The indirect effects of childhood attention deficit hyperactivity disorder on alcohol problems in adulthood through unique facets of impulsivity: Alcohol problems, impulsivity and ADHD
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BACKGROUND AND AIMS: Research has not studied unique impulsivity dimensions as prospective links between childhood attention deficit hyperactivity disorder (ADHD) and alcohol problems. We examined the association between childhood ADHD, five facets of impulsivity and alcohol problems in adulthood and the indirect effects of childhood ADHD-to-impulsivity-to-alcohol problems. DESIGN, SETTING AND PARTICIPANTS: Participants were from a longitudinal study (n = 289, meanage = 28.67) of individuals with (n = 170) and without (n = 119) childhood ADHD. The ADHD sample, as part of an ADHD summer treatment program, was diagnosed initially in childhood (1987-96, Pittsburgh, PA, USA) via structured parent interview and standardized parent/teacher ratings. The ADHD sample and demographically similar individuals without ADHD (living in the greater Pittsburgh area) were recruited to participate in the Pittsburgh ADHD Longitudinal Study (PALS) between 1999 and 2003. MEASUREMENTS: Self-reported impulsivity (UPPS-P) and alcohol-related problems were assessed in adulthood (2011-14). FINDINGS: Adults with, compared with those without, childhood ADHD had more alcohol problems (β = 0.34, P < 0.05) and higher levels of negative urgency, positive urgency, lack of perseverance and lack of planning (βs = 0.24-0.31, Ps < 0.001). Impulsivity facets (except sensation-seeking) were related to number of alcohol problems (βs = 0.34-0.61, Ps < 0.05). Negative (β = 0.26, P < 0.01) and positive (β = 0.27, P < 0.01) urgency mediated the association between childhood ADHD and number of adult alcohol problems. CONCLUSIONS: Elevated levels of emotional impulsivity (negative/positive urgency) may place children with attention deficit hyperactivity disorder at increased risk for alcohol problems in adulthood.
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Adult ADHD is robustly associated with impulsivity components including Negative Urgency, Lack of Perseverance, and Lack of Planning.
“Studies of adult ADHD suggest robust associations with components of impulsivity (Lynam et al., 2006), including Negative Urgency (negative affect-driven rash action), Lack of Perseverance (inability to persist on a task through completion), and Lack of Planning (action without careful thinking; Miller et al., 2010; Pedersen et al., 2016; reviewed by Berg et al., 2015)”
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- Authors
- Pedersen, S. L., Walther, C. A. P., Harty, S. C., Gnagy, E. M., Pelham, W. E., & Molina, B. S. G.
- Affiliations
- University of Pittsburgh (US)
- University of Houston - Clear Lake (US)
- Chatham University (US)
- Florida International University (US)
- Corresponding author
- Pedersen, Sarah L.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2016-06-08
- Volume
- 111
- Issue
- 9
- Pages
- 1582-1589
- ISSN
- 0965-2140 (ISSN-L)
- PMC
- PMC4983236
- OpenAlex
- W2409180639
- Cited by
- 64
- References
- 28
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 5 · 2021: 11 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 4 · 2016: 3
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (AA011873, AA00202 and K01 AA021135)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- alcohol problems, impulsivity, negative urgency, positive urgency, emotional impulsivity, lack of perseverance, lack of planning, sensation seeking, UPPS-P, mediation, adult alcohol use
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Impulsive Behavior, Longitudinal Studies, Male, Prospective Studies, United States, Case-Control Studies, Alcohol-Related Disorders, Young Adult
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