Heterogeneous Trajectories of Problematic Alcohol Use, Depressive Symptoms, and their Co-Occurrence in Young Adults with and without Childhood ADHD.

Frances L Wang, Sarah L Pedersen, Bernie Devlin, Elizabeth M Gnagy, William E Pelham, Brooke S G Molina
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引用次数: 1

Abstract

The literature is inconsistent regarding whether childhood ADHD confers risk for adulthood problematic alcohol use, depressive symptoms, and their co-occurrence. These inconsistencies could be due to meaningful heterogeneity in the adulthood outcomes of children with ADHD that were obscured in traditional group-based analyses. The current study tested this possibility, as well as the contribution of adulthood ADHD symptom persistence, in order to clarify long-term risk in this population. Children diagnosed with ADHD and demographically-similar children without ADHD were followed longitudinally into adulthood and repeatedly assessed on heavy drinking, alcohol problems, and depressive symptoms from ages 21-29 (84.1% White (not Hispanic); 86.9% male; 51.2% childhood ADHD; 14.7% adulthood-persistent ADHD; N = 320). Group-based multi-trajectory modeling identified six groups with different combinations of trajectories across these variables. Heterogeneous longitudinal outcomes for those with ADHD were found. Some children with ADHD showed increased risk as typically predicted, with a higher likelihood of membership in a group with stable-moderate alcohol outcomes and stable-severe depression (adulthood persistent ADHD also predicted this group), whereas some children with ADHD were more likely to belong to a group with virtually no alcohol outcomes and low depression. Additionally, adulthood persistent ADHD predicted membership in a group with stable-severe alcohol outcomes and stable-moderate depression. Given the severity associated with co-occurring alcohol and depressive disorders, studies of early risk and protective factors and long-term outcomes for these disparate trajectory patterns are needed, particularly for those with childhood and persisting ADHD.

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问题酒精使用、抑郁症状的异质轨迹及其在有或没有儿童多动症的年轻人中的共现
关于儿童期ADHD是否会给成年期酗酒、抑郁症状及其共存带来风险,文献并不一致。这些不一致可能是由于ADHD儿童成年后的结果有意义的异质性,这在传统的基于群体的分析中被掩盖了。目前的研究测试了这种可能性,以及成年ADHD症状持续的贡献,以澄清这一人群的长期风险。被诊断为ADHD的儿童和人口统计学上相似的非ADHD儿童被纵向随访至成年,并在21-29岁期间反复评估重度饮酒、酒精问题和抑郁症状(白人(非西班牙裔)84.1%);男性86.9%;儿童ADHD占51.2%;14.7%为成人期持续性ADHD;n = 320)。基于组的多轨迹建模确定了六个组,这些组在这些变量之间具有不同的轨迹组合。ADHD患者的纵向结果存在差异。一些患有多动症的儿童表现出更高的风险,正如通常预测的那样,他们更有可能成为稳定-中度酒精结果和稳定-重度抑郁的一组成员(成年期持续的多动症也预测了这一组),而一些患有多动症的儿童更有可能属于几乎没有酒精结果和低抑郁的一组。此外,成年期持续的ADHD预示着一个有稳定-严重酒精后果和稳定-中度抑郁的群体的成员。鉴于酒精和抑郁症同时发生的严重性,需要对这些不同轨迹模式的早期风险和保护因素以及长期结果进行研究,特别是对那些儿童期和持续性多动症患者。
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期刊介绍: Research on Child and Adolescent Psychopathology brings together the latest innovative research that advances knowledge of psychopathology from infancy through adolescence. The journal publishes studies that have a strong theoretical framework and use a diversity of methods, with an emphasis on empirical studies of the major forms of psychopathology found in childhood disorders (e.g., disruptive behavior disorders, depression, anxiety, and autism spectrum disorder). Studies focus on the epidemiology, etiology, assessment, treatment, prognosis, and developmental course of these forms of psychopathology. Studies highlighting risk and protective factors; the ecology and correlates of children''s emotional, social, and behavior problems; and advances in prevention and treatment are featured. Research on Child and Adolescent Psychopathology is the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.
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