Hyperactivity-inattention symptoms in childhood and substance use in adolescence: The youth gazel cohort (original) (raw)
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European Psychiatry, 2010
Purpose: To examine the link between symptoms of hyperactivity-inattention and conduct disorder in childhood, and the initiation of tobacco and cannabis use, controlling for other behavioral symptoms, temperament and environmental risk factors. Method: The sample (N = 1107 participants, aged 4 to 18 years at baseline) was recruited from the population-based longitudinal Gazel Youth study with a follow-up assessment 8 years later. Psychopathology, temperament, environmental variables, and initiation of tobacco and cannabis use were self-reported. Event time analyses were performed to assess the effects of childhood disruptive symptoms on age at first use of tobacco and cannabis. Results: Proportional hazard models revealed that participants with high levels of childhood symptoms of both hyperactivity-inattention and conduct disorder were at highest risk of early tobacco initiation (in males: hazard ratio [HR] = 2.05; confidence interval [CI]: 1.24-3.38; in females: HR = 2.01; CI: 1.31-3.09), and, in males, of early cannabis initiation (HR = 1.95; CI: 1.04-3.64). Temperament, through activity in both males and females and negative emotionality in females, was also associated to early substance use initiation. Conclusions: Children who simultaneously have high levels of symptoms of hyperactivity-inattention and conduct disorder are at increased risk for early substance initiation. These associations may guide childhood health professionals to consider the liability for early substance initiation in high-risk groups.
Childhood symptoms of inattention-hyperactivity predict cannabis use in first episode psychosis
2011
Background: A history of childhood symptoms of inattention-hyperactivity is often reported in first episode psychosis (FEP) as is cannabis use. In the general population childhood ADHD predicts future cannabis use but the relationship has not been tested in FEP. Method: Parents of patients with a first episode of psychosis (n = 75) retrospectively assessed their affected child for symptoms of early-life disorders, namely, attention deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) using the Child Behaviour Checklist (CBCL). Assessments were made prospectively of cannabis use over two years following a FEP and of SCID diagnosis of cannabis-use disorder. Results: Childhood hyperactivity-inattention symptoms predicted inability to maintain abstinence from cannabis following treatment (Wald = 8.4, p = .004) and lifetime cannabis-use diagnosis (Wald = 5.3, p = .022) in a logistic regression controlling for relevant covariates including symptoms of CD and ODD from ages 12 to 18. When the symptom of inattention was considered in place of the hyperactivity-inattention syndrome it predicted cannabis-use diagnosis (Wald = 6.4, p = .011) and persistent abstinence from cannabis (Wald = 5.3, p = .021). Symptoms of CD and ODD did not predict cannabis use when hyperactivityinattention symptoms were controlled for. Conclusions: Symptoms of childhood inattention-hyperactivity predict subsequent cannabis use in FEP.
PEDIATRICS, 2006
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 eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. 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.
Attention Problems in Childhood and Adult Substance Use
The Journal of Pediatrics, 2013
Objective To assess the link between childhood attention problems (AP) and substance use 18 years later. Study design This cohort study was conducted in a community sample of 1103 French youths followed from 1991 to 2009. Exposures and covariates were childhood behavioral problems (based on parental report at baseline), early substance use, school difficulties, and family adversity. Outcome measures were regular tobacco smoking, alcohol problems, problematic cannabis use, and lifetime cocaine use (based on youth reports at follow-up).
Addiction, 2015
AimsTo examine the association between developmental trajectories of inattention, hyperactivity–impulsivity and delinquency through childhood and adolescence (ages 8–16 years) and subsequent binge drinking and marijuana use in early adulthood (age 21 years).DesignProspective naturalistic follow‐up of children with attention deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment‐phase assessments occurred at 3, 9 and 14 months after randomization; follow‐up assessments occurred at 24 months, 36 months, and 6, 8 and 12 years after randomization.SettingSecondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi‐site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care.ParticipantsA total of 579 children with DSM‐IV ADHD combined type, aged 7.0 and 9.9 years at baseline (mean = 8.5, SD = 0.80).MeasurementsRatings of ina...
Journal of Studies on Alcohol and Drugs, 2009
Increased knowledge about the mechanisms by which some individuals are at risk for early onset of cannabis use might contribute to the improvement of prevention efforts. We focus on the roles of early-adolescent high-intensity pleasure, disruptive behavior, and their interplay in the prediction of onset of cannabis use 2 years later. Method: Data from 81% (n = 1,804) of the participants (51.9% girls) of the Tracking Adolescents' Individual Lives Survey (TRAILS), a prospective general population study in the north of The Netherlands, were analyzed. Measures included parent-reported high-intensity pleasure, and parent-and self-reported general disruptive behavior, attention-defi cit hyperactivity, oppositional problems, and conduct problems (Child Behavior Checklist/6-18 and Youth Self-Report) at ages 10-12. Onset of cannabis use was assessed at age 12-14 by means of self-reports. Analyses were carried out in Mplus. Results: Early adolescent high-intensity pleasure and disruptive behavior, mainly conduct problems and to some extent attention-defi cit hyperactivity, predicted the onset of cannabis use in adolescence. Although we found some mediation by general disruptive behavior, conduct problems, and attention-defi cit hyperactivity, the contribution of high-intensity pleasure in predicting the onset of cannabis use was found to be mainly independent from disruptive behavior. Conclusions: The unique contribution of both high-intensity pleasure and disruptive behavior points in the direction of different pathways toward onset of cannabis use.
American Journal on Addictions, 2009
Employing a prospective paradigm, this investigation derived the childhood phenotype and the environtype associated with risk for cannabis use disorder. Two hundred and sixteen boys were evaluated between age 10-12 on a comprehensive protocol using self, mother, and teacher reports and followed-up at ages 19 and 22 to determine the presence of cannabis use disorder. The Transmissible Liability Index (TLI) and Non-Transmissible Liability Index (NTLI) were derived using item response theory. Logistic regression was conducted to evaluate the accuracy of the indexes, singly and in combination, to predict cannabis use disorder. The TLI and NTLI together predicted with 70% and 75% accuracy cannabis use disorder manifest by age 19 and age 22. Sensitivity was 75% at both ages 19 and 22, whereas specificity was respectively 51% and 64%. The findings pertaining to sensitivity indicate that SUD risk for cannabis use disorder can be screened in childhood; however, the specificity scores demonstrate that a low score on the TLI does not inevitably portend a good prognosis up to 10 years later. Cannabis is the most frequently used illicit drug. Huge expenditures and intensive effort are accordingly directed at reducing prevalence of consumption through interdiction; criminal prosecution; crop poisoning; and family-, school-, and community-centered prevention programs. These efforts notwithstanding, the prevalence of cannabis use is high, and currently is essentially the same as two decades ago. In 2006, the annual prevalence was 31.5% among high school seniors compared to 33.1% in 1988, 1 when the Office of National Drug Control Policy was established. Experimentation with drugs during adolescent development does not invariably portend an adverse outcome. 2 Regular cannabis users, however, have elevated rates of psychiatric disorder. Notably, the rates of anxiety and depression disorders are as high as 31% and 46% among adolescents who have used cannabis at least 10 times. 3 Evidence has also been accrued that indicates that habitual cannabis use amplifies the risk for psychosis. 4 Whereas lifetime prevalence of cannabis dependence in the population is 4.2%, 5 up to 90% of affected individuals have a co-occurring mental disorder. 6 The epidemiological findings underscore both the importance and difficulty of detecting high risk youths. One method of identifying high risk youths is based on the observation that children whose parents have substance use disorder (SUD) are 4-7 times more likely to also develop SUD. 7 However, parental history as a method of detecting high risk youth
Childhood hyperactivity-inattention symptoms and smoking in adolescence
Drug and Alcohol Dependence, 2005
Background: The objective of the study was to examine in both genders the link between childhood hyperactivity-inattention symptoms (HI-s) and smoking in adolescence, controlling for psychopathology, temperament and environmental risk factors. Methods: Subjects (421 males, 495 females), aged 7 to 18, were recruited in the GAZEL cohort representative of the general population and surveyed in 1991 and 1999. Parent and adolescent self-report measures were used to assess child psychopathology and smoking patterns. Logistic regression was used to assess the effects of childhood hyperactivity-inattention symptoms and other predictors on adolescent smoking. Results: In females, hyperactivity-inattention symptoms contributed independently to subsequent daily smoking (OR = 1.98, p = 0.04). In males, hyperactivity-inattention symptoms alone did not increase the risk for smoking. Conduct disorder symptoms was an important predictor in males (OR = 2.95, p < 0.01) and females (OR = 1.75, p = 0.09). The risk of adolescent smoking was significantly increased in boys with high activity level (OR = 1.70, p = 0.03) and decreased in shy girls (OR = 0.60, p = 0.02). Parental smoking increased the liability to smoking in their offspring (males: OR = 1.96, p < 0.01; females: OR = 1.63, p = 0.02). Conclusions: If replicated, these findings suggest a role for smoking prevention in girls with hyperactivity-inattention symptoms and in boys with high activity level.
Addiction, 2007
This study aims at evaluating the association between attention-deficit/hyperactivity disorder (ADHD) and illicit substance use disorders (SUD) (marijuana, cocaine and inhalants), controlling for the association with conduct disorder (CD), in a community-based sample of adolescents. Design Case-control, community-based study. Setting A delimited geographical area in the South of Brazil, served by four public health clinics. Participants A total of 968 male adolescents (15-20 years of age) were screened for SUD in their households. Of the subjects who were screened positive, we selected 61 cases with illicit SUD. For each case we selected, from the group which was screened negative, three controls without illicit or alcohol SUD, matched by age and proximity with the case's household. Measurements The screening instrument was the Alcohol Smoking and Substance Screening Test (ASSIST). SUD diagnoses were assessed by the drug section of the Mini International Neuropsychiatry Interview (MINI). Other psychiatric diagnoses were based on semistructured (Schedule for Affective Disorders and Schizophrenia for School-Age Children-epidemiological version; MINI) and clinical interviews. Findings Adolescents with ADHD presented a significantly higher odds ratio (OR) for illicit SUD than youths without ADHD, even after adjusting for potential confounders (CD, ethnicity, religion and estimated IQ) (OR = 9.12; 95% CI = 2.84-29.31, P < 0.01). Conclusions Our results suggest an association between ADHD and illicit SUD in Brazilian adolescents that is not mediated by CD. These findings are potentially important from a prevention perspective because treatments are available for ADHD.