ABSTRACT
BACKGROUND: The positive association between attention deficit hyperactivity disorder (ADHD) symptoms and smoking in youth has been well documented. Less research has examined why individuals with ADHD, particularly college students, are at increased risk for smoking. OBJECTIVES: This longitudinal study examined whether smoking motives [cognitive enhancement, tolerance, negative reinforcement (smoking to reduce negative affect or stress), craving, social influences, and weight control] helped to explain the relation between ADHD symptoms (inattention and hyperactivity/impulsivity) and cigarette smoking among college students. METHODS: Participants were 889 undergraduates (21% men) and their parents who completed online surveys at the beginning and end of the Fall semester regarding their smoking behaviors, ADHD symptoms, and smoking motives. Structural equation modeling was used to analyze data and answer research questions. RESULTS: Nineteen percent of students reported smoking, while 20% reported one or more inattentive symptoms, 35% reported one or more hyperactive/impulsive symptoms, and 3.3% met criteria for ADHD. All smoking motives significantly moderated the relation between inattentive symptoms and smoking, while most smoking motives (negative reinforcement, tolerance, craving, cognitive enhancement, and weight control) moderated the link between hyperactive/impulsive symptoms and smoking. Results remained significant after controlling for stimulant medication use and conduct disorder symptoms. Conclusions/Importance. Addressing negative reinforcement, craving, social influences, and tolerance in prevention and intervention efforts on college campuses may reduce smoking. Results also highlight the importance of assessing a range of ADHD symptoms in college students as ADHD symptoms, even at subthreshold levels, were associated with increased smoking rates among college students.
Subject(s)
Attention Deficit Disorder with Hyperactivity/psychology , Motivation , Smoking/psychology , Students/psychology , Adolescent , Cognition , Female , Humans , Impulsive Behavior , Longitudinal Studies , Male , Parents , Reinforcement, Psychology , Smoking/epidemiology , Surveys and Questionnaires , Universities , Young AdultABSTRACT
Medical malpractice litigation involving seven to nine figure settlements has been on the rise over the past decade. Given the life-altering scope of these incidents, forensic child psychiatrists may be asked to opine on the effects of a permanent perinatal injury on normal human development. Whether forensic child psychiatrists can assess risk of future psychiatric effects from such incidents is an important question. This paper is spurred by two separate cases, each involving a male infant having a portion of their genitals accidentally amputated by an obstetrician-gynecologist (OB/GYN) during a routine circumcision. In each case, the genitals were repaired, but permanent defects remained. The question arises how such injuries would affect these children as they matured. An analysis of the literature supported that there are risks of psychiatric effects of such birth-related injuries. Such predictions are made with reference to what is already known about human development, and by an exploration of the literature on the psychiatric effects of comparable injuries to children.
Subject(s)
Circumcision, Male/adverse effects , Developmental Disabilities/etiology , Adolescent , Child , Child, Preschool , Circumcision, Male/legislation & jurisprudence , Developmental Disabilities/diagnosis , Forensic Psychiatry/methods , Humans , Infant , Infant, Newborn , Interviews as Topic , Male , Penis/injuries , Perinatal Care/legislation & jurisprudence , Risk AssessmentABSTRACT
Research indicates that attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for heavy alcohol use and related problems. Research also suggests that positive alcohol expectancies (i.e., positive beliefs about the effects of alcohol) are predictive of risky alcohol use and related problems (e.g., driving while intoxicated). However, no research has examined the association between ADHD symptoms and positive expectancies or the role of ADHD symptoms in the relation between positive expectancies and alcohol use and related problems, an unexplored area addressed by the current study. Participants were 889 undergraduates (76% female, 82.3% Caucasian) at a Southeastern University who completed self-report measures. Parent report (59%) of current and childhood ADHD symptoms was also collected. Findings indicated that ADHD symptoms moderated the relation between positive alcohol expectancies and alcohol-related problems, but not the relation between expectancies and alcohol use. Additional analyses revealed that ADHD symptoms moderated the specific relation between positive expectancies and social alcohol problems (e.g., engaging in unplanned sexual behavior), but not between expectancies and internal alcohol problems (e.g., feeling sad). Moderating effects were significant even after controlling for conduct disorder symptoms and stimulant medication use. Findings have implications for the identification of college students who are at particularly high risk for heavy drinking and alcohol-related problems. Results may also aid in the development of interventions aimed at reducing risky drinking among students.
