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Pollard J, Reardon T, Williams C, Creswell C, Ford T, Gray A, Roberts N, Stallard P, Ukoumunne OC, Violato M. The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta-analysis. JCPP ADVANCES 2023; 3:e12149. [PMID: 37720587 PMCID: PMC10501703 DOI: 10.1002/jcv2.12149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 09/19/2023] Open
Abstract
Background Over a quarter of people have an anxiety disorder at some point in their life, with many first experiencing difficulties during childhood or adolescence. Despite this, gaps still exist in the current evidence base of the multiple consequences of childhood anxiety problems and their costs. Methods A systematic review of Medline, PsycINFO, EconLit and the National Health Service Economic Evaluation Database was conducted for longitudinal and economic studies reporting on the association between childhood anxiety problems and at least one individual-, family- or societal-level outcome or cost. All studies were synthesised narratively. For longitudinal studies, 'effect direction' was used as a common metric, with random effects meta-analysis undertaken where possible. Results Eighty-three studies met inclusion criteria and were synthesised narratively. We identified 788 separate analyses from the longitudinal studies, which we grouped into 15 overarching outcome domains. Thirteen of the studies were incorporated into 13 meta-analyses, which indicated that childhood anxiety disorders were associated with future anxiety, mood, behaviour and substance disorders. Narrative synthesis also suggested associations between anxiety problems and worse physical health, behaviour, self-harm, eating, relationship, educational, health care, employment, and financial outcomes. 'Effect direction' was conflicting in some domains due to a sparse evidence base. Higher economic costs were identified for the child, their families, healthcare providers and wider society, although evidence was limited and only covered short follow-up periods, up to a maximum of 2 years. Total annual societal costs per anxious child were up to £4040 (2021 GBP). Conclusions Childhood anxiety problems are associated with impaired outcomes in numerous domains, and considerable economic costs, which highlight the need for cost-effective interventions and policies to tackle them. More economic evidence is needed to inform models of the long-term, economic-related, consequences of childhood anxiety problems.
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Affiliation(s)
- Jack Pollard
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Tessa Reardon
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Chloe Williams
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Cathy Creswell
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation TrustCambridgeUK
| | - Alastair Gray
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Nia Roberts
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | | | - Obioha C. Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Mara Violato
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
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2
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Karlsson P, Ekendahl M, Raninen J. Exploring the Link between ADHD and Cannabis Use in Swedish Ninth Graders: The Role of Conduct Problems and Sensation-Seeking. Subst Use Misuse 2023; 58:311-319. [PMID: 36617861 DOI: 10.1080/10826084.2022.2155478] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Attention deficit hyperactivity disorder (ADHD) has in several studies been linked to substance use, including cannabis use. However, crucial gaps remain regarding how to understand this association. Analyzing the association between ADHD and substance use is complicated because of a pronounced overlap between ADHD, conduct problems, and traits such as sensation-seeking. Objectives: Using data from a large and nationally representative study among Swedish adolescents, this study explored the role of conduct problems, but also of sensation-seeking, in accounting for the association between ADHD and cannabis use. Results: There was a notable association between ADHD and cannabis use that was attenuated when conduct problems were controlled for. The association between cannabis use and conduct problems, in turn, was attenuated when sensation-seeking was controlled for. Individuals with both ADHD and conduct problems were more likely to have used cannabis than individuals with ADHD only, but not compared with individuals with conduct problems only. Conclusions: Whereas conduct problems largely explain the link between ADHD and cannabis use, sensation-seeking seems to account for the association between conduct problems and cannabis use.
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Affiliation(s)
- Patrik Karlsson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Mats Ekendahl
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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3
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Sensitization-based risk for substance abuse in vulnerable individuals with ADHD: Review and re-examination of evidence. Neurosci Biobehav Rev 2022; 135:104575. [PMID: 35151770 PMCID: PMC9893468 DOI: 10.1016/j.neubiorev.2022.104575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
Evidence of sensitization following stimulants administration in humans is just emerging, which prevents reaching more definitive conclusions in favor or against a purported protective role of stimulant treatments for ADHD for the development of substance use disorders. Existing evidence from both animal and human research suggest that stimulants produce neurophysiological changes in the brain reward system, some of which could be persistent. This could be relevant in choosing optimal treatments for young patients with ADHD who have additional clinical risk factors for substance abuse (e.g. conduct disorder (CD) and/or familial addictions). Here we stipulate that, while the majority of youth with ADHD greatly benefit from treatments with stimulants, there might be a subpopulation of individuals whose neurobiological profiles may confer risk for heightened vulnerability to the effects of stimulants on the responsiveness of the brain reward system. We propose that focused human research is needed to elucidate the unknown effects of prolonged stimulant exposure on the neurophysiology of the brain reward system in young patients with ADHD.
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4
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An Exploration of Intra-individual Mechanisms for the Association Between Childhood Conduct Problems and Early Adolescent Substance Use. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00701-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Meinzer MC, Oddo LE, Vasko JM, Murphy JG, Iwamoto D, Lejuez CW, Chronis-Tuscano A. Motivational interviewing plus behavioral activation for alcohol misuse in college students with ADHD. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:803-816. [PMID: 33600197 PMCID: PMC8371056 DOI: 10.1037/adb0000663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: College is a high-risk period for the initiation and escalation of problem alcohol use. College students with attention-deficit/hyperactivity disorder (ADHD) are at particularly high risk for experiencing alcohol-related negative consequences relative to typically developing peers. Despite this, the best therapeutic approach for addressing alcohol problems in college students with ADHD has not been identified. Behavioral activation (BA) may augment the effects of gold-standard College drinking interventions [i.e., brief motivational intervention (BMI)] for students with ADHD who are engaging in problem drinking. Method: 113 college students with ADHD (Mean age = 19.87, SD = 1.44; 49.1% male) were randomized to either BMI + BA or BMI plus supportive counseling (BMI + SC). Both groups received ADHD psychoeducation delivered in MI style. Outcomes were assessed using the Brief Young Adult Alcohol Consequences Questionnaire, Daily Drinking Questionnaire, Barkley Functional Impairment Scale, and Beck Depression Inventory. Results: There were no significant differences in outcomes for the sample as a whole; in both conditions, participants showed significant reductions in their alcohol-related negative consequences, alcohol use, and depressive symptoms at 1- and 3-month follow-ups. Exploratory moderation analyses revealed that participants with elevated depressive symptoms at baseline evidenced greater reductions in alcohol-related negative consequences in the BMI + BA condition compared to BMI + SC at the 3-month follow-up. Those low in depressive symptoms evidenced greater reductions of alcohol-related negative consequences in BMI + SC compared to BMI + BA. Conclusions: For college students with ADHD who reported elevated baseline depressive symptoms, the inclusion of BA with BMI resulted in significantly greater decreases in alcohol-related negative consequences, compared to BMI + SC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Lauren E Oddo
- Department of Psychology, University of Maryland, College Park
| | | | | | - Derek Iwamoto
- Department of Psychology, University of Maryland, College Park
| | - Carl W Lejuez
- Department of Psychological Sciences, University of Connecticut
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6
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The unspecified residual category of the DSM-5: The challenges of a catch-all diagnosis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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7
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Corona JC. Role of Oxidative Stress and Neuroinflammation in Attention-Deficit/Hyperactivity Disorder. Antioxidants (Basel) 2020; 9:antiox9111039. [PMID: 33114154 PMCID: PMC7690797 DOI: 10.3390/antiox9111039] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood. Although abnormalities in several brain regions and disturbances of the catecholaminergic pathway have been demonstrated, the pathophysiology of ADHD is not completely understood, but as a multifactorial disorder, has been associated with an increase in oxidative stress and neuroinflammation. This review presents an overview of factors that increase oxidative stress and neuroinflammation. The imbalance between oxidants and antioxidants and also the treatment with medications are two factors that can increase oxidative damage, whereas the comorbidity between ADHD and inflammatory disorders, altered immune response, genetic and environmental associations, and polymorphisms in inflammatory-related genes can increase neuroinflammation. Evidence of an association with these factors has become valuable for research on ADHD. Such evidence opens up new intervention routes for the use of natural products as antioxidants that could have potential as a treatment against oxidative stress and neuroinflammation in ADHD.
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Affiliation(s)
- Juan Carlos Corona
- Laboratory of Neurosciences, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico
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8
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Depression and ADHD-Related Risk for Substance Use in Adolescence and Early Adulthood: Concurrent and Prospective Associations in the MTA. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1903-1916. [PMID: 31273568 DOI: 10.1007/s10802-019-00573-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is prospectively linked to substance use and disorder. Depression emerging in adolescence is an understudied risk factor that may explain some of this risk. In the present study, we considered mediating and moderating roles of adolescent depression in explaining this association by using longitudinal data from the prospective 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA). Participants were 547 children diagnosed with DSM-IV ADHD Combined Type, and 258 age- and sex-matched comparison children. In adolescence, depressive symptoms did not exacerbate effects of childhood ADHD on any substance use. For both groups, time-varying and average depressive symptoms were associated with more frequent use of all substances. Prospectively, we found no evidence of depression mediation to adult substance use. However, adolescent depression moderated the association between childhood ADHD and adult marijuana use. Although adults without ADHD histories used marijuana more frequently if they had elevated depressive symptoms in adolescence, marijuana use by adults with ADHD histories was independent of their adolescent depression. In adulthood, depression diagnoses and ADHD persistence continued to operate as independent, additive correlates of substance use risk. Our findings suggest a circumscribed role for depression in substance use risk that adds to, but does not alter or explain, ADHD-related risk.
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Hoffmeister JR, Cohoon AJ, Sorocco KH, Acheson A, Lovallo WR. Addiction resistance to alcohol: What about heavy drinkers who avoid alcohol problems? Drug Alcohol Depend 2019; 204:107552. [PMID: 31539868 PMCID: PMC6878140 DOI: 10.1016/j.drugalcdep.2019.107552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Some individuals are resistant to alcohol use disorders despite high levels of intake. Addiction Resistance (AR) measures the disparity between alcohol consumption and alcohol use disorder (AUD) symptoms, such that some persons exhibit few (AUD) symptoms despite higher intake. The validity of the concept and the factors contributing to AR are not well understood. The aim of this study was to predict AR based on variables related to risk for addiction that are measured in the Family Health Patterns Project. METHOD Participants were healthy young adults (n = 1122) with and without a family history of alcohol and other substance use disorders who were given measures of mood stability and risk-taking tendencies, and were interviewed to determine alcohol intake, AUD symptoms, and other substance use disorders (SUD). AR was calculated using maximal lifetime alcohol intake and number of AUD symptoms. RESULTS A principal components analysis was run with varimax rotation, which yielded three components: Component 1 indexed behavioral and mood regulation, Component 2 encompassed family and environmental factors, and Component 3 included cognitive factors. A multiple regression analysis revealed that Component 1 and Component 2 were predictive of AR whereas Component 3 was not. DISCUSSION Individuals who reported greater emotional stability, norm adherence, risk avoidance, and fewer family members with substance use disorders were more resistant to AUD despite higher alcohol intake. These findings suggest that AUD risk and resistance may represent different points of the same continuum.
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Affiliation(s)
- Jordan R. Hoffmeister
- Department of Psychiatry, Behavioral Sciences Labs, The University of Oklahoma Health Sciences Center, 755 Research Parkway, Ste. 568, Oklahoma City, OK 73104 USA
| | - Andrew J. Cohoon
- Department of Psychiatry, Behavioral Sciences Labs, The University of Oklahoma Health Sciences Center, 755 Research Parkway, Ste. 568, Oklahoma City, OK 73104 USA
| | - Kristen H. Sorocco
- Department of Psychiatry, Behavioral Sciences Labs, The University of Oklahoma Health Sciences Center, 755 Research Parkway, Ste. 568, Oklahoma City, OK 73104 USA
| | - Ashley Acheson
- Department of Psychiatry, College of Medicine, at the University of Arkansas for Medical Sciences, Little Rock, AR 72205 USA
| | - William R. Lovallo
- Department of Psychiatry, Behavioral Sciences Labs, The University of Oklahoma Health Sciences Center, 755 Research Parkway, Ste. 568, Oklahoma City, OK 73104 USA
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Kang SY, Lee JA, Kim YS. Short report: depressive mood moderates the association between family communication and self-rated health in married couples. PSYCHOL HEALTH MED 2019; 25:102-109. [PMID: 31122055 DOI: 10.1080/13548506.2019.1622747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Self-rated health, a valid measure of general health, is influenced by family dynamics and depression. In this study, using data from the Family Cohort Study in Primary Care, we investigated whether depressive mood moderated the association between family communication and self-rated health in married couples. Among the 520 couples in the cohort, we cross-sectionally analyzed the responses of 420 couples (840 participants) who provided answers to the Center for Epidemiologic Studies Depression Scale, the Family Communication Scale of the Family Adaptation and Cohesion Evaluation Scale-IV, and a self-rated health question. Hierarchical regression analyses were performed to evaluate the interactions between depressive mood and family communication on self-rated health. High levels of family communication were associated with better self-rated health (r = -.16, p < .01), and that depressive mood moderated the association between family communication and self-rated health (β = .10, p = .008). Specifically, the association between family communication and self-rated health was significant only when levels of depressive mood were low (β = -.175, p = < .001), and the association was lost when levels of depressive mood were high (β = -.031, p = .446). High levels of depressive mood weakened the positive association between family communication and self-rated health. Our findings highlight the significant influence of depressive symptoms on family dynamics and health among patients in primary care.
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Affiliation(s)
- Seo Young Kang
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - Jung Ah Lee
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - Young Sik Kim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
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Wilens TE, Isenberg BM, Kaminski TA, Lyons RM, Quintero J. Attention-Deficit/Hyperactivity Disorder and Transitional Aged Youth. Curr Psychiatry Rep 2018; 20:100. [PMID: 30221318 DOI: 10.1007/s11920-018-0968-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Extensive research has been conducted on attention-deficit/hyperactivity disorder (ADHD) in children and adults; however, less is known about ADHD during the transition from childhood to adulthood. Transitional aged youth (TAY) with ADHD represents a particularly vulnerable population as their newfound independence and responsibility often coincides with the development of comorbid disorders. The purpose of this review is to provide an update on the evaluation, diagnosis, and treatment of TAY-ADHD. RECENT FINDINGS Recent studies discovering ADHD symptoms emerging in TAY call the classification of ADHD as a disorder necessarily developing in childhood into question. TAY-ADHD are also shown to be vulnerable to academic and social impairments, increased risky behavior, and comorbid psychiatric disorders. Due to the risk of stimulant diversion in TAY, providers are advised to take precaution when prescribing medication to this population. Recent studies demonstrating the efficacy of psychotherapy in conjunction with non-stimulant or extended release stimulant medication provide a feasible alternative. This review highlights research on the course and evaluation of ADHD, impairments and comorbidities specific to TAY, and treatments tailored to address the unique challenges associated with TAY-ADHD.
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Affiliation(s)
- Timothy E Wilens
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.
| | - Benjamin M Isenberg
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Tamar A Kaminski
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Rachael M Lyons
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Javier Quintero
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Medical School, Complutense University of Madrid, Madrid, Spain
- PSIKIDS, Madrid, Spain
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12
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Jo JM, Won SD. Serial Progression from Attention-Deficit/Hyperactivity Disorder to Alcohol Use Disorder: Serial Multiple Mediated Effects of Externalizing Disorders and Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:267-275. [PMID: 30121976 PMCID: PMC6124877 DOI: 10.9758/cpn.2018.16.3.267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/16/2017] [Accepted: 06/01/2017] [Indexed: 01/13/2023]
Abstract
Objective Externalizing disorders such as attention-deficit/hyperactivity disorder (ADHD), conduct disorder and antisocial personality disorder, as well as depression are common comorbidities in alcohol use disorder (AUD). The current study focused on the temporal relationship between the onsets of these disorders and AUD, and investigated the serial multiple mediator model of externalizing disorders (e.g., ADHD) and depression on AUD. Methods We analyzed the mediated effects of the Adult ADHD Self-Report Scale (ASRS), the Barratt Impulsiveness Scale motor (BIS_M) and the Beck Depression Inventory (BDI) on Korean version of the Alcohol Dependence Scale (ADS_K) using the multiple-step multiple mediation procedure regression analysis. In addition, we comparatively analyzed different clinical characteristics in relation to conduct problems. Results The multiple-step multiple mediation procedure found the serial multiple mediated effects of the BIS_M and the BDI on the relationship between the ASRS and the ADS_K. Also, the group with conduct problem was significantly high in ADHD symptoms, depression, anxiety, impulsivity, legal problems and alcohol-related problems, compared to the group without conduct problems. Conclusion To sum up, the results of this study show that ADHD symptoms in childhood could exert significant effects on the severity of AUD in adulthood, and both disorders might be mediated by the externalizing disorders characterized by the core feature of motor impulsivity, and depression serially. Thus, the treatment of preceding disorders in accordance with developmental stages is an overarching clinical component for preventing the subsequent development of AUD and for its treatment.
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Affiliation(s)
- Jung Min Jo
- Department of Clinical Psychology, Keyo Medical Foundation Keyo Mental Hospital, Uiwang, Korea
| | - Sung Doo Won
- Department of Clinical Psychology, Keyo Medical Foundation Keyo Mental Hospital, Uiwang, Korea
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Modesto-Lowe V, Charbonneau V, Farahmand P. Psychotherapy for Adolescents With Attention-Deficit Hyperactivity Disorder: A Pediatrician's Guide. Clin Pediatr (Phila) 2017; 56:667-674. [PMID: 27895149 DOI: 10.1177/0009922816673308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) presents with high levels of inattention, impulsiveness, and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. ADHD symptoms lead to decreased functionality in various life domains and result in poor academics, behavioral challenges, delayed independence, and strained relationships. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. This article aims to provide a review of the psychotherapeutic interventions available for teens that receive pharmacotherapy but continue to struggle with the residual symptoms of ADHD that interfere with academic function, relationship formation, and psychological development.
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Affiliation(s)
- Vania Modesto-Lowe
- 1 Connecticut Valley Hospital, Middletown, CT, USA.,2 University of Connecticut School of Medicine, Farmington, CT, USA.,3 Quinnipiac University, Hamden, CT, USA
| | | | - Pantea Farahmand
- 4 New York-Presbyterian Hospital/Columbia-Cornell, Child and Adolescent Psychiatry, New York, NY, USA
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