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Child /Adolescent - ADHD

(PS1-68) Impact of ADHD Symptomatology on Adolescent Alcohol Use Expectancies

Friday, November 15, 2024
8:30 AM – 9:30 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown

    Author(s)

  • SA

    Samuel O. Agbeh, B.A.

    Research Assistant
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • OW

    Owen Winters, B.A.

    Research Assistant
    Medical University of South Carolina
    Charleston, South Carolina, United States

    • Co-Author(s)

  • RG

    Rejoyce Green, Ph.D.

    Research Assistant Professor
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • PF

    Pamela Ferguson, Ph.D.

    Director of Planning and Research
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • KG

    Kevin Gray, Ph.D.

    Professor
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • LS

    Lindsay Squeglia, Ph.D.

    Professor
    Medical University of South Carolina
    Charleston, South Carolina, United States

Abstract Text: Adolescents with attention-deficit hyperactivity disorder (ADHD) are at greater risk for hazardous alcohol use compared to their peers without ADHD. Positive or negative beliefs about substance use may predict future use. ADHD may impact expectancies about alcohol use; however, few studies have prospectively examined the causal relationship between ADHD and alcohol use expectancies among adolescents. The present study included 9,744 substance naïve youth from the Adolescent Brain Cognitive Development (ABCD) study. We used causal mediation analysis to examine whether parent-reported symptoms of internalizing disorders and externalizing disorders at age ~12 mediated the relationship between baseline (age ~10) ADHD diagnosis and positive and negative expectancies about alcohol at age ~13. The Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) was used to diagnose ADHD and the Child Behavior Checklist (CBCL) was used to capture internalizing and externalizing disorders. Average causal mediation effect (ACME) was examined as our indicator of the presence of causal mediation. At baseline, 681 (7.0%) of youth met diagnostic criteria for ADHD. The results showed that symptoms of internalizing disorders significantly mediated the relationship between baseline ADHD and positive alcohol expectancies (ACME: 0.06, 95% CI = 0.06 – 0.07). Adolescents with an ADHD diagnosis had greater internalizing disorder symptoms (B = 3.73, p < .01), and greater internalizing disorder symptoms predicted greater positive alcohol expectancies (B = 0.02, p < .01). Symptoms of externalizing disorders significantly mediated the relationship between baseline ADHD and negative alcohol expectancies (ACME: -0.06, 95% CI = -0.07 – -0.06). Adolescents with an ADHD diagnosis had greater externalizing disorder symptoms (B = 5.49, p < .01), and greater externalizing disorder symptoms were associated with fewer negative alcohol expectancies (B = -0.01, p = .03). Symptoms of internalizing and externalizing disorders may serve as an indirect pathway through which ADHD increases positive and decreases negative expectancies about alcohol use. As beliefs about alcohol may serve as a highly proximal risk factor for initiation, identifying paths through which ADHD may alter expectancies about alcohol use may provide additional targets for prevention and early interventions.