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

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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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  • 07 September 2020

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Funding

This research was principally supported by AA011873 (Molina) and DA12414 (Pelham). Support was also provided by AA00202 (Molina), AA007453 (Molina, Richardson).

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Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St., Pittsburgh, PA, 15213, USA

    Frances L. Wang, Sarah L. Pedersen, Bernie Devlin & Brooke S.G. Molina

  2. Department of Psychology, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL, 33199, USA

    Elizabeth M. Gnagy & William E. Pelham Jr

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  1. Frances L. Wang
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  2. Sarah L. Pedersen
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  3. Bernie Devlin
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  4. Elizabeth M. Gnagy
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  5. William E. Pelham Jr
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  6. Brooke S.G. Molina
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Contributions

Conceptualization: Frances Wang, Brooke Molina, Sarah Pedersen; Formal Analysis: Frances Wang and Bernie Devlin; Data Curation: Elizabeth Gnagy; Funding Acquisition: Brooke Molina, Sarah Pedersen, William Pelham Jr.; Writing-Original Draft: Frances Wang; Writing: Review & Editing: Frances Wang, Brooke Molina, Sarah Pedersen, Bernie Devlin, Elizabeth Gnagy.

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Correspondence to Frances L. Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (University of Pittsburgh Institutional Review Board, #970723) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Wang, F.L., Pedersen, S.L., Devlin, B. et al. Heterogeneous Trajectories of Problematic Alcohol Use, Depressive Symptoms, and their Co-Occurrence in Young Adults with and without Childhood ADHD. J Abnorm Child Psychol 48, 1265–1277 (2020). https://doi.org/10.1007/s10802-020-00675-y

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