Relationship between problem gambling and substance use in a methadone maintenance population.

Few studies have examined the relationship between pathological gambling and substance abuse treatment outcome. This study assessed the gambling behavior of 62 patients enrolled in a methadone maintenance treatment program. Eleven (17.7%) met current SOGS criteria for probable pathological gambling. Patients with and without probable pathological gambling were compared on substance abuse treatment outcome measures including urine toxicology results for heroin and cocaine use, and clinic dropout. Results indicated that those who were probable pathological gamblers were more likely to use cocaine through therapy, and more likely to drop out of the clinic treatment program than nonpathological gamblers. Implications for substance abuse treatment are discussed.

Smoking patterns and abstinence effects in smokers with no ADHD, childhood ADHD, and adult ADHD symptomatology.

Cigarette smokers are known to be overrepresented among adults with Attention Deficit Hyperactivity Disorder (ADHD). To date, however, no attempt has been made to determine the extent to which a lifetime diagnosis of ADHD may be associated with smoking even in the absence of current symptomatology. We hypothesized that nicotine dependence and abstinence effects-especially effects relevant to ADHD symptomatology-would be more pronounced in adult ADHD smokers in comparison with those who reported childhood ADHD symptoms only. Results indicated that, in contrast to controls without ADHD symptomatology, both adult and childhood ADHD groups were significantly more likely to experience a number of nicotine withdrawal symptoms, including irritability and difficulty concentrating; in no instance did the ADHD groups differ from one another in this regard. Thus, studying people with childhood symptoms of ADHD, even in the absence of an adult diagnosis, may shed light on the known association between smoking and ADHD.

The Assessment of Hyperactivity and Attention (AHA): development and preliminary validation of a brief self-assessment of adult ADHD.

A brief self-rating scale, the Assessment of Hyperactivity and Attention (AHA), was developed and validated using a "gold standard" DSM-based semi-structured interview. The sample consisted of 101 smokers (74% male, 73% Caucasian)-38.6% with no DSM-IV ADHD diagnosis, 10.9% with a childhood diagnosis only, and 50.5% with an adult diagnosis (requiring childhood diagnosis as well). The mean age SD was 33.7 9.7; participants smoked a mean of 19.0 5.6 cigarettes/day. Results indicate that the AHA has utility as a screening tool and as a self-report assessment of ADHD with sensitivity of .80, specificity of .60, positive predictive power of .67, negative predictive power of .75, kappa of .40, odds ratio of 6.15, and an area under the curve (receiver operating characteristic analysis) of .79. Given the high rate of ADHD among smokers, the AHA may be useful in identifying smokers who may need more in-depth clinical evaluation for attentional problems.