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Objective: To test whether smoking-specific risk factors in early adulthood mediate prediction to daily smoking from childhood ADHD. Methods: Participants were 237 with and 164 without childhood ADHD. A smoking risk profile score comprising smoking-specific factors measured between ages 18 to 25 (e.g., craving severity) and age of initiation was tested as mediator of the association between childhood ADHD and age 29 daily smoking. Results: Childhood ADHD predicted age 29 smoking (β = −.15, p = .019), 35% of ADHD versus 17% of nonADHD, and the profile score (β = −.07, p = .004), which in turn mediated prediction to age 29 daily smoking (β = −.03; p = .007). When tested individually, three profile variables (# cigarettes/day, difficulty concentrating during abstinence, and nicotine dependence) were significant mediators ( ps = 0.005–0.038), above and beyond early adult smoking, ADHD persistence, and delinquency. Conclusions: These behavioral smoking characteristics help explain later daily cigarette smoking for adults with ADHD histories and may need to be targeted in intervention.

Emerging evidence suggests impulsive states may be reliably measured in the moment using ecological momentary assessment (EMA); however, research has not investigated whether the multi-factor structure of impulsive traits also characterizes impulsive states. In two independent samples spanning adolescence through young adulthood ( n = 211, n = 222), we adapted global self-report measures of impulsive traits to EMA and conducted multilevel confirmatory factor analyses to characterize the within- and between-person factor structure of five impulsive traits (negative urgency, planning, persistence, sensation seeking, and positive urgency). Across both studies, factor models with one factor for each UPPS-P facet fit the data well at both levels, though some latent factors were highly correlated. Aggregated impulsive states, especially negative urgency, predicted oppositional defiant disorder symptoms, emotional problems, alcohol problems, and attention deficit hyperactivity disorder symptoms. Our results suggest that EMA measures can capture a range of impulsive states that mirrors the heterogeneity seen in the trait literature.

Objective: Recent studies suggest attention-deficit/hyperactivity disorder (ADHD) may emerge post-childhood. We integrate qualitative methods to systematically characterize contextual factors that may (a) delay identification of ADHD in childhood and (b) inform why ADHD symptoms emerge post-childhood. Method: Suspected late-onset ADHD cases from the local normative comparison group of the Multimodal Treatment Study of ADHD completed a qualitative interview (14 young adults and 7 caregivers). Interviews were qualitatively analyzed. Results: We identified five themes. Three themes may attenuate or delay identification of childhood ADHD: external factors (e.g., supportive adults), internal factors (e.g., strong intellectual functioning), and other factors (e.g., dismissive attitudes toward ADHD). Two themes may accompany an increase in ADHD symptoms post-childhood: external factors (e.g., increased external demands) and internal factors (e.g., perceived stress). Conclusion: Clinicians should probe these factors in suspected late-onset cases to address (a) whether, how, and to what extent ADHD was attenuated in childhood and (b) why symptoms emerge post-childhood.

Objective: Test the hypothesis that alcoholism, including antisocial alcoholism, is more prevalent among mothers and fathers of children with versus without ADHD. Method: Mothers (312 ADHD group, 235 non-ADHD group) and fathers (291 ADHD group, 227 non-ADHD group) in the Pittsburgh ADHD Longitudinal Study were interviewed along with their adolescent and young adult offspring. Results: Maternal and paternal alcoholism, with and without comorbid antisociality, was more prevalent in the ADHD group. Paternal alcoholism without antisociality was only marginally higher for probands after controlling for paternal ADHD. Offspring conduct disorder comorbidity was associated with parental antisociality but not parental antisocial alcoholism. Conclusion: Our findings that 44% of proband fathers and 25% of proband mothers experienced alcohol problems with or without antisociality are further evidence of increased alcoholism prevalence in families affected by ADHD. Maternal alcoholism and antisociality are prominent contributors to this family-level vulnerability. These findings indicate the need to assess long-term offspring outcomes as a function of parental alcohol and externalizing comorbidities, and perhaps other indicators of parental alcoholism phenotype, as familial vulnerability unfolds across development.

Objective: Excessive alcohol consumption increases risk of perpetrating intimate partner violence (IPV). ADHD is associated with problematic drinking and IPV, but it is unclear whether problem drinkers with ADHD are more likely than those without ADHD to perpetrate IPV. Method: We compared the strength of association between problem drinking trajectories and IPV perpetration among 19- to 24-year-old men with ( n = 241) and without ( n = 180) childhood ADHD. Results: Men with ADHD who reported higher heavy episodic drinking or alcohol use problems at age 19, and slower decreases in alcohol use problems from age 19 to 24, were more likely to perpetrate IPV than problem drinkers without ADHD, among whom the same associations were non-significant. Associations between problem drinking and IPV were not attenuated in adults with ADHD upon controlling for antisocial personality disorder. Conclusion: Study findings highlight the heightened risk of problem drinkers with ADHD perpetrating IPV.

Objective: Research has clearly documented the social dysfunction of youth with ADHD. However, little is known about the interpersonal relationships of adults diagnosed with ADHD in childhood, including rates of intimate partner violence (IPV). Method: Using data from the Pittsburgh ADHD Longitudinal Study, analyses compared the level of IPV (verbal aggression, violence) reported by young adult (18- to 25-year-old) males with childhood ADHD ( n = 125) with reports by demographically similar males without ADHD histories ( n = 88). Results: Males with childhood ADHD, especially those with conduct problems persisting from childhood, were more likely to be verbally aggressive and violent with romantic partners than males without histories of ADHD or conduct problems. Conclusions: Research is needed to replicate these findings, to explore potential mechanisms, and to develop effective interventions for romantic relationship discord among young adults with ADHD histories, especially those with persistent conduct problems.

Objective: To characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method: The study included 58 women from a larger longitudinal study of ADHD. A total of 34 ( M = 19.97 years old) met DSM criteria for ADHD in childhood, whereas the remaining 24 ( M = 19.83 years old) did not. Self- and parent-reports of psychopathology, delinquency, interpersonal relationships, academic achievement, job performance, and substance use were collected. Results: The findings suggest that girls with ADHD experience difficulties in late adolescence and young adulthood, such as more conflict with their mothers, being involved in fewer romantic relationships, and experiencing more depressive symptoms than comparison women. However, differences did not emerge in all domains, such as job performance, substance use, and self-reported ADHD symptomatology. Conclusion: The findings of this study add to the literature on the negative late adolescent and young adult outcomes associated with childhood ADHD in women. ( J. of Att. Dis. 2011; 15(3) 204-214)

In this study, the authors examined the association between childhood attention-deficit/hyperactivity disorder (ADHD) and anxiety and mood disorders in adolescence.They compared a group of 142 adolescents ages 13 to 18 years with a history of ADHD in childhood to group of 100 community-recruited adolescents without ADHD.The two groups did not differ in rates of anxiety and mood disorders in adolescence.Within the ADHD group, however, anxiety and mood disorders in adolescence were predicted by childhood externalizing disorder symptoms and social problems but not by childhood internalizing disorder symptoms.The current findings provided little evidence of an overall increased risk for anxiety and mood disorders in adolescents who had childhoodADHD.Children with ADHD who have more severe externalizing symptoms and social problems in childhood may be at elevated risk for certain internalizing disorders.

A clinic-referred sample of 109 children with attention-deficit/hyperactivity disorder (ADHD) was followed into adolescence for the ascertainment of alcohol and other drug use and abuse. Learning disability (reading or math) in childhood was examined as a predictor of adolescent substance use and substance use disorder for alcohol and marijuana. No statistically significant group differences for children with LD versus those without LD emerged even after using different methods to compute LD. IQ/achievement discrepancy scores were similarly not predictive of later use or abuse. However, children with ADHD who had higher IQs and higher levels of academic achievement in childhood were more likely to try cigarettes, to smoke daily, and to have their first drink of alcohol or first cigarette at an early age. Children with ADHD who had higher reading achievement scores were less likely to have later alcohol use disorder. Although these findings are necessarily preliminary, due to the small number of children interviewed, the pattern of results suggests that level of cognitive functioning—rather than discrepancy between IQ and achievement—is important for the prediction of later substance use and abuse, at least in this clinic-referred sample of children with ADHD. Further, different mechanisms of risk related to cognitive functioning may be operating for experimentation with legal drugs such as alcohol and tobacco, regular cigarette smoking, and problematic alcohol use.