This study focused on an audience at high risk for heavy use of licit and illicit substances: young adults who as children had attention-deficit/hyperactivity disorder (ADHD). The participants in this study were part of a longitudinal study of the life histories of 492 children, one third of whom were identified as hyperactive in 1974 and whose childhood symptom ratings and medical histories were used to establish Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R) ADHD diagnoses (American Psychiatric Association, 1987). The objectives of the study centered on describing (a) developmental history of tobacco use among ADHD and non-ADHD participants in a longitudinal sample, (b) the characteristic adult patterns of tobacco use from early adolescence through early adulthood, and (c) the relationship between ADHD status and tobacco and substance dependence outcomes. Adult data were obtained for 81% of the original 492 participants (77% of the ADHD and 86% of the controls). Lifetime and current tobacco use were assessed from child, adolescent, and adult data, yielding eight measures of smoking status. The study showed that participants with and without ADHD did not differ in age of initiation to smoking, but there was a significant difference in the age they began smoking regularly. By age 17, 46% of all participants with ADHD, as contrasted with 24% of the age-mate controls, reported smoking cigarettes daily. In adulthood, the proportion of participants with ADHD who were current smokers (42%) continued to exceed that of the age-mate controls (26%). Among current adult smokers, 35% with ADHD smoked daily as compared to 16% of the age-mate controls. There were significantly different lifetime tobacco dependence rates--40% compared to 19% for age-mate controls. The rates for cocaine dependence were 21% for participants with ADHD and 10% for age-mate controls. We reported a significant difference in rates of daily smoking and tobacco dependence for those with ADHD who had used stimulant medication in childhood in contrast to controls. Results were interpreted to support a possible link between ADHD treatment histories and levels of tobacco smoking and tobacco dependence in adulthood.

This study reconsiders the relationship of childhood Attention Deficit/Hyperactivity Disorder (ADHD) and childhood conduct problems with adult criminal activity by clarifying the role of the cardinal behaviors associated with the DSM-IV ADHD subtypes (inattention and hyperactivity/impulsivity). Since their childhood (average age 9 years), 230 male and 75 female subjects have been followed prospectively and were interviewed as young adults (average age 26 at follow-up). Early childhood behavior ratings by parents and teachers were examined to determine the role of conduct problems, hyperactivity-impulsivity, and inattention in predicting adult criminal involvement as measured by both official arrest records and self-report. Results show that both hyperactivity-impulsivity and early conduct problems independently, as well as jointly, predict a greater likelihood of having an arrest record for males, but not for females. For male subjects with 10 or more self-reported crimes, both early conduct problems and hyperactivity-impulsivity were significant predictors, both alone and in combination. Therefore, it appears that predominantly the symptoms of hyperactivity-impulsivity, but not inattention, contribute to the risk for criminal involvement over and above the risk associated with early conduct problems alone.

This study reconsiders the relationship of childhood Attention Deficit/Hyperactivity Disorder (ADHD) and childhood conduct problems with adult criminal activity by clarifying the role of the cardinal behaviors associated with the DSM-IV ADHD subtypes (inattention and hyperactivity/impulsivity). Since their childhood (average age 9 years), 230 male and 75 female subjects have been followed prospectively and were interviewed as young adults (average age 26 at follow-up). Early childhood behavior ratings by parents and teachers were examined to determine the role of conduct problems, hyperactivity-impulsivity, and inattention in predicting adult criminal involvement as measured by both official arrest records and self-report. Results show that both hyperactivity-impulsivity and early conduct problems independently, as well as jointly, predict a greater likelihood of having an arrest record for males, but not for females. For male subjects with 10 or more self-reported crimes, both early conduct problems and hyperactivity-impulsivity were significant predictors, both alone and in combination. Therefore, it appears that predominantly the symptoms of hyperactivity-impulsivity, but not inattention, contribute to the risk for criminal involvement over and above the risk associated with early conduct problems alone.

Guided by the goal of documenting the natural course of the life histories of a large sample of hyperactive children and their control counterparts, this research reports the extent to which prenatal, developmental, and health history factors distinguish hyperactive and control groups, as well as the relative contributions of the various medical factors. Results indicate that prenatal factors, rather than those occurring later in the child's medical history, are the best predictors of subsequent hyperactive diagnosis.

In the continuum of services for students with emotional and behavioral problems, school-based day treatment programs are at the point at which maximum collaboration and coordination between school and mental health is typically involved. With shared diagnostic and program responsibility, a mutually identified student cohort, and frequent interaction across agency boundaries, this interface between school and mental health presents a unique opportunity to examine diagnostic similarities and differences between the two systems. Archival record searches were conducted to gather data regarding the diagnostic and treatment histories of 85 children and adolescents served in two exemplary school-based day treatment programs in California. Findings suggest a significant lag time between first symptoms, referral for services, and treatment; marked instability of psychiatric diagnoses over time; and lack of concordance between DSM diagnoses and IDEA SED characteristics. These data raise serious concerns regarding the availability of prevention and early intervention services, even in locales striving to develop a coordinated system-of-care approach to treatment. They also raise questions about the integrity and congruity of the psychiatric and educational diagnostic systems utilized by school and mental health personnel.