Development of Alcohol Use and Abuse in ADHD Adolescents

描述（由申请人提供）：这是一项关于注意力缺陷/多动障碍（ADHD）与酒精滥用之间关系的前瞻性纵向研究。在这项研究中，患有ADHD的儿童（n = 350+）在他们参加匹兹堡大学西部精神病研究所和诊所的ADHD夏季治疗计划后的小学年龄段被确定。这是迄今为止同类研究中最大的ADHD-酗酒关联样本。非ADHD组（n = 240例人口统计学相似的受试者）是在先证者的首次随访期间招募的，当时先证者和对照组的年龄范围为11至25岁。在这种队列序贯设计中，受试者每年进行一次评估，通过发展时期，其中酒精消费开始，达到高峰，随后在一般人群中减少。在提供支助的头五年，确定了样本，开发了成套工具，参与者完成了两波评估。目前，第三波正在进行中。第一波的初步研究结果表明：（1）多动症是早期开始、大量饮酒和酒精问题的危险因素，（2）ADHD-控制酒精问题的差异受预期和同伴网络的影响;（3）先证者的酒精问题家族史更大;和（4）使用兴奋剂药物治疗与更多的酒精和其他物质使用有关。我们建议继续这些年度评估，因为样本成熟到成年早期，将我们的横截面研究结果扩展到纵向，允许测试ADHD样本内以及ADHD和非ADHD样本之间饮酒的过程，原因和后果的个体差异的假设（即，两组之间的差异解释了ADHD组的酒精脆弱性）。这项研究的独特之处包括：（1）丰富的标准化和客观的儿童期数据，这些数据描述了先证者在儿童期的特征;（2）关于终生兴奋剂治疗和学校功能的完整信息;（3）大样本量，这将允许以前动力不足的共病检查;（4）非酒精性物质的评估，以及（5）与酒精中毒发展独特相关的领域的综合评估（例如，酒精预期、动机、同伴物质使用和态度、父母饮酒和酗酒家族史）。

DESCRIPTION (provided by applicant): This is a prospective longitudinal study of the association between Attention-Deficit/Hyperactivity Disorder (ADHD) and alcohol abuse. In this study, children with ADHD (n = 350+) were ascertained in their elementary school-aged years following their participation in the ADHD Summer Treatment Program at Western Psychiatric Institute and Clinic, University of Pittsburgh. This is by far the largest sample of its kind to examine the ADHD-alcoholism association. The non-ADHD group (n = 240 demographically similar subjects) was recruited during the first follow-up of the probands, when probands and controls ranged in age from 11 to 25 years old. In this cohort-sequential design, subjects are assessed annually through the developmental periods in which alcohol consumption is initiated, reaches its peak, and subsequently decreases in the general population. In the first five years of support, the sample was ascertained, the battery developed, and participants completed two waves of assessments. The third wave is currently underway. Preliminary findings from Wave 1 document that (1) ADHD is a risk factor for early starting, heavy consumption of, and problems with alcohol, (controlling for childhood conduct problems); (2) ADHD-control differences in alcohol problems are influenced by expectancies and the peer network; (3) family history of alcohol problems is greater in probands; and (4) treatment with stimulant medication is related to greater alcohol and other substance use. We propose to continue these annual assessments as the sample matures through young adulthood to extend our cross-sectional findings to the longitudinal, allowing testing of hypotheses regarding individual differences in the course, causes, and consequences of alcohol consumption within the ADHD sample and between the ADHD and non-ADHD samples (i.e., what differences between the groups explain alcohol vulnerability in the ADHD group). Unique features of the study include (1) the wealth of standardized and objective childhood data that characterize the proband sample in childhood, (2) complete information regarding lifetime stimulant treatment and school functioning, (3) a large sample size that will allow previously underpowered examinations of comorbidity; (4) assessment of nonalcoholic substances, and (5) comprehensive assessment of domains uniquely relevant to the development of alcoholism (e.g., alcohol expectancies, motives, peer substance use and attitudes, parental drinking, and family history of alcoholism).