http://www.eurekalert.org/pub_releases/2003-08/apa-soa081203.php
Severity of ADHD in children increases risk of drug use in adolescence
Inattention symptoms appears to be culprit of early drug use and multiple
substance use
WASHINGTON -- Children diagnosed with attention-deficit/hyperactivity disorder
(ADHD) are more at risk for using illicit drugs, having problems with alcohol,
smoking cigarettes, and using marijuana in their adolescence than children
without ADHD, say researchers who report their findings on childhood predictors
of later substance use in the August issue of the Journal of Abnormal
Psychology, published by the American Psychological Association (APA).
Furthermore, childhood ADHD is linked to earlier first use of cigarettes,
earlier progression to daily smoking and earlier use of illicit drugs.
According to the study, those children with the most severe attention problems
in childhood were most at risk for alcohol and marijuana problems and cigarette
smoking by their teens. Those children with ADHD with other behavior problems,
such as defying parents and fighting, were also at risk for illicit drug use,
but severity of attention problems was a better predictor for drinking,
tobacco, and marijuana outcomes. This could be, say the researchers, because
problems with paying attention in childhood have an immediate effect on school
learning and social relationships, which may set the stage for other problems
later on that include drug use and abuse.
Psychologists Brooke S. G. Molina, Ph.D., and William E. Pelham, Jr., Ph.D.
compared drug use between 142 teenagers (13-18 years of age) diagnosed with
ADHD in childhood with 100 children (same ages) without ADHD, using measures of
ADHD and antisocial behavior reported by the teachers and parents. Because the
children with ADHD had been diagnosed and followed from childhood, the
researchers were able to evaluate whether the severity of symptoms in the ADHD
group predicted elevated drug use in adolescence.
The presence of ADHD in childhood was found to increase the risk for elevated
use and abuse of alcohol and heavier drugs and the earlier use of tobacco and
other drugs by the teenage years, said the authors. Furthermore, said Dr.
Molina, "childhood ADHD symptoms, particularly the inattention dimension of
ADHD, predicted later substance use to a greater degree than childhood
antisocial behaviors." This suggests that the severity of ADHD is a leading
factor for the early emergence of substance use behavior, said Molina. Thus, it
was not surprising that those children who still had ADHD in adolescence (about
72% of them) reported more drunkenness from alcohol, more alcohol problems, and
more cigarette smoking than the adolescents without childhood ADHD. Children
with ADHD who developed severe conduct problems by adolescence (about 26% of
them) reported the highest levels of drinking, smoking, and drug use.
The ADHD symptom of inattention versus hyperactivity and oppositional defiant
disorder/conduct disorder (ODD/CD) better predicts later substance use, suggest
the authors, because "executive functions associated with inattention and not
hyperactivity may be at the root of the progression to substance use. A child
may begin having poor academic performance and peer difficulties and then
gravitate toward nonconformist peer groups as an adolescent where substance
abuse is accepted as a way of life," said Molina.
The study may not have found strong prediction from symptoms of impulsivity
because they are few and confounded with the hyperactivity symptoms. Both
inattention and impulsivity are likely to play important roles in prediction of
later substance use outcomes for ADHD children.
This study sheds light on the importance of early identification and treatment
of problems with paying attention in childhood. Knowing the early signs of
ADHD, providing early intervention, and providing help to teachers and parents
through the teenage years, may help teachers and parents recognize risk factors
and intervene before a child's use of alcohol and drugs turns into a life long
dependence, said the authors.
Article: "Childhood Predictors of Adolescent Substance Use in a Longitudinal
Study of Children With ADHD," Brooke S. G. Molina, Ph.D., Western Psychiatric
Institute and Clinic and University of Pittsburgh School of Medicine and
William E. Pelham, Jr., Ph.D., State University of New York at Buffalo; Journal
of Abnormal Psychology, Vol. 112, No. 3.
Full text of the article is available from the APA Public Affairs Office or at
http://www.apa.org/journals/abn/press_releases/august_2003/abn1123497.html
Brooke S. G. Molina, PhD can be reached by phone at 412-624-4633.
The American Psychological Association (APA), in Washington, DC, is the largest
scientific and professional organization representing psychology in the United
States and is the world's largest association of psychologists. APA's
membership includes more than 150,000 researchers, educators, clinicians,
consultants and students. Through its divisions in 53 subfields of psychology
and affiliations with 60 state, territorial and Canadian provincial
associations, APA works to advance psychology as a science, as a profession and
as a means of promoting health, education and human welfare.