Trajectories of childhood aggression and inattention/hyperactivity: differential effects on substance abuse in adolescence.
OBJECTIVE
Aggression and hyperactivity/inattention each are linked to risk of alcohol use disorder (AUD), but their unique contributions remain ambiguous. The present study disaggregated these two domains developmentally and examined the relation between childhood behavior trajectories and adolescent substance use.


METHODS
A total of 335 children of alcoholic and nonalcoholic fathers were studied prospectively. Parallel process latent trajectory class analysis was developed with behavioral ratings by parents and teachers of aggression and inattention/hyperactivity across ages 7 to 16. Membership in the four latent classes was used as a predictor for problem adolescence alcohol use and substance onset.


RESULTS
Youths in the four latent trajectory classes differed in number of alcohol problems at age 16: healthy class (39% of sample, mean 2.1 alcohol-related problems), inattentive/hyperactive but not aggressive (33%; mean 2.7 problems), aggressive but not inattentive/hyperactive (4%, mean 5.0 problems), and comorbid (24%; mean 4.0 problems). Survival analysis revealed that the aggressive, comorbid, and inattentive/hyperactive classes had significantly earlier onsets of drinking, drunkenness, and marijuana use than the healthy class. Illicit drug use was also significantly increased in the comorbid, aggressive, and inattentive/hyperactive classes compared to the healthy class.


CONCLUSIONS
Three levels of behavioral risk of substance abuse exist, the highest having trajectories of increased aggressive and inattentive/hyperactive problems throughout childhood, the next involving only an increased inattentive/hyperactive behavioral trajectory, and the lowest involving those with neither type of problem. Children with both inattention/hyperactivity and aggression have the greatest need for childhood intervention to prevent substance abuse in adolescence.
Jester
Jennifer M
JM
Addiction Research Center and Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2700, USA. jjester@umich.edu
Nigg
Joel T
JT
Buu
Anne
A
Puttler
Leon I
LI
Glass
Jennifer M
JM
Heitzeg
Mary M
MM
Fitzgerald
Hiram E
HE
Zucker
Robert A
RA
D000293:Adolescent; D017668:Age of Onset; D000374:Aggression / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D007389:Internal-External Control; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D010641:Phenotype; D011446:Prospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D016019:Survival Analysis
D013287:Illicit Drugs