Drug Use and Psychosocial Functioning of a Community-Derived Sample of Adolescents with Childhood ADHD

Abstract

We describe the late adolescent psychosocial outcomes from a relatively large, community-identified sample of children with ADHD who have been assessed longitudinally from childhood through late adolescence. A range of outcomes were compared between ADHD (n = 119) and normal control (n = 93) groups, as well as ADHD subgroups that varied as a function of the course of externalizing predominantly ODD problems (persisters, desisters, escalaters, and resisters). ADHD youths that did not show externalizing problems during childhood (ADHD resisters) were associated with drug use outcomes generally comparable to the normal non-affected controls. All other ADHD groups with externalizing problems (ADHD persisters, ADHD escalaters, and ADHD desisters) consistently revealed worse drug use outcomes compared to controls/ADHD resisters. However, ADHD youths with or without externalizing problems showed worse outcomes compared to the control group on the non-drug, psychosocial functioning variables. The study highlights that ADHD with coexisting disruptiveness, whether the disruptiveness persists or remits before adolescence, is associated with an increased risk for drug involvement and that ADHD, regardless of the comorbid pattern, confers a poorer level of psychosocial functioning.

KEYWORDS:

• ADHD
• adolescence
• psychosocial functioning

Support for this manuscript was obtained from the Minnesota Department of Human Services, State Operated Services (Realmuto and August) and NIDA grants DA12995 and DA01534 (Winters).

Notes

^a Within the ADHD groups, differences in IQ were non-significant.

^b Hollingshead, 1975; range 17–66.

¹When we applied the same cutoffs to the control group, there were 3 desisters, 2 escalaters, and 77 resisters. All cases in the control group were included in the present study.

Note: Gender 1 = male, 0 = female (reference group).

∗p < .05.

∗∗p < .01.

Note: Gender 1 = male, 0 = female (reference group).

∗p < .05.

∗∗p < .01.

Note: Gender 1 = male, 0 = female (reference group). P = ADHD persister, D = ADHD desister, R = ADHD resister.

^a Including a fourth group, ADHD escalaters, in the analyses (logistic regression, ANCOVA, and negative binomial regression) yielded similar results, but with less power to detect significance in some outcomes (e.g., regular tobacco use). Escalaters did not significantly differ from any of the other groups.

∗p < .05.

∗∗p < .01.

Note: P = ADHD persister, D = ADHD desister, R = ADHD resister.