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. 2013 Jan;22(1):23-32.
doi: 10.1111/j.1521-0391.2013.00325.x.

Associations between attention deficit hyperactivity disorder symptom domains and DSM-IV lifetime substance dependence

Katherine J Ameringer  1 , Adam M Leventhal
Affiliations

Associations between attention deficit hyperactivity disorder symptom domains and DSM-IV lifetime substance dependence

Katherine J Ameringer et al. Am J Addict. 2013 Jan.

Abstract

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.

Methods: 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.

Results: 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.

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Conflict of interest statement

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Figures

FIGURE 1
FIGURE 1
(a) Weighted percentage (± SE) of lifetime DSM-IV alcohol dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms (y-axis ranges from 0% to 50%). (b) Weighted percentage (± SE) of lifetime DSM-IV nicotine dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms (y-axis ranges from 0% to 50%). (c) Weighted percentage (± SE) of lifetime DSM-IV cannabis dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms (y-axis ranges from 0% to 20%). (d) Weighted percentage (± SE) of lifetime DSM-IV polysubstance dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms (y-axis ranges from 0% to 35%). N = 34,344.
FIGURE 2
FIGURE 2
(a) Weighted percentage (±SE) of lifetime DSM-IV stimulant dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms. (b) Weighted percentage (±SE) of lifetime DSM-IV depressant dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms. (c) Weighted percentage (±SE) of lifetime DSM-IV opioid dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms. (d) Weighted percentage (±SE) of lifetime DSM-IV hallucinogen dependence by increasing number of inattentive symptoms and hyperactive-impulsive symptoms. All y-axes range from 0% to 10%; N = 34,344.
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