ADHD and Alcohol Use: A Longitudinal Examination of Dual Processes

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PROJECT SUMMARY The proposed Mentored Research Scientist Development Award (K01) will launch Dr. Amy Stamates’ program of research as an independent scientist focusing on the etiology of alcohol problems among young adults. This goal will be achieved through a 5-year parallel research and tailored training plan. Training goals include building expertise in (1) clinical knowledge of alcohol use; (2) executive functioning (EF) and attention- deficit/hyperactivity disorder (ADHD); (3) ecological momentary assessment (EMA); (4) advanced longitudinal data analyses; and (5) grantsmanship. Training goals will be met through a comprehensive training plan involving meetings with Drs. Lynda Stein (expert in alcohol interventions), Lisa Weyandt (expert in ADHD), Kristina Jackson (expert in EMA methods and analyses), and Timothy Wilens (expert in ADHD and substance use disorders); workshops; conferences; coursework; and experiential activities. Skills gained through the training plan will be put into action through a complementary research plan aimed to understand the alcohol- risk process of young adult drinkers with ADHD. Young adults with ADHD are at greater risk for experiencing alcohol problems (e.g., risky sex, driving after drinking) and developing alcohol use disorder (AUD) compared to those without ADHD. However, it is unclear why those with ADHD are at greater risk because research supports that they drink less than or equivalent to their non-ADHD peers. The proposed project will study this discrepancy by utilizing a measurement-burst design pairing laboratory and EMA to examine controlled (EF) and automatic (craving) processes in relation to alcohol use among those with and without ADHD. Participants (stratified by ADHD and gender) will be 141 young adult drinkers who complete three bursts over a one-year period (baseline, 6-months, and 12-months). Each timepoint will include a laboratory session assessing EF followed by 17 days of EMA assessing craving, alcohol use, alcohol problems, context, and social setting. The proposed project has three specific aims: (1) examine the impact of ADHD on EF and alcohol outcomes (craving, alcohol use, and alcohol problems) at baseline; (2) determine within-person changes between EF and alcohol outcomes over one year for those with and without ADHD; (3) identify event-level predictors (context, social setting) that heighten craving, alcohol use, and alcohol problems for those with ADHD. Findings from the proposal will provide preliminary data for a R01 application to be completed by Dr. Stamates during the award period. The proposed research seeks to address knowledge gaps of etiological factors underlying ADHD and AUD, with the ultimate goal to identify opportunities to tailor prevention and intervention approaches for young adults with ADHD. Thus, this proposal is in line with NIAAA’s 2017-2021 Strategic Plan for Research to investigate mechanisms underlying comorbid alcohol and psychiatric disorders. Completion of the K01 will provide Dr. Stamates with the expertise to conduct innovative, high-impact research focusing on the etiology of alcohol-related problems, particularly young adults with ADHD who may be most vulnerable.