Associations between Attention Deficit Hyperactivity Disorder Symptom Domains and DSM-IV Lifetime Substance Dependence
Article first published online: 7 FEB 2013
Copyright © American Academy of Addiction Psychiatry
The American Journal on Addictions
Volume 22, Issue 1, pages 23–32, January-February 2013
How to Cite
Ameringer, K. J. and Leventhal, A. M. (2013), Associations between Attention Deficit Hyperactivity Disorder Symptom Domains and DSM-IV Lifetime Substance Dependence. The American Journal on Addictions, 22: 23–32. doi: 10.1111/j.1521-0391.2013.00325.x
- Issue published online: 7 FEB 2013
- Article first published online: 7 FEB 2013
- Manuscript Accepted: 21 DEC 2011
- Manuscript Revised: 9 NOV 2011
- Manuscript Received: 16 AUG 2011
Background and Objectives
Most studies of attention deficit hyperactivity disorder (ADHD) in the substance dependence literature have assessed ADHD as a single, categorical entity. This approach limits characterization across the spectrum of ADHD symptomatology and may mask differences across the two core domains of ADHD symptoms—hyperactive-impulsive (HI) and inattention (IN). Further, it is unclear whether relations of HI and IN symptoms to substance dependence extend across drug classes and to the general population.
This cross-sectional study investigated associations of lifetime ADHD HI and IN symptom levels to individual classes of lifetime substance dependence (alcohol, nicotine, depressants, opioids, stimulants, cannabis, hallucinogens, polysubstance) in a population-based sample of 34,653 American adults.
HI and IN were associated with the majority of dependence diagnoses in a linear pattern, such that each additional symptom was associated with a proportional increase in odds of dependence. After adjusting for the overlap between symptom domains, both HI and IN uniquely associated with alcohol, nicotine, and polysubstance dependence, but only HI uniquely associated with dependence on illicit substances.
Conclusions and Scientific Significance
These findings suggest that individuals in the general population with elevated levels of ADHD (particularly HI) symptoms are at risk for various forms of substance dependence and could benefit from preventive interventions. (Am J Addict 2012;XX:000–000) (Am J Addict 2013;22:23-32)