Attention deficit hyperactivity disorder symptoms mediate early-onset smoking.

BACKGROUND/AIMS: Symptoms of attention deficit hyperactivity disorder (ADHD) have often been associated with early-onset smoking. We hypothesize that reductions in ADHD symptoms due to an intervention have a mediating effect on early-onset smoking. METHODS: In a universal, school-based, randomized controlled intervention trial, we examined whether intervention-induced reductions in ADHD symptoms at age 9 mediated the reduced risk of tobacco use onset among these children at age 10 or 11 years. A sample of 477 first-grade boys and girls were randomly assigned to the Good Behavior Game intervention (n = 263), a 2-year (grades 2 and 3) universal classroom-based intervention aimed at reducing disruptive behavior problems, or to a control condition (n = 214). ADHD symptoms were assessed through teacher ratings. Early onset of tobacco use was assessed through self-report. RESULTS: The intervention-induced reductions in ADHD symptoms fully mediated the distal effect of intervention on reductions in early-onset smoking. CONCLUSIONS: Our results showed that programs that target ADHD symptoms may protect children from early-onset smoking as well. Further research is needed to examine pathways from ADHD symptoms to tobacco use.

Determinants of self-reported emotional and behavioral problems in Turkish immigrant adolescents aged 11-18.

OBJECTIVE: The aim of this study was to determine how adolescent, parent, family and stress factors and parental psychopathology are associated with self-reported emotional and behavioral problems in Turkish immigrant adolescents. METHODS: Multiple logistic models were fitted to determine the associations between problems, assessed by the Youth Self-Report (n = 363), and determinants, derived from the Turkish Immigrant Assessment Questionnaire and the General Health Questionnaire-28 filled in by parents. RESULTS: Repeating a grade,not living with both parents, remarriage and death or serious health problems in the family were associated with higher YSR scores. Support from the mother's family was of major importance. The strongest predictive power was found for family-related factors in boys and for parent-related factors in girls. CONCLUSIONS: Cultural aspects and post-immigration issues play an important underlying role in explaining problem behavior in Turkish immigrant adolescents. Future research should include additional immigrant-specific factors, e. g., acculturation-related issues, preferably in a longitudinal study design to gain more insight into the complex relationship between immigrant status and psychopathology.