Attention-Deficit/Hyperactivity Disorder Symptoms, Sensation-Seeking, and Sensory Modulation Dysfunction in Substance Use Disorder: A Cross Sectional Two-Group Comparative Study

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) and sensation-seeking, a trait characterized by risk-related behaviors, have been recognized as risk factors in substance use disorder (SUD). Though ADHD co-occurs with sensory modulation dysfunction (SMD), SMD has scarcely been explored in SUD. Thus, this study aimed to characterize ADHD symptomology, sensation-seeking, and SMD, as well as to explore their contribution to SUD likelihood. Methods: A cross sectional two-group comparative study including therapeutic community residents with SUD (n = 58; study group) and healthy individuals (n = 62; comparison group) applying the MOXO continuous performance test (MOXO-CPT) evaluating ADHD-related symptoms. In addition, participants completed the ADHD Self-Report Scale—Version 1.1 for ADHD screening; the Brief Sensation Seeking Scale quantifying risk-taking behaviors; and the Sensory Responsiveness Questionnaire-Intensity Scale for identifying SMD. Results: The study group demonstrated higher SMD incidence (53.57% vs. 14.52%) and lower performance in three MOXO-CPT indexes: Attention, Impulsivity, and Hyperactivity, but not in Timing, compared to the comparison group. Sensory over-responsiveness had the strongest relationship with SUD, indicating 27-times increased odds for SUD (95% CI = 5.965, 121.216; p ≤ 0.0001). A probability risk index is proposed. Conclusion: We found SMD with the strongest relation to SUD exceeding that of ADHD, thus contributing a new perspective for developing future therapeutic modalities. Our findings highlight the need to address SMD above and beyond ADHD symptomology throughout the SUD rehabilitation.

Drinking alcohol to cope with hyperactive ADHD? Self-reports vs. continuous performance test in patients with ADHD and/or alcohol use disorder

“…Larger samples might be needed to detect group differences in ADHD related deficits ( 11 , 31 ) due to a large overlap of affected domains in ADHD and AUD ( 41 ). However, larger samples often lead to more heterogeneous groups ( 31 ).…”

Proposing a “Brain Health Checkup (BHC)” as a Global Potential “Standard of Care” to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of “Dopamine Homeostasis”

“…Attention deficits are common in SUD patients [243][244][245][246]. In fact, research has shown that of adults presenting with SUD, 20-30% have concurrent ADHD, and 20-40% of adults diagnosed with ADHD also have a history of SUD [180,[243][244][245][246].…”

“…Attention deficits are common in SUD patients [243][244][245][246]. In fact, research has shown that of adults presenting with SUD, 20-30% have concurrent ADHD, and 20-40% of adults diagnosed with ADHD also have a history of SUD [180,[243][244][245][246]. Therefore, the Test of Variables of Attention (TOVA), which is an attention screening test, would be useful in the diagnosis and subsequent treatment of SUD.…”

Provenance of a “sense‐sational” wait: A call for introducing sensory processing differences into diagnostic criteria for attention‐deficit/hyperactivity disorder

“…Neurodivergent people frequently receive multiple diagnostic labels that overlap to explain underpinning characteristics (Kooij et al., 2019 ; Werkhoven et al., 2022 ), which has negative implications for resource management of waiting lists, risks associated with delayed pharmacological and/or nonpharmacological interventions, and difficulty managing patients’ expectations (Al‐Khudairi et al., 2019 ). When individuals do not receive the appropriate support for ADHD‐related difficulties because of delayed assessment or delayed treatment, identified risks have included increased harm to self, substance misuse, unemployment, and criminality (Assayag et al., 2022 ; Johnson et al., 2021 ). Improving the specificity and sensitivity of the diagnostic criteria for ADHD through revisions and refinements should enable the right diagnosis, at the right time.…”