Substance use through adolescence into early adulthood after childhood‐diagnosed ADHD: findings from the MTA longitudinal study

Molina, Brooke S. G.; Barbaree, Howard E.; Swanson, James M.; Stehli, Annamarie; Mitchell, John T.; Kennedy, Traci M.; Epstein, Jeffery N.; Arnold, L. Eugene; Hechtman, Lily; Vitiello, Benedetto; Hoza, Betsy

doi:10.1111/jcpp.12855

Cited by 97 publications

(94 citation statements)

References 60 publications

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“…Our findings regarding the importance of early substance use for the development of later problems are consistent with recent findings in the MTA study (Molina, et al, 2018), which followed children with the Combined ADHD subtype to adulthood. Our findings extend theirs to a population-based sample, with greater representation of females and different ADHD subtypes.…”

Section: Discussionsupporting

confidence: 91%

“…Among other contributing factors, children with an ADHD diagnosis are more likely to initiate use of these substances early and escalate use during adolescence (e.g., Sibley et al, 2014). Recent findings that frequent tobacco and marijuana (but not alcohol) use become particularly associated with ADHD by adulthood (Molina et al, 2018) amplify the importance of an improved understanding of the mechanisms underlying these relationships.…”

Section: Introductionmentioning

confidence: 99%

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Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

Elkins

Saunders

Malone

et al. 2018

Child Psychology Psychiatry

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Background: We examined whether increased risk for adolescent tobacco and marijuana problems associated with childhood ADHD is explained by key intermediary influences during adolescence and differs by gender. Methods: Longitudinal structural equation models examined mediating effects on problems with both substances (or each substance separately) through age-14 peer impairment, internalizing, and adolescent ADHD symptoms in two twin samples, prospectively assessed since age 11 (N=2,164). Whether these mediators contributed beyond mediating effects of early-adolescent substance use was also considered. Twin difference analyses further illuminated which mediators might be potentially causal. Results: Direct effects of childhood ADHD on age-17 tobacco and marijuana problems (i.e., independent of included mediators), as well as effects of adolescent ADHD symptoms, were significant only for females. By contrast, mediation by peer impairment, evident particularly for marijuana, was relatively stronger for males than females. Depression and anxiety were not prospectively associated with age-17 substance problems when earlier substance problems were considered. Consistent with causal influence of early substance use on later problems, monozygotic twins with more severe tobacco or marijuana problems at age 14 than their co-twins were also more likely to have substance problems later in adolescence. Conclusions: Mediation through peer impairment, continued presence of ADHD symptoms, and early substance use may alter development so that childhood ADHD indirectly contributes to problems with tobacco and marijuana. Targeting gender-sensitive interventions prior to mid-adolescence, before these patterns become established, is essential.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

Elkins

Saunders

Malone

et al. 2018

Child Psychology Psychiatry

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“…This disorder may also be associated with academic failure and/ or learning disabilities. When ADHD goes undiagnosed, there may be a higher risk for substance abuse, a factor at play in half of all suicide deaths [8,[48][49][50]. In our study, only males were at higher risk for suicide when they met with academic failure alone.…”

Section: Pan Et Al Demonstrated a Direct Link Between Academicmentioning

confidence: 49%

Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group

Ligier

Giguère²,

Notredame

et al. 2020

Child Adolesc Psychiatry Ment Health

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Background: Suicide is the third leading cause of death worldwide among youth aged 10-to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often under-diagnosed and undertreated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk. Methods:We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics. Results:Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18. Conclusions:This study underlines the importance for parents, teachers, and educators to identify children with school difficulties-academic failure and behavioral difficulties at school-as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.

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“…First, based on current theory, this review focused on broad categories of mental health problems, which resulted in missing studies on Attention Deficit Hyperactivity Disorder (ADHD) and specific anxiety subtypes. Recent studies have shown that ADHD is also positively associated with later alcohol use [88,111], and it is very likely that a particular trait within the domain of the disorder is the driver for later alcohol use [112]. Future studies should compare how the associations may change when focusing on different symptoms within a certain disorder, such as aggression, impulsivity, sensation seeking under externalising domain, and social withdrawal under internalising domain.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The association between early life mental health and alcohol use behaviours in adulthood: A systematic review

Ning¹,

Gondek²,

Patalay³

et al. 2020

PLoS ONE

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This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.

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Substance use through adolescence into early adulthood after childhood‐diagnosed ADHD: findings from the MTA longitudinal study

Abstract: Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.

Cited by 97 publications

References 60 publications

Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group

The association between early life mental health and alcohol use behaviours in adulthood: A systematic review

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