Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample

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.

Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: Race and gender differences

“…This might be that impulsive behavior contributes more to current smoking than IN symptoms; whereas the severity of symptoms (inclusive of both IN and HI symptoms) contribute to greater increases in cigarette consumption over development. While other research has also reported that HI symptoms are a better predictor of smoking outcomes than IN symptoms (Chang et al, 2012; Roberts et al, 2014), caution in interpretation is warranted. This is because the mixed findings across previous research regarding relative magnitude of HI and IN could largely result from several methodological differences such as longitudinal vs. cross-sectional studies, years of observation, and measures of ADHD symptoms and smoking behaviors.…”

Adult ADHD: Associations with Personality and Other Psychopathology

“…Most research in this area has focused solely on examining the relations between ADHD diagnoses, personality, and other psychopathology; however, recent work indicates that incremental information is gained when explicating ADHD relations at the symptom (rather than diagnostic) level (De Alwis et al 2014;Di Nicola et al 2014;Gudjonsson et al 2013;McKinney et al 2013;Roberts et al 2014). In a related vein, Markon et al (2011) analyses of data from 58 studies involving 59,575 participants indicate that continuous psychopathology measures are both more reliable and valid than discrete measures.…”

The indirect effects of childhood attention deficit hyperactivity disorder on alcohol problems in adulthood through unique facets of impulsivity

“…Despite impulsivity being related to both ADHD and alcohol use, there has been a paucity of research directly testing impulsivity’s contribution to alcohol problems in this population beyond persistence of ADHD diagnostic symptoms (7–9) . However, two cross-sectional studies of college students provide tentative support for increased disinhibited personality characteristics (i.e., impulsivity and sensation seeking) being a link to more alcohol problems for individuals with ADHD (10,11) .…”