Developmental Sequence From Disruptive Behavior Diagnosis to Adolescent Alcohol Dependence

Kuperman, Samuel; Schlosser, Steven; Kramer, John; Bucholz, Kathleen K.; Hesselbrock, Victor; Reich, Theodore; Reich, Wendy

doi:10.1176/appi.ajp.158.12.2022

Cited by 134 publications

(116 citation statements)

References 16 publications

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“…Consistent with the literature, rates of monthly drinking and drinking to intoxication were not associated with increasing ADHD symptomatology; however, individuals with higher ADHD symptoms were considerably more likely to meet criteria for a lifetime history of alcohol dependence (Disney et al, 1999;Flory et al, 2003;Knopik et al, 2009;Kuperman et al, 2001). However, the presence of AT appeared to signifi cantly reverse the direction of association with alcohol (but not nicotine and cannabis) use measures such that individuals with higher AT scores were less likely to report drinking to intoxication.…”

Section: Alcoholsupporting

confidence: 77%

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

Alwis

Agrawal

Reiersen

et al. 2014

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder frequently co-occur. Several studies show increased risk of substance use disorders in ADHD, yet there is limited information related to how ADHD symptoms, autistic traits, and their combined effects are associated with nicotine, alcohol, and cannabis use and use disorders in the general population. Method: Cross-sectional interview and self-report questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years) were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Substance use disorders-based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria-were assessed in the full sample as well as in those who reported substance use. Logistic regression analyses were used for comparing the associations between ADHD symptoms, autistic traits, substance use, and substance misuse after conduct disorder, sex, age, and zygosity were controlled for. Results: Greater ADHD symptoms and autistic traits scores were associated with elevated levels of regular smoking; cannabis use; and nicotine, alcohol, and cannabis use disorders, even after conduct disorder was adjusted for. In contrast, for alcohol use, those with high autistic traits scores were less likely to report drinking to intoxication. However, upon initiation, and similar to the fi ndings for nicotine and cannabis, they were at elevated risk for developing alcohol dependence. Conclusions: Increased liability to ADHD and elevated autistic traits scores were associated with substance use and misuse, with the exception of alcohol use. Given the social underpinnings of drinking, persons with autistic traits may be less likely to engage in it; however, upon engagement in drinking, their vulnerability to alcohol dependence is elevated. (J. Stud. Alcohol Drugs, 75, 211-221, 2014)

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Section: Alcoholsupporting

confidence: 77%

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

Alwis

Agrawal

Reiersen

et al. 2014

J. Stud. Alcohol Drugs

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“…For example, increasing use of alcohol over a 6-year period was predicted by the presence of CD in a prospective study of adolescent boys by White et al (2001). Using data collected from a large collaborative study on 54 alcohol-dependent adolescents, Kuperman et al (2001) found that-among disruptive behavioral diagnoses-CD, in particular, led to the use of substances that predicted alcohol dependence. In our 30-year follow-up of subjects in the birth cohort featured in this study, we found that boys who would develop alcohol dependence later in life reported signifi cantly more antisocial acts than those who would not develop alcohol dependence (Knop et al, 2003).…”

mentioning

confidence: 99%

Childhood ADHD and Conduct Disorder as Independent Predictors of Male Alcohol Dependence at Age 40

Knop

Penick

Nickel

et al. 2009

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The Danish Longitudinal Study on Alcoholism was designed to identify antecedent predictors of adult male alcoholism. The infl uence of premorbid behaviors consistent with childhood conduct disorder (CD) and attention-defi cit/hyperactivity disorder (ADHD) on the development of alcohol misuse was examined. Method: Subjects were selected from a Danish birth cohort (9,125), which included 223 sons of alcoholic fathers (high risk) and 106 matched sons of nonalcoholic fathers (low risk). These subjects have been studied systematically over the past 40 years. They were evaluated in their teens (n = 238), later as adults at age 30 (n = 241), and more recently at age 40 (n = 202). At 19-year/20-year follow-ups, an ADHD scale was derived from teacher ratings and a CD scale was derived from a social worker interview. At 30-year and 40-year follow-ups, a psychiatrist used structured interviews and criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, to quantify lifetime alcoholism severity and to diagnose alcohol-use disorder. Of the original subjects, 110 had complete data for the two childhood measures and the adult alcoholism outcomes. Results: In this smaller subsample, paternal risk did not predict adult alcohol dependence. Subjects who were above a median split on both the ADHD and the CD scales were more than six times more likely to develop alcohol dependence than subjects who scored below the median on both. Although the two childhood measures were correlated, a multiple regression showed that each independently predicted a measure of lifetime alcoholism severity. Conclusions: ADHD comorbid with CD was the strongest predictor of later alcohol dependence. (J. Stud. Alcohol

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“…37,38 As a result, several researchers have posited a developmental sequence from ADHD to CD and only then to alcohol, tobacco, marijuana, and other drug use. 39 Recent reviews have attempted to resolve the controversy, arguing that adolescents with comorbid ADHD and CD have the highest risk of developing substance use but that ADHD alone confers an intermediate risk. 40,41 Researchers recently tested the predictive power of specific symptoms of ADHD rather than the diagnosis.…”

mentioning

confidence: 99%

Behavioral Predictors of Substance-Use Initiation in Adolescents With and Without Attention-Deficit/Hyperactivity Disorder

et al. 2006

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OBJECTIVE. Our goal was to examine substance-use initiation in healthy adolescents and in adolescents who have been diagnosed with attention-deficit/hyperactivity disorder. METHODS. Seventy-eight adolescents (28 healthy and 50 with attention-deficit/hyperactivity disorder) participated in an ongoing longitudinal study of predictors of substance use. The substances most commonly reported were tobacco, alcohol, and marijuana. Aggression, conduct problems, hyperactivity, impulsivity, inattention, anxiety/depression, social difficulties, and somatic complaints were assessed at study entry and tested as predictors for later substance use. RESULTS. With an average of 4 years into the study, 37 adolescents had not used any substances, 41 had experimented with at least 1 substance, and 29 experimented with >1 substance. Psychiatric diagnoses (attention-deficit/hyperactivity disorder, attention-deficit/hyperactivity disorder and conduct disorder, and attention-deficit/hyperactivity disorder and depression/anxiety) did not influence reports of substance use. Distinct behavioral measures collected at study entry predicted use of different substances. In a multivariate analysis, aggression had the greatest association with tobacco smoking and marijuana use. Impulsivity was associated with alcohol use. Severity of drug exposure, indexed by the number of substances used, was predicted by aggression. CONCLUSIONS. This 4-year longitudinal study captured the onset of substance use, not abuse. Behavioral predictors differed with the type of substance used. These behavioral characteristics may raise suspicion among pediatricians for enhanced risk for substance-use initiation.

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Developmental Sequence From Disruptive Behavior Diagnosis to Adolescent Alcohol Dependence

Abstract: Disruptive behavior diagnoses, particularly conduct disorder, typically precede the initiation of use of a variety of substances that, in turn, precede the diagnosis of alcohol dependence in adolescents.

Cited by 134 publications

References 16 publications

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

Childhood ADHD and Conduct Disorder as Independent Predictors of Male Alcohol Dependence at Age 40

Behavioral Predictors of Substance-Use Initiation in Adolescents With and Without Attention-Deficit/Hyperactivity Disorder

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