Effective intervention programming: improving maternal adjustment through parent education.

This study assessed the secondary effects of a parent training intervention program on maternal adjustment, with a focus on understanding ways in which program efficacy differed for participants as a function of whether or not their children had behavior problems. Mothers (N = 99) of toddlers (2-3 years of age) were randomly assigned to receive one of three levels of intervention: (1) informational booklet (2) booklet + face-to-face parent training sessions, or (3) booklet + web-based parent training sessions. Findings indicated that all levels of intervention were associated with increases in maternal well-being for participants with typically developing children. Mothers of toddlers with behavior problems, however, did not benefit from receiving only the booklet but significantly benefitted from receiving either the face-to-face or web-based interventions. Findings are discussed in terms of efficient and efficacious program dissemination and the resulting implications for public policy.

Symptoms of ADHD and close friendships in adolescence.

OBJECTIVE: This study examined the relationship of ADHD symptoms to different aspects of close friendship quality as rated by both adolescents (target adolescent and a close friend) within a friendship dyad. METHOD: Participants were 41 same-sex friendship dyads who completed questionnaires about their friendship. Separate symptom dimensions of ADHD (inattention and hyperactivity-impulsivity) were examined. Teacher and parent ratings of social functioning were also used. RESULTS: Symptoms of inattention, hyperactivity-impulsivity, and overall ADHD were positively related to target-reported friendship quality, and symptoms of inattention and total ADHD were positively associated with friend-reported friendship quality. Potential explanations for these surprising findings were explored. CONCLUSION: Results suggest that the close friendships of adolescents with symptoms of ADHD may be distinct from the peer rejection commonly faced by this population and that adolescents with symptoms of ADHD may have at least one close, positive friendship. Treatment implications and future research directions are discussed.

Are symptoms of ADHD related to substance use among college students?

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that often persists into adolescence and adulthood and has been associated with an increased risk for substance use. Due to improved treatment and educational policies, more students with high levels of ADHD symptoms are attending college despite continued ADHD symptoms. Little research has examined whether college students with higher levels of ADHD symptoms are at increased risk for heavy substance use compared to college students with few ADHD symptoms. The current study examined the relation of ADHD symptoms to substance use (e.g., cigarette smoking, alcohol use, marijuana use, and cocaine use). We hypothesized that greater ADHD symptomatology (inattentive, hyperactive/impulsive, and total ADHD) would be related to higher rates of cigarette smoking, alcohol use, alcohol-problems, and illicit drug use. Participants were 889 college undergraduates who completed an online survey. Results suggest that ADHD symptoms, particularly inattentive symptoms, were positively associated with cigarette smoking and problems associated with alcohol after controlling for conduct disorder (CD) symptoms. ADHD symptoms were not significantly associated with alcohol use or illicit drug use after the effects of CD symptoms were accounted for. Results have important implications for prevention and treatment of college student substance use. Limitations and future directions are discussed.

Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review.

Given the clinical and public health significance of substance disorders and the need to identify their early risk factors, we examined the association of childhood attention-deficit/hyperactivity disorder (ADHD) with substance use (nicotine, alcohol, marijuana) and abuse/dependence outcomes (nicotine, alcohol, marijuana, cocaine, other). To strengthen a potential causal inference, we meta-analyzed longitudinal studies that prospectively followed children with and without ADHD into adolescence or adulthood. Children with ADHD were significantly more likely to have ever used nicotine and other substances, but not alcohol. Children with ADHD were also more likely to develop disorders of abuse/dependence for nicotine, alcohol, marijuana, cocaine, and other substances (i.e., unspecified). Sex, age, race, publication year, sample source, and version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose ADHD did not significantly moderate the associations with substance outcomes that yielded heterogeneous effect sizes. These findings suggest that children with ADHD are significantly more likely to develop substance use disorders than children without ADHD and that this increased risk is robust to demographic and methodological differences that varied across the studies. Finally, few studies addressed ADHD and comorbid disruptive behavior disorders (DBD), thus preventing a formal meta-analytic review. However, we qualitatively summarize the results of these studies and conclude that comorbid DBD complicates inferences about the specificity of ADHD effects on substance use outcomes.

ADHD and comorbid conduct problems among adolescents: associations with self-esteem and substance use.

Attention-deficit/hyperactivity disorder (ADHD) is a common child and adolescent disorder that is associated with negative outcomes (e.g., emotional and behavioral problems, substance use) and is often comorbid with Conduct Problems (CP). Research findings are mixed as to whether youth with ADHD alone or comorbid ADHD/CP suffer from low self-esteem. Research has also shown links between low self-esteem and ADHD (alone and with CP) with substance use; yet, no research has examined the links between self-esteem and substance use in adolescents with ADHD and CP. The current study examined the relation between ADHD with and without comorbid CP and self-esteem, and whether self-esteem moderated the relation between ADHD and ADHD/CP with substance use among adolescents. We hypothesized that adolescents with comorbid ADHD/CP would experience lower self-esteem than adolescents with ADHD alone or with neither disorder and that self-esteem would moderate the association between ADHD, CP, and substance use. Participants were 62 adolescents who completed the laboratory-based study with a parent. Results suggested that adolescents with comorbid ADHD and CP had significantly lower self-esteem than adolescents with ADHD alone or neither disorder. Self-esteem was not significantly different for adolescents with ADHD alone versus those in the control group. There was one marginally significant interaction between ADHD and self-esteem predicting substance use, such that individuals with comorbid ADHD/CP who also had low self-esteem tended to use more substances. Results have implications for treatments that target adolescents with ADHD and comorbid CP, as these adolescents are at risk for many deleterious outcomes.

Why does ADHD confer risk for cigarette smoking? A review of psychosocial mechanisms.

Research has documented that adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for cigarette smoking, but less attention has examined why this risk exists. The current paper reviews the literature on different psychosocial mechanisms [self-medication hypothesis, social factors (social modeling, social impairments), cognitive factors (attitudes, coping skills), and psychological variables (ADHD symptom dimensions, comorbidity)] that might explain this increased smoking risk. Results of the review suggest that, while the self-medication hypothesis has some theoretical merit, it has not been adequately examined among adolescents and young adults with ADHD. Further, cognitive and social factors may be important mechanisms that help to explain the association between ADHD and cigarette smoking, but research in these areas is sparse. Finally, a larger body of literature suggests that different psychological aspects of ADHD (e.g., comorbidity, symptom dimensions) are related to smoking. Interpretation of findings of many of these studies was hindered due to significant methodological problems and the lack of a guiding theoretical orientation. Potential theories that might facilitate future work in this area are discussed. Future research should continue to explore these important psychosocial mechanisms as well as gene-environment interactions in examining the link between ADHD and cigarette smoking.