Delinquent behavior and emerging substance use in the MTA at 36 months: prevalence, course, and treatment effects.
OBJECTIVE
To compare delinquent behavior and early substance use between the children in the Multimodal Treatment Study of Children With ADHD (MTA; N = 487) and those in a local normative comparison group (n = 272) at 24 and 36 months postrandomization and to test whether these outcomes were predicted by the randomly assigned treatments and subsequent self-selected prescribed medications.


METHODS
Most MTA children were 11 to 13 years old by 36 months. Delinquency seriousness was coded ordinally from multiple measures/reporters; child-reported substance use was binary.


RESULTS
Relative to local normative comparison group, MTA children had significantly higher rates of delinquency (e.g., 27.1% vs. 7.4% at 36 months; p = .000) and substance use (e.g., 17.4% vs. 7.8% at 36 months; p = .001). Children randomized to intensive behavior therapy reported less 24-month substance use than other MTA children (p = .02). Random effects ordinal growth models revealed no other effects of initial treatment assignment on delinquency seriousness or substance use. By 24 and 36 months, more days of prescribed medication were associated with more serious delinquency but not substance use.


CONCLUSIONS
Cause-and-effect relationships between medication treatment and delinquency are unclear; the absence of associations between medication treatment and substance use needs to be re-evaluated at older ages. Findings underscore the need for continuous monitoring of these outcomes as children with attention-deficit/hyperactivity disorder enter adolescence.
Brooke S G
BSG
Molina
Kate
K
Flory
Stephen P
SP
Hinshaw
Andrew R
AR
Greiner
L Eugene
LE
Arnold
James M
JM
Swanson
Lily
L
Hechtman
Peter S
PS
Jensen
Benedetto
B
Vitiello
Betsy
B
Hoza
William E
WE
Pelham
Glen R
GR
Elliott
Karen C
KC
Wells
Howard B
HB
Abikoff
Robert D
RD
Gibbons
Sue
S
Marcus
C Keith
CK
Conners
Jeffery N
JN
Epstein
Laurence L
LL
Greenhill
John S
JS
March
Jeffrey H
JH
Newcorn
Joanne B
JB
Severe
Timothy
T
Wigal
D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome