Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder.

Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11 years old were screened for histories of childhood maltreatment, and SUD diagnoses were formulated in accordance with the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Lifetime history of problematic substance use was obtained for each parent at baseline. Childhood maltreatment predicted SUD outcome over and above that accounted for by childhood conduct disorder and problematic parental substance use, two potent predictors of adolescent SUDs.

A prospective look at substance use and criminal behavior in urban ADHD youth: what is the role of maltreatment history on outcome?

Children with attention-deficit/hyperactivity disorder (ADHD) are at heightened risk of antisocial behavior during adolescence/early adulthood. Here, we characterize the antisocial outcomes of a sample of urban, lower-socioeconomic-status, ethnically diverse ADHD youth and investigate the impact of maltreatment history on criminal and substance use disorder (SUD) outcomes. Ninety-eight participants diagnosed with ADHD in childhood were re-assessed 10 years later and compared with controls. Regression analyses investigated the effect of maltreatment on antisocial outcomes among four groups based on ADHD and maltreatment status. ADHD subjects and controls did not differ in rates of arrest, conviction, incarceration, or recidivism. ADHD youth were younger at their first arrest with higher rates of SUDs when compared to controls. Controls and ADHD subjects with maltreatment had significantly higher rates of SUDs compared to the no-ADHD/no-maltreatment group. Only ADHD youth with maltreatment had significantly higher rates of arrest than the reference group. In contrast to prior studies, ADHD youth did not differ from controls on most measures of antisocial behavior. Maltreatment increased the rate of arrest only among ADHD youth, though increased the rate of SUD for ADHD youth and controls. This suggests that ADHD youth, in the absence of maltreatment, are at no greater risk of SUDs or arrest than controls without maltreatment.

Childhood maltreatment and conduct disorder: independent predictors of criminal outcomes in ADHD youth.

OBJECTIVE: Children with attention-deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment in childhood and criminality as they enter into adolescence and early adulthood. Here, we investigated the effect of moderate to severe childhood maltreatment on later criminality among adolescents/young adults diagnosed with ADHD in childhood while accounting for the contributions of other known risk factors such as early conduct disorder (CD). METHODS: Eighty-eight participants from a longitudinal study of children diagnosed with ADHD and screened for comorbid disorders at age 7-11 years were assessed for maltreatment histories at the time of the 10-year adolescent follow-up. Detailed juvenile and adult criminal records were obtained from the New York State Division of Criminal Justice Services approximately 3-years after commencement of the follow-up study. We used regression analyses to determine predictors of adolescent/young adult criminal behavior. RESULTS: Moderate to severe childhood maltreatment increased the risk of adolescent/young adult arrest over and above the risk associated with childhood CD, while both childhood maltreatment and childhood CD significantly increased the risk of recidivism. ADHD youth classified as maltreated were three and a half times more likely to be arrested when compared to ADHD youth without a maltreatment classification. CONCLUSION: We established maltreatment as a risk factor for criminality in ADHD youth and demonstrated that this relationship was independent of the contributions of CD, and established risk factor for antisocial behavior in this population. The findings highlight the need for maltreatment screening in children with ADHD in order to identify those at heightened risk for criminal activity, and target treatment to improve outcome in this high-risk group of children.