Differential Associations Between Alcohol Expectancies and Adolescent Alcohol Use as a Function of Childhood ADHD

Abstract

ABSTRACT. Objective: Individuals with attention-defi cit/hyperactivity disorder (ADHD) are at increased risk for experiencing alcohol-related problems. However, previous research has not examined alcohol expectancies, a widely studied risk factor for alcohol use, in this population. The current study examined mean differences in alcohol expectancies for adolescents with and without a history of childhood ADHD. The differential association between alcohol expectancies and alcohol use 1 year later as a function of ADHD status was also examined. Method: Two hundred and eighty-six adolescents ages 11-17 (ADHD: n = 165; non-ADHD: n = 121) reported their alcohol expectancies and alcohol use over a 1-year period as part of the Pittsburgh ADHD Longitudinal Study. Results: Individuals with a history of ADHD had lower mean levels of alcohol expectancies compared with individuals without ADHD. Specifi cally, at Time 1, individuals with ADHD reported lower levels of sociability, cognitive and behavioral impairment, and liquid courage expectancies than individuals without ADHD. Further, the association between negative alcohol expectancies at Time 1 and alcohol use at Time 2 differed for individuals with and without a history of ADHD. Conclusions: These fi ndings highlight the possibility that individuals with a history of ADHD may rely less on explicit cognitions, such as alcohol expectancies, when making decisions to drink alcohol. This is consistent with the dual process model of alcohol cognitions that has posited that individuals with decreased executive control may rely more on implicit cognitions about alcohol. (J. Stud. Alcohol Drugs, 75, 145-152, 2014) Received: November 5, 2012. Revision: June 5, 2013. This research was supported by National Institute on Alcohol Abuse and Alcoholism Grants AA011873, AA021135, AA007453, and AA00202. Additional support was provided by Grants DA12414, MH50467, MH12010, ESO5015, AA12342, DA016631, MH065899, KAI-118-S1, DA85553, MH077676, MH069614, MH62946, MH065899, MH53554, MH069434, IES LO3000665A, IESR324B060045, and NS39087. *Correspondence may be sent to Sarah L. Pedersen at the Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, or via email at: pedersensl@upmc.edu. A DOLESCENT ALCOHOL USE is a signifi cant health concern and is related to a variety of negative outcomes in adulthood. For example, higher levels of adolescent alcohol use are related to alcohol-related problems, aggression, theft, and suicidal ideation in young adulthood (Duncan et al., 1997). National data also highlight that alcohol use increases over the course of adolescence. Approximately 27% of 8th graders, 50% of 10th graders, and 64% of high school seniors report alcohol use in the past year. Further, a signifi cant portion of adolescents also report drinking to the point of being drunk in the past year, and this increases with age (11% of 8th graders, 29% of 10th graders, and 42% of 12th graders; Johnston et al., 2012). Studying predictors of early alcohol use is...

ADHD and Marijuana-Use Expectancies in Young Adulthood

“…This finding is important for multiple reasons. First, it extends our prior similar findings for alcohol use expectancies (Pedersen et al, 2014) to those for marijuana, suggesting that ADHD may be associated with a decreased awareness of the subjective effects of psychoactive substances with different psychoactive profiles. These results also suggest that the dual process model offered by Stacey and Weirs (2010), in which implicit cognitive processes, as compared to explicit cognitions, are more strongly associated with substance use behaviors among individuals with executive functioning difficulties, may explain the role of marijuana expectancies for individuals with ADHD.…”

“…Poor insight is a well-established characteristic of many individuals with ADHD (Hoza, Pelham, Owens, & Pillow, 2002). Recent work from our group (Pedersen, Harty, Pelham, Gnagy, & Molina, 2014) found a pattern of results opposite to the Dattilo findings. Adolescents with a documented history of ADHD in childhood had lower levels of both positive and negative alcohol expectancies compared to individuals without ADHD and, consistent with the dual process model of alcohol cognition (Stacy & Wiers, 2010), negative alcohol expectancies were less related to alcohol use for individuals with, compared to individuals without, ADHD.…”

How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning

“…This exploratory analysis also demonstrates the utility of a qualitative approach to identify perceptions that are not captured using traditional quantitative methods (Harty et al, in press; Pedersen et al, 2014). Contrary to past studies that have demonstrated nicotine (Conners et al, 1996; Levin et al, 1996; Potter & Newhouse, 2004, 2008) and ad libitum cigarette smoking (Mitchell et al, 2014) improve attention in adults with ADHD, participants with ADHD histories did not perceive improvement in such functioning when asked to reflect on their smoking in the current study.…”

“…In another prospective study of young adults with alcohol-dependent fathers, alcohol expectations mediated the relation between externalizing symptoms and alcohol use (Schuckit & Smith, 2006), indicating that SU perceptions are an important factor in maladaptive use in at-risk samples. However, despite being at-risk for various SU outcomes, individuals with ADHD endorse lower levels of expectancies about the effects of different forms of SU (Harty, Pederson, Gnagy, Pelham, & Molina, in press; Pedersen, Harty, Pelham, Gnagy, & Molina, 2014), suggesting that ADHD may be associated with decreased awareness of subjective effects of SU using traditional rating scales (Harty et al, in press). To best capture such complex perceptions of SU and emotions in those with ADHD, qualitative methodology may have utility.…”

Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults.

“…Screening and diagnostic procedures have been described previously (Molina et al, 2012; Pedersen et al, 2014; Sibley et al, 2012). Briefly, participants with childhood ADHD were diagnosed with DSM-III-R or DSM-IV ADHD at the ADD Clinic, Western Psychiatric Institute and Clinic, in Pittsburgh, PA between 1987 and 1996.…”