past 24 hours and completed the 5-item Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire to measure symptoms.

RESULTS

Amount and variety of reported sweetened beverage consumption (including energy drinks) were greater among boys versus girls and among black and Hispanic versus white students. Risk of hyperactivity/inattention increased by 14% for each additional sweetened beverage consumed, adjusting for age, race/ethnicity, sex, school lunch eligibility, family structure, and sugary food consumption. Students reporting consumption of energy drinks were 66% more likely to be at risk for hyperactivity/inattention after adjusting for number of drinks, other types of drinks consumed, and other potential confounders.

CONCLUSIONS

Results support recommendations to limit consumption of sweetened beverages and to avoid consumption of energy drinks among children. Interventions to reduce sweetened beverage consumption should explicitly focus on energy drinks and other emerging sweetened beverages such as sports and sweetened coffee drinks. More research is needed to understand the direction of effects and the mechanisms behind the association between sweetened beverages and hyperactivity/inattention symptoms.

A gender-specific analysis of adolescent dietary caffeine, alcohol consumption, anger, and violent behavior

Self-reported dietary caffeine and alcohol consumption were examined in relation to anger and violent behavior in Icelandic tenth-graders. Structural equation modeling (SEM) was used to investigate direct and indirect effects of measured and latent variables in the population sample of 3,670, controlling for parental financial standing, family structure, ADHD, and peer delinquency. Gender differences were observed that have not been reported previously, especially in relation to anger as a possible mediator of violent behavior against a background of caffeine and alcohol consumption. Study findings suggest the need to take account of caffeine consumption in relation to adolescent anger and violence.

Ostracising caffeine from the pharmacological arsenal for attention-deficit hyperactivity disorder--was this a correct decision? A literature review

Caffeine is one of the most widespread psychotropic substances in the world. It exerts multiple effects on the brain including adenosine receptor antagonism, and thereby has been found to modulate aspects of cognition, including attention, in animal models and in healthy human volunteers. This review considers what is known of the effects of caffeine on symptoms and cognitive functions in attention-deficit hyperactivity disorder (ADHD), a prototypical disorder of cognitive dysfunction. We consider the merits of investigating further caffeine's therapeutic potential as a monotherapy or as an adjunctive agent in ADHD. The potential benefits of re-opening a dialogue regarding the use of caffeine in ADHD clinical practice are highlighted, along with potential implications for the use of adenosine receptor antagonists in ADHD and other disorders characterised by cognitive impairment.

Adolescent caffeine consumption and self-reported violence and conduct disorder

Caffeine is the most widely used psychoactive substance in the world and currently the only one legally available to children and adolescents. The sale and use of caffeinated beverages has increased markedly among adolescents during the last decade. However, research on caffeine use and behaviors among adolescents is scarce. We investigate the relationship between adolescent caffeine use and self-reported violent behaviors and conduct disorders in a population-based cross-sectional sample of 3,747 10th grade students (15-16 years of age, 50.2 % girls) who were enrolled in the Icelandic national education system during February 2012. Through a series of multiple regression models, while controlling for background factors, Attention Deficit Hyperactivity Disorder symptoms and current medication and peer delinquency, and including measures on substance use, our findings show robust additive explanatory power of caffeine for both violent behaviors and conduct disorders. In addition, the association of caffeine to the outcomes is significantly stronger for girls than boys for both violent behaviors and conduct disorders. Future studies are needed to examine to what extent, if at all, these relationships are causal. Indication of causal connections between caffeine consumption and negative outcomes such as those reported here would call into question the acceptability of current policies concerning the availability of caffeine to adolescents and the targeting of adolescence in the marketing of caffeine products.

Playing video games while using or feeling the effects of substances: associations with substance use problems

This study tested the hypothesis that playing video games while using or feeling the effects of a substance—referred to herein as “concurrent use”—is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejeiro Salguero and Bersabé Morán’s 2002 problem video game play (PVP) measure, and measures for substance use problems were taken from the National Survey of Drug Use and Health (NSDUH). Separate structural equation modeling analyses were conducted for users of caffeine, tobacco, alcohol, and marijuana. In all four models, concurrent use was directly associated with substance use problems, but not with PVP. Video gaming as an enthusiastic hobby was associated with substance use problems via two indirect paths: through PVP for all substances, and through concurrent use for caffeine, tobacco, and alcohol only. Results illustrate the potential for “drug interaction” between self-reinforcing behaviors and addictive substances, with implications for the development of problem use.