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Lee K, Fung HW. The mediated model of PTSD between ADHD symptoms and alcohol abuse in a population of college students in Taiwan. J Formos Med Assoc 2024:S0929-6646(24)00359-0. [PMID: 39209668 DOI: 10.1016/j.jfma.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/28/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE Impulsivity, inattention, childhood trauma, PTSD, and depressive symptoms were the high-risk factors of alcohol abuse in ADHD symptoms. There is a lack of a comprehensive framework of trauma and PTSD in ADHD symptoms with alcohol abuse to explain why ADHD college students become problematic alcohol drinking. METHOD 521 college students were recruited from online platforms (e.g., Facebook, LINE, or Google) after informed consent (females, 67.9%, n = 354; averaged age = 20.34, S.D. = 1.98). All of them completed the questionnaires, which included symptoms of ADHD, inattention and impulsivity, depressive symptoms, childhood trauma, PTSD symptoms, and problematic alcohol drinking. One-way ANOVA and path analysis were applied to examine the significance of eight paths. RESULTS Our results supported the mediating effects of childhood trauma and PTSD symptoms in ADHD symptoms with problematic alcohol drinking. DISCUSSION The effect of complex PTSD between impulsivity and problematic alcohol drinking is still unclear. In addition to impulsivity and inattention to ADHD symptoms with problematic alcohol drinking, the impact of hyperactivity also needs to be considered. CONCLUSIONS Effective treatment for ADHD symptoms with alcohol abuse could focus on self-control training and emotional regulation in the future.
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Affiliation(s)
- Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Taiwan.
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
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Marsh NP, Oddo L, Murphy JG, Chronis-Tuscano A. Sleep, Alcohol and Cannabis Use in College Students With and Without Attention-Deficit/Hyperactivity Disorder. Subst Use Misuse 2024; 59:1141-1149. [PMID: 38555872 PMCID: PMC11062626 DOI: 10.1080/10826084.2024.2320376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Background: Relations among attention-deficit/hyperactivity disorder (ADHD), sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use. Methods: College students who drink alcohol with (n = 51) and without (n = 50) ADHD completed an assessment that included a diagnostic interview assessing ADHD, and questionnaire measures of sleep quality, substance use, and associated consequences. Analyses utilized a series of hierarchical linear regression models and explored these aims for cannabis use in a subset of participants (n = 52 participants that used cannabis). Results: College students who drink alcohol with ADHD reported significantly worse sleep quality and more alcohol-related consequences, relative to those without ADHD. When ADHD and sleep quality were included in the model, ADHD-but not sleep quality-was independently associated with alcohol consequences, but not cannabis consequences. There were no moderating effects of ADHD on the associations between sleep and substance-related consequences. Conclusions: Students who drank alcohol with ADHD may be particularly vulnerable to experiencing poor sleep and consequences from their substance use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.
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Affiliation(s)
- Nicholas P. Marsh
- Department of Psychology, University of Maryland College Park, College Park, USA
| | - Lauren Oddo
- Department of Psychology, University of Maryland College Park, College Park, USA
| | - James G. Murphy
- Department of Psychology, University of Memphis, Tennessee, USA
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Chugani CD, Jones KA, Coulter RW, Anderson JC, Talis J, Goldstein TR, Chung T, Miller E. Increased risk for binge drinking among college students with disability who report sexual violence. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:691-697. [PMID: 32407169 PMCID: PMC7666107 DOI: 10.1080/07448481.2020.1760281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/19/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThis study investigated binge drinking in college students with and without disabilities and sexual violence (SV). Participants: This analysis includes 2,113 college students recruited from campus health or counseling centers between 2015 and 2017, aged 18-24. Method: Multinomial logistic regression procedures were used to estimate adjusted odds ratios (AOR) for past month binge drinking days (BDD). Results: Among students with disabilities, 68% endorsed SV, compared with 53% of those without disability. Disability was not significantly associated with BDD; SV was significantly associated with BDD (p < .0001). Students with SV, regardless of disability status, had 1.7- to 2.1-fold greater odds of having 4+ past month BDD. Conclusions: While disability alone is not a risk factor for binge drinking, novel findings include that students with disabilities binge drink at similarly high rates to their nondisabled peers, and are at elevated risk for SV, which is closely associated with binge drinking.
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Affiliation(s)
- Carla D. Chugani
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelley A. Jones
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert W.S. Coulter
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Graduate School of Public Health, Department of Behavioral and Communit Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jocelyn C. Anderson
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Janine Talis
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tina R. Goldstein
- School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tammy Chung
- School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
- School of Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Cavicchioli M, Ogliari A, Movalli M, Maffei C. Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders. Subst Use Misuse 2022; 57:1837-1853. [PMID: 36096483 DOI: 10.1080/10826084.2022.2120358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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Meinzer MC, Oddo LE, Vasko JM, Murphy JG, Iwamoto D, Lejuez CW, Chronis-Tuscano A. Motivational interviewing plus behavioral activation for alcohol misuse in college students with ADHD. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:803-816. [PMID: 33600197 PMCID: PMC8371056 DOI: 10.1037/adb0000663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: College is a high-risk period for the initiation and escalation of problem alcohol use. College students with attention-deficit/hyperactivity disorder (ADHD) are at particularly high risk for experiencing alcohol-related negative consequences relative to typically developing peers. Despite this, the best therapeutic approach for addressing alcohol problems in college students with ADHD has not been identified. Behavioral activation (BA) may augment the effects of gold-standard College drinking interventions [i.e., brief motivational intervention (BMI)] for students with ADHD who are engaging in problem drinking. Method: 113 college students with ADHD (Mean age = 19.87, SD = 1.44; 49.1% male) were randomized to either BMI + BA or BMI plus supportive counseling (BMI + SC). Both groups received ADHD psychoeducation delivered in MI style. Outcomes were assessed using the Brief Young Adult Alcohol Consequences Questionnaire, Daily Drinking Questionnaire, Barkley Functional Impairment Scale, and Beck Depression Inventory. Results: There were no significant differences in outcomes for the sample as a whole; in both conditions, participants showed significant reductions in their alcohol-related negative consequences, alcohol use, and depressive symptoms at 1- and 3-month follow-ups. Exploratory moderation analyses revealed that participants with elevated depressive symptoms at baseline evidenced greater reductions in alcohol-related negative consequences in the BMI + BA condition compared to BMI + SC at the 3-month follow-up. Those low in depressive symptoms evidenced greater reductions of alcohol-related negative consequences in BMI + SC compared to BMI + BA. Conclusions: For college students with ADHD who reported elevated baseline depressive symptoms, the inclusion of BA with BMI resulted in significantly greater decreases in alcohol-related negative consequences, compared to BMI + SC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Lauren E Oddo
- Department of Psychology, University of Maryland, College Park
| | | | | | - Derek Iwamoto
- Department of Psychology, University of Maryland, College Park
| | - Carl W Lejuez
- Department of Psychological Sciences, University of Connecticut
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6
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Lefler EK, Flory K, Canu WH, Willcutt EG, Hartung CM. Unique considerations in the assessment of ADHD in college students. J Clin Exp Neuropsychol 2021; 43:352-369. [PMID: 34078248 DOI: 10.1080/13803395.2021.1936462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Evidence-based practice in psychology (EBPP) has long focused on treatment, but evidence-based psychological assessment (EBPA) is also crucial given the important role of accurate and reliable diagnostic practices in treatment planning. In terms of the diagnosis of attention-deficit/hyperactivity disorder (ADHD), EBPA practices are well-established for children, and more recently for adults, but for college students in particular there are special considerations that warrant attention. College students with symptoms of ADHD have some challenges that are unique, and thus the assessment and diagnosis of ADHD in these students is unique. The aim of this review is not to cover all EBPA strategies for diagnosing ADHD in emerging adult college students; rather, we will focus on the unique considerations at play in college ADHD assessment. These include (a) conceptual matters such as the appropriateness of the DSM-5 criteria for college students, the limitations of our understanding of ADHD this population because of a lack of diversity in research studies, and the issue of late-identified ADHD; and (b) practical matters, such as specific documentation needs, how to gather and interpret self- and other-report of symptoms, how to assess impairment, and alternate explanations for ADHD-like symptoms in college students.
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Affiliation(s)
- Elizabeth K Lefler
- Department of Psychology, University of Northern Iowa, Cedar Falls, IA, USA
| | - Kate Flory
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, NC, USA
| | - Erik G Willcutt
- Deparment of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, USA
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7
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Elkins IJ, Saunders GRB, Malone SM, Wilson S, McGue M, Iacono WG. 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 Alcohol Depend 2020; 212:107947. [PMID: 32444170 PMCID: PMC7293951 DOI: 10.1016/j.drugalcdep.2020.107947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Persistence and emergence of ADHD in adulthood are associated with substance problems. We investigate differential implications of ADHD course for tobacco, alcohol, or marijuana problems by sex, then whether substance misuse results from ADHD or contributes to it, through a twin differences design. METHODS A population-based cohort of 998 twins (61 % monozygotic; 52 % female), born in Minnesota from 1988 to 1994, was prospectively assessed from ages 11-24. Childhood ADHD was oversampled. At age 24, 255 had a history of childhood-onset ADHD (160 persistent, 95 remitted); 93 had late-onset ADHD symptoms identified in late-adolescence/adulthood. Persistent, remitted, and late-onset groups were compared to those without ADHD (N = 459) on childhood characteristics and age-24 substance problems. RESULTS Persistent and late-onset groups differed in childhood; twin concordances suggested greater genetic etiology for persistent ADHD. As adolescents, however, both groups were high in conduct problems; by adulthood, they were comparably high in substance problems. In particular, women whose ADHD persisted were 5 times more likely to develop tobacco use disorder than women without ADHD. Remitted ADHD was associated with less-increased risk, except for alcohol problems among women. Consistent with possible causality, monozygotic female twins with more age-17 ADHD symptoms than co-twins had more age-24 tobacco symptoms; a similar association was found for alcohol. CONCLUSIONS Presence or emergence of ADHD in early adulthood increases substance problems to a greater degree for women than men. While effects of substances on later ADHD were not statistically significant, detection was limited by the relative rarity of late-adolescent substance symptoms.
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Affiliation(s)
- Irene J. Elkins
- University of Minnesota, Twin Cities: Department of Psychology, 75 E. River Rd, Minneapolis, MN 55455
| | - Gretchen R. B. Saunders
- University of Minnesota, Twin Cities: Department of Psychology, 75 E. River Rd, Minneapolis, MN 55455
| | - Stephen M. Malone
- University of Minnesota, Twin Cities: Department of Psychology, 75 E. River Rd, Minneapolis, MN 55455
| | - Sylia Wilson
- University of Minnesota, Twin Cities: Institute of Child Development, 51 E. River Rd, Minneapolis, MN 55455, United States
| | - Matt McGue
- University of Minnesota, Twin Cities: Department of Psychology, 75 E. River Rd, Minneapolis, MN 55455
| | - William G. Iacono
- University of Minnesota, Twin Cities: Department of Psychology, 75 E. River Rd, Minneapolis, MN 55455
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8
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Mochrie KD, Whited MC, Cellucci T, Freeman T, Corson AT. ADHD, depression, and substance abuse risk among beginning college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:6-10. [PMID: 30257141 DOI: 10.1080/07448481.2018.1515754] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/13/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18-25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.
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Affiliation(s)
- Kirk D Mochrie
- Department of Psychology, East Carolina University, Greenville, South Carolina, USA
| | - Mathew C Whited
- Department of Psychology, East Carolina University, Greenville, South Carolina, USA
| | - Tony Cellucci
- Department of Psychology, East Carolina University, Greenville, South Carolina, USA
| | - Taylor Freeman
- Department of Psychology, East Carolina University, Greenville, South Carolina, USA
| | - Ansley Taylor Corson
- Department of Psychology, East Carolina University, Greenville, South Carolina, USA
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Momentary fluctuations in impulsivity domains: Associations with a history of childhood ADHD, heavy alcohol use, and alcohol problems. Drug Alcohol Depend 2019; 205:107683. [PMID: 31704385 PMCID: PMC7851800 DOI: 10.1016/j.drugalcdep.2019.107683] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/13/2019] [Accepted: 10/07/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND The current study examined if fluctuation in in-the-moment impulsivity was more pronounced for adults with, versus without, a childhood history of ADHD and if ADHD group moderated the association between fluctuation in impulsivity and alcohol use behaviors. METHODS Two hundred and eleven adult drinkers (52% ADHD) completed a 10-day, 6 times/day, momentary assessment of state impulsivity. Self-reported trait impulsivity, alcohol problems, and frequency of 5+ drinks in the past 12 months were also assessed. RESULTS The ADHD group had more variability in three domains of state impulsivity (negative urgency, positive urgency, sensation seeking) compared to the nonADHD group. After including global trait impulsivity, the ADHD and nonADHD groups only differed on state sensation seeking. Fluctuation in two domains of state impulsivity were related to frequency of 5+ drinks (lack of planning: ADHD RR = 3.60, p < 0.001, nonADHD RR=0.90, p = 0.81; negative urgency: ADHD RR=4.32, p = 0.01, nonADHD RR=0.49, p = 0.24) and number of different alcohol problems (lack of planning: ADHD RR=4.87, p < 0.001, nonADHD RR=0.58, p = 0.29; negative urgency: ADHD RR=4.96, p = 0.01, nonADHD RR=0.24, p = 0.04) for participants with a history of ADHD but were not related (or related to fewer problems) for those without childhood ADHD. Higher variability in positive urgency was related to more alcohol problems for the participants with childhood ADHD but not the nonADHD participants (ADHD RR=3.00, p = 0.03, nonADHD RR=0.50, p = 0.25). CONCLUSIONS Findings highlight the importance of assessing fluctuation in several domains of impulsivity and may elucidate important treatment targets for alcohol problems for adults with ADHD histories.
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Kuppa A, Maysun A. Risk of Alcohol Abuse in Humans with Attention-deficit/Hyperactivity Disorder Symptoms. Cureus 2019; 11:e5996. [PMID: 31807384 PMCID: PMC6876904 DOI: 10.7759/cureus.5996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The relationship between attention-deficit/hyperactivity disorder (ADHD) and the risk of alcohol abuse is widely studied. Even though this topic has been of interest for several years, it is heavily debated. We studied various papers and conducted a systematic review using PubMed as the main source of data collection. We found that several studies put forward the concept of a positive association between alcohol abuse and ADHD symptoms, but a minority of them also showed opposing and contradictory results. We discovered that this inconsistency observed in studies could be a result of a biased approach in studies and a subjective attempt in interpretations. These biases could be studied in terms of sample size involved in the analysis, age at which studies are conducted among other statistical parameters. We believe that the deviations in the outcomes prove that the studies may be incomplete and that a standardized method of interpretation is required. Therefore, this paper recommends the need for further research to explore the connection between alcohol abuse in patients showing ADHD symptoms.
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Affiliation(s)
- Annapurna Kuppa
- Internal Medicine and Gastroenterology, University of Michigan, Ann Arbor, USA
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11
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Brief Intervention to Reduce Problem Drinking in College Students With ADHD. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2019.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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12
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Grazioli VS, Gmel G, Rougemont-Bücking A, Baggio S, Daeppen JB, Studer J. Attention deficit hyperactivity disorder and future alcohol outcomes: Examining the roles of coping and enhancement drinking motives among young men. PLoS One 2019; 14:e0218469. [PMID: 31216319 PMCID: PMC6584013 DOI: 10.1371/journal.pone.0218469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/03/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Although there is evidence that Attention Deficit Hyperactivity Disorder (ADHD) symptoms are positively related to alcohol use and related problems among young adults, little research has examined the mechanisms that might explain this association. In response, this study examined the mediating effects of coping and enhancement drinking motives on the prospective associations between ADHD symptoms and alcohol outcomes. Method Participants (N = 4,536) were young men from the Cohort Study on Substance Use Risk Factors. Measures of ADHD symptoms and those of drinking motives, heavy episodic drinking (HED) and alcohol use disorder symptoms were used from the baseline and 15-month follow-up assessments. Results Findings indicated that the associations of ADHD-inattention symptoms with alcohol use disorder (AUD) symptoms and with HED were partially and completely mediated through drinking motives, respectively, whereas drinking motives did not mediate the ADHD-hyperactivity/impulsivity-symptoms-alcohol outcomes associations. Conclusion Results indicated that coping and enhancement motives partially explained the ADHD-inattention symptoms—subsequent alcohol outcomes association. These findings suggest that interventions targeting enhancement and coping motives may help prevent problematic drinking among young men with elevated ADHD-inattention symptoms.
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Affiliation(s)
- Véronique S. Grazioli
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
- * E-mail:
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
- Addiction Switzerland, Lausanne, Switzerland
- Centre for Addiction and Mental Health, Toronto, Canada
- University of the West of England, Bristol, United Kingdom
| | | | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland
- Life Course and Social Inequality Research Centre, University of Lausanne, Lausanne, Switzerland
| | | | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
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13
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Wang FL, Pedersen SL, Joseph H, Gnagy EM, Curran P, Pelham WE, Molina BS. Role of ADHD in the Co-Occurrence Between Heavy Alcohol Use and Depression Trajectories in Adulthood. Alcohol Clin Exp Res 2019; 43:342-352. [PMID: 30537147 PMCID: PMC6370516 DOI: 10.1111/acer.13934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is associated with greater heavy alcohol use and depressive symptoms in adulthood. Yet, few studies have investigated whether childhood ADHD predicts an increased association between heavy drinking and depression in adulthood when this co-occurrence becomes more common. We examined associations among heavy alcohol use and depression longitudinally from ages 21 to 29 and whether these associations differed for those with or without childhood ADHD, as well as for those with or without persistent ADHD in adulthood. METHODS Data were from the Pittsburgh ADHD Longitudinal Study, a prospective cohort of children diagnosed with ADHD and demographically similar individuals without ADHD histories. ADHD symptoms in adulthood were self- and parent reported; depressive symptoms and frequency of drinking 5 or more drinks in a single drinking occasion were self-reported and measured at 5 time-points from ages 21 to 29. Depression and alcohol use were modeled in a multiple-group, parallel process longitudinal growth model. RESULTS The slopes of heavy alcohol use and depression were significantly and positively associated from ages 25 to 29 but not at the younger ages. Although the strength of these associations did not differ by group (with or without ADHD, childhood or adulthood), the slopes of depression and heavy drinking at the older ages were highly variable and individuals with ADHD showed significantly faster growth in depression from ages 25 to 29. CONCLUSIONS Due to the strengthening association between heavy drinking and depression for adults in their late 20s, and increasing depression for adults with ADHD histories, individuals with ADHD may be at greater risk for co-occurring depression and binge drinking. Negative reinforcement-related alcohol use may strengthen as these individuals age toward the fourth decade of life. More rigorous testing of this possibility is warranted.
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Affiliation(s)
- Frances L. Wang
- Department of Psychiatry University of Pittsburgh Medical Center
| | | | - Heather Joseph
- Department of Psychiatry University of Pittsburgh Medical Center
| | | | - Patrick Curran
- Department of Psychology University of North Carolina, Chapel Hill
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14
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Loya JM, McCauley KL, Chronis-Tuscano A, Chen SZ, Gad A, MacPherson L, Lejuez CW. An experimental paradigm examining the influence of frustration on risk-taking behavior. Behav Processes 2018; 158:155-162. [PMID: 30366109 DOI: 10.1016/j.beproc.2018.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 11/19/2022]
Abstract
The present study examined the impact of frustration on risk-taking in college students with low and high ADHD symptomatology (L-ADHD and H-ADHD). Participants completed the Balloon Analogue Risk Task (BART) following induced frustration from a mood manipulation task (experimental session) and following no mood manipulation (control session). A manipulation check revealed a significant three-way interaction where the H-ADHD group reported higher frustration levels compared to the L-ADHD group, particularly in response to the frustration induction in the experimental condition. Primary results revealed that the L-ADHD group exploded significantly fewer balloons in the experimental condition compared to the control condition; there was a nonsignificant difference of balloon explosions across conditions for the H-ADHD group. The study provides initial laboratory-based support for the impact of frustration on the risk behavior of those with low and high levels of ADHD, with potential implications for future studies and ultimately for intervention.
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Affiliation(s)
- Jennifer M Loya
- George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030, United States; Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States.
| | - Katherine L McCauley
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; VA Puget Sound, 1660 South Columbian Way, Seattle, WA 98108, United States
| | - Andrea Chronis-Tuscano
- University of Maryland, 1147C Biology/Psychology Building, College Park, MD 20742, United States
| | - Starr Z Chen
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States
| | - Abanoub Gad
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States
| | - Laura MacPherson
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; Greenebaum Comprehensive Cancer Center, 22 S Greene Street, Baltimore, MD 21201, United States
| | - C W Lejuez
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Strong Hall, Room 250, Lawrence, KS 66045, United States
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Daurio AM, Aston SA, Schwandt ML, Bukhari MO, Bouhlal S, Farokhnia M, Lee MR, Leggio L. Impulsive Personality Traits Mediate the Relationship Between Adult Attention-Deficit/Hyperactivity Symptoms and Alcohol Dependence Severity. Alcohol Clin Exp Res 2018; 42:173-183. [PMID: 29063627 PMCID: PMC5750112 DOI: 10.1111/acer.13538] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/15/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND While the role of attention-deficit/hyperactivity disorder (ADHD) as a risk factor for developing alcohol use disorder (AUD) has been established, the underlying pathways connecting the two are still not fully understood. Overlapping constructs such as impulsivity may explain the increased risk for developing AUD in individuals with ADHD. METHODS In this study, we assessed whether adult ADHD symptoms increase the odds of having a diagnosis of AUD. Furthermore, we tested whether facets of impulsivity explained the relationship between ADHD symptoms and alcohol dependence (AD) severity. RESULTS In a logistic regression of 749 participants (464 = AD, 285 = controls), overall adult ADHD symptoms, and more specifically, symptoms of hyperactivity/restlessness and problems with self-concept, increased the odds of having a diagnosis of AD. Within the AD sample, we found that impulsivity mediated the relationship between adult ADHD symptoms and AD severity. In particular, negative and positive urgency meditated the relationship of overall adult ADHD symptoms, and symptoms of hyperactivity/restlessness and problems with self-concept with AD severity. CONCLUSIONS These results highlight the importance of looking at cohorts of ADHD symptoms and facets of impulsivity to assess the risk of developing AUD. They also suggest potential avenues for intervention strategies in individuals with preexisting adult ADHD symptoms who are seeking treatment for AUD.
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Affiliation(s)
- Allison M. Daurio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Sean A. Aston
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Melanie L. Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Mohammad O. Bukhari
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Sofia Bouhlal
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Mehdi Farokhnia
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Mary R. Lee
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
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17
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Reward-related ventral striatum activity links polygenic risk for attention-deficit/hyperactivity disorder to problematic alcohol use in young adulthood. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:180-187. [PMID: 28825048 DOI: 10.1016/j.bpsc.2016.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Problematic alcohol use in adolescence and adulthood is a common and often debilitating correlate of childhood attention-deficit/hyperactivity disorder (ADHD). Converging evidence suggests that ADHD and problematic alcohol use share a common additive genetic basis, which may be mechanistically related to reward-related brain function. In the current study, we examined whether polygenic risk for childhood ADHD is linked to problematic alcohol use in young adulthood through alterations in reward-related activity of the ventral striatum, a neural hub supporting appetitive behaviors and reinforcement learning. METHODS Genomic, neuroimaging, and self-report data were available for 404 non-Hispanic European-American participants who completed the ongoing Duke Neurogenetics Study. Polygenic risk scores for childhood ADHD were calculated based on a genome-wide association study meta-analysis conducted by the Psychiatric Genomics Consortium and tested for association with reward-related ventral striatum activity, measured using a number-guessing functional magnetic resonance imaging paradigm, and self-reported problematic alcohol use. A mediational model tested whether ventral striatum activity indirectly links polygenic risk for ADHD to problematic alcohol use. RESULTS Despite having no main effect on problematic alcohol use, polygenic risk for childhood ADHD was indirectly associated with problematic alcohol use through increased reward-related ventral striatum activity. CONCLUSIONS Individual differences in reward-related brain function may, at least in part, mechanistically link polygenic risk for childhood ADHD to problematic alcohol use.
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18
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Weyandt LL, Oster DR, Gudmundsdottir BG, DuPaul GJ, Anastopoulos AD. Neuropsychological functioning in college students with and without ADHD. Neuropsychology 2017; 31:160-172. [PMID: 27831696 PMCID: PMC5280458 DOI: 10.1037/neu0000326] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. METHOD The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. RESULTS Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. CONCLUSION College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University
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Pedersen SL, Walther CA, Harty SC, Gnagy EM, Pelham WE, Molina BSG. The indirect effects of childhood attention deficit hyperactivity disorder on alcohol problems in adulthood through unique facets of impulsivity. Addiction 2016; 111:1582-9. [PMID: 26999438 PMCID: PMC4983236 DOI: 10.1111/add.13398] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 12/15/2015] [Accepted: 03/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Research has not studied unique impulsivity dimensions as prospective links between childhood attention deficit hyperactivity disorder (ADHD) and alcohol problems. We examined the association between childhood ADHD, five facets of impulsivity and alcohol problems in adulthood and the indirect effects of childhood ADHD-to-impulsivity-to-alcohol problems. DESIGN, SETTING AND PARTICIPANTS Participants were from a longitudinal study (n = 289, meanage = 28.67) of individuals with (n = 170) and without (n = 119) childhood ADHD. The ADHD sample, as part of an ADHD summer treatment program, was diagnosed initially in childhood (1987-96, Pittsburgh, PA, USA) via structured parent interview and standardized parent/teacher ratings. The ADHD sample and demographically similar individuals without ADHD (living in the greater Pittsburgh area) were recruited to participate in the Pittsburgh ADHD Longitudinal Study (PALS) between 1999 and 2003. MEASUREMENTS Self-reported impulsivity (UPPS-P) and alcohol-related problems were assessed in adulthood (2011-14). FINDINGS Adults with, compared with those without, childhood ADHD had more alcohol problems (β = 0.34, P < 0.05) and higher levels of negative urgency, positive urgency, lack of perseverance and lack of planning (βs = 0.24-0.31, Ps < 0.001). Impulsivity facets (except sensation-seeking) were related to number of alcohol problems (βs = 0.34-0.61, Ps < 0.05). Negative (β = 0.26, P < 0.01) and positive (β = 0.27, P < 0.01) urgency mediated the association between childhood ADHD and number of adult alcohol problems. CONCLUSIONS Elevated levels of emotional impulsivity (negative/positive urgency) may place children with attention deficit hyperactivity disorder at increased risk for alcohol problems in adulthood.
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Squeglia LM, Brammer WA, Ray LA, Lee SS. Attention Deficit/Hyperactivity Disorder (ADHD) Symptoms Predict Alcohol Expectancy Development. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016; 25:159-179. [PMID: 27110089 PMCID: PMC4840407 DOI: 10.1080/1067828x.2014.969856] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Positive alcohol expectancies and attention deficit/hyperactivity disorder (ADHD) are independent risk factors for adolescent alcohol problems and substance use disorders. However, the association of early ADHD diagnostic status, as well as its separate dimensions of inattention and hyperactivity, with alcohol expectancies is essentially unknown. METHOD At baseline (i.e., Wave 1), parents of 139 6-to 9-year-old children (71% male) with (N = 77; 55%) and without (N = 62; 45%) ADHD completed structured diagnostic interviews of child psychopathology. Approximately two years later (i.e., Wave 2), children completed a Memory Model-Based Expectancy Questionnaire (MMBEQ) to ascertain their positive and negative expectancies regarding alcohol use. All children were alcohol naïve at both baseline and follow-up assessments. RESULTS Controlling for age, sex, IQ, as well as the number of Wave 1 oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms, the number of baseline hyperactivity symptoms prospectively predicted more positive arousing (i.e., MMBEQ "wild and crazy" subscale) alcohol expectancies at Wave 2. No predictive association was observed for the number of Wave 1 inattention symptoms and alcohol expectancies. CONCLUSIONS Childhood hyperactivity prospectively and positively predicted expectancies regarding the arousing properties of alcohol, independent of inattention and ODD/CD symptoms, as well as other key covariates. Even in the absence of explicit alcohol engagement, youths with elevated hyperactivity may benefit from targeted intervention given its association with more positive arousing alcohol expectancies.
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Affiliation(s)
| | | | - Lara A Ray
- University of California, Los Angeles, CA, USA
| | - Steve S Lee
- University of California, Los Angeles, CA, USA
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21
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Davis C, Cohen A, Davids M, Rabindranath A. Attention-deficit/hyperactivity disorder in relation to addictive behaviors: a moderated-mediation analysis of personality-risk factors and sex. Front Psychiatry 2015; 6:47. [PMID: 25941494 PMCID: PMC4403287 DOI: 10.3389/fpsyt.2015.00047] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/23/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Research has shown that those with attention-deficit/hyperactivity disorder (ADHD) have an increased risk for addiction disorders like alcoholism and substance abuse. What is less clear is the mechanism(s) whereby ADHD gives rise to increased engagement in addictive behaviors, and whether there are sex differences in the ADHD-addiction propensity. Both ADHD and addictions have also been associated with personality traits such as impulsivity, reward seeking, anxiousness, and negative affect. In this study, we tested a moderator-mediation model, which predicted that both sex and ADHD-symptom status would make independent contributions to the variance in personality risk and in addictive behaviors, with males, and those with diagnosed ADHD, scoring higher on both dependent variables. Our model also predicted that the effect of sex and ADHD-symptom status on addictive behaviors would be via the mediating or intervening influence of personality-risk factors. METHODS A community-based sample of young men and women took part in the study. Among these individuals, 46 had received a lifetime diagnosis of ADHD. The non-diagnosed participants were dichotomized into a high-ADHD-symptom group (n = 83) and a low-symptom group (n = 84). RESULTS We found that a high-risk personality profile may, in part, account for the relationship between ADHD symptomatology and the use/abuse of a broad range of addictive behaviors. However, we found no sex differences in personality risk for addiction or in the use of addictive behaviors; nor did sex moderate the relationships we assessed. CONCLUSION While ADHD status showed a strong relationship with both dependent variables in the model, we found no difference between those who had been diagnosed with ADHD and treated with stimulants, and their high-symptom non-diagnosed/non-treated counterparts. These results add support to claims that the treatment of ADHD with stimulant medication neither protects nor fosters the risk for substance abuse disorders.
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Affiliation(s)
- Caroline Davis
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Alina Cohen
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Mark Davids
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Alex Rabindranath
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
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Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R. Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample. Addict Behav 2014; 39:1272-7. [PMID: 24813555 DOI: 10.1016/j.addbeh.2014.04.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/13/2014] [Accepted: 04/02/2014] [Indexed: 12/13/2022]
Abstract
Adults with attention-deficit/hyperactivity disorder (ADHD) are at higher risk to use substances than their nonclinical peers. Increased levels of impulsivity are generally thought to contribute to their increased levels of risk. Impulsivity is a multifaceted construct, however, and little research to date has attempted to identify which facets of impulsivity contribute to the increased rates of substance abuse among individuals with ADHD. The current study examined the relation among ADHD symptom clusters (i.e., hyperactivity/impulsivity and inattention), substance use rates (i.e., alcohol use, nicotine use, and marijuana use), and personality processes associated with impulsive behavior in a group of young adults. Participants were 361 undergraduate students. Both symptom clusters were positively associated with rates of substance use. Specifically, hyperactive/impulsive symptoms were associated with alcohol and nicotine use, and inattentive symptoms were associated with alcohol use. Several pathways from hyperactive/impulsive symptoms to alcohol, nicotine, and marijuana use via specific facets of impulsivity were identified. These findings have implications for understanding the relation between ADHD symptoms and substance use, as well as clinical implications for preventing and treating substance use problems in individuals with symptoms of ADHD.
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Affiliation(s)
- Walter Roberts
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington KY, 40506, United States
| | - Jessica R Peters
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington KY, 40506, United States
| | - Zachary W Adams
- National Crime Victims Research & Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 37 President Street, MSC 681, 2nd Floor, IOP South Bldg. Charleston, SC, 29425, United States
| | - Donald R Lynam
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN, 47907, United States
| | - Richard Milich
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington KY, 40506, United States.
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