title: Evaluation of underlying mechanisms in the link between childhood ADHD symptoms and risk for early initiation of substance use.
abstract: Although there has been support for attention-deficit/hyperactivity disorder (ADHD) as a risk for early substance use, this link is not fully established or understood. Furthermore, the potential mechanisms explaining these associations are unclear. The current study examined peer rejection, school bonding, and internalizing problems as potential mediators of the association between childhood ADHD symptoms and risk for early initiation of substance use. The sample included a control group of 126 students with problematic aggression (79% African American, 66% male) from an intervention study following children from fourth to ninth grade. Results suggested that ADHD symptoms follow a path to early initiation of tobacco use through the combined effects of peer rejection and internalizing problems as well as through internalizing problems alone. ADHD symptoms were also associated with the cubic slope of marijuana use initiation, such that increased ADHD symptoms were associated with a strong cubic trend (e.g., a more rapid acceleration of risk for initiation). ADHD symptoms were not associated with risk for early initiation of alcohol use. Identification of important vulnerability factors in children with ADHD symptoms highlight the need for primary prevention and psychological interventions that target these factors and decrease the likelihood of early tobacco and marijuana use initiation.
authors.affiliation: Department of Psychology, University of Tennessee.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Vitulano
authors.affiliation: Department of Psychology, University of Kansas.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Fite
authors.affiliation: Department of Psychology, University of Tennessee.
authors.forename: Derek R
authors.initials: DR
authors.lastname: Hopko
authors.affiliation: Department of Psychology, University of Alabama.
authors.forename: John
authors.initials: J
authors.lastname: Lochman
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine.
authors.forename: Karen
authors.initials: K
authors.lastname: Wells
authors.affiliation: Department of Family Medicine, University of Tennessee Graduate School of Medicine.
authors.forename: Irfan
authors.initials: I
authors.lastname: Asif
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000374:Aggression / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D001290:Attitude; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology / Q000523:psychology*; D009010:Monte Carlo Method; D009769:Object Attachment; D010379:Peer Group; D016016:Proportional Hazards Models; D012929:Psychological Distance; D012307:Risk Factors; D012574:Schools; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D016019:Survival Analysis; D000066608:Underage Drinking / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States