Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

Irene J. Elkins, Gretchen R.B. Saunders, Stephen M. Malone, Sylia Wilson, Matt McGue, William G. Iacono

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: We examined whether increased risk for adolescent tobacco and marijuana problems associated with childhood ADHD is explained by key intermediary influences during adolescence and differs by gender. Methods: Longitudinal structural equation models examined mediating effects on problems with both substances (or each substance separately) through age-14 peer impairment, internalizing, and adolescent ADHD symptoms in two twin samples, prospectively assessed since age 11 (N = 2,164). Whether these mediators contributed beyond mediating effects of early-adolescent substance use was also considered. Twin difference analyses further illuminated which mediators might be potentially causal. Results: Direct effects of childhood ADHD on age-17 tobacco and marijuana problems (i.e., independent of included mediators) as well as effects of adolescent ADHD symptoms were significant only for females. By contrast, mediation by peer impairment, evident particularly for marijuana, was relatively stronger for males than females. Depression and anxiety were not prospectively associated with age-17 substance problems when earlier substance problems were considered. Consistent with causal influence of early substance use on later problems, monozygotic twins with more severe tobacco or marijuana problems at age 14 than their co-twins were also more likely to have substance problems later in adolescence. Conclusions: Mediation through peer impairment, continued presence of ADHD symptoms, and early substance use may alter development so that childhood ADHD indirectly contributes to problems with tobacco and marijuana. Targeting gender-sensitive interventions prior to mid-adolescence, before these patterns become established, is essential.

Original languageEnglish (US)
Pages (from-to)1083-1093
Number of pages11
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Volume59
Issue number10
DOIs
StatePublished - Oct 2018

Fingerprint

Cannabis
Tobacco
Monozygotic Twins
Structural Models
Anxiety
Depression

Keywords

  • ADHD
  • gender difference
  • longitudinal studies
  • substance use
  • twins

Cite this

@article{106f37fc00b7427bb8c1d6406fb2e3e0,
title = "Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems: roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender",
abstract = "Background: We examined whether increased risk for adolescent tobacco and marijuana problems associated with childhood ADHD is explained by key intermediary influences during adolescence and differs by gender. Methods: Longitudinal structural equation models examined mediating effects on problems with both substances (or each substance separately) through age-14 peer impairment, internalizing, and adolescent ADHD symptoms in two twin samples, prospectively assessed since age 11 (N = 2,164). Whether these mediators contributed beyond mediating effects of early-adolescent substance use was also considered. Twin difference analyses further illuminated which mediators might be potentially causal. Results: Direct effects of childhood ADHD on age-17 tobacco and marijuana problems (i.e., independent of included mediators) as well as effects of adolescent ADHD symptoms were significant only for females. By contrast, mediation by peer impairment, evident particularly for marijuana, was relatively stronger for males than females. Depression and anxiety were not prospectively associated with age-17 substance problems when earlier substance problems were considered. Consistent with causal influence of early substance use on later problems, monozygotic twins with more severe tobacco or marijuana problems at age 14 than their co-twins were also more likely to have substance problems later in adolescence. Conclusions: Mediation through peer impairment, continued presence of ADHD symptoms, and early substance use may alter development so that childhood ADHD indirectly contributes to problems with tobacco and marijuana. Targeting gender-sensitive interventions prior to mid-adolescence, before these patterns become established, is essential.",
keywords = "ADHD, gender difference, longitudinal studies, substance use, twins",
author = "Elkins, {Irene J.} and Saunders, {Gretchen R.B.} and Malone, {Stephen M.} and Sylia Wilson and Matt McGue and Iacono, {William G.}",
year = "2018",
month = "10",
doi = "10.1111/jcpp.12977",
language = "English (US)",
volume = "59",
pages = "1083--1093",
journal = "Journal of Child Psychology and Psychiatry and Allied Disciplines",
issn = "0021-9630",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Mediating pathways from childhood ADHD to adolescent tobacco and marijuana problems

T2 - roles of peer impairment, internalizing, adolescent ADHD symptoms, and gender

AU - Elkins, Irene J.

AU - Saunders, Gretchen R.B.

AU - Malone, Stephen M.

AU - Wilson, Sylia

AU - McGue, Matt

AU - Iacono, William G.

PY - 2018/10

Y1 - 2018/10

N2 - Background: We examined whether increased risk for adolescent tobacco and marijuana problems associated with childhood ADHD is explained by key intermediary influences during adolescence and differs by gender. Methods: Longitudinal structural equation models examined mediating effects on problems with both substances (or each substance separately) through age-14 peer impairment, internalizing, and adolescent ADHD symptoms in two twin samples, prospectively assessed since age 11 (N = 2,164). Whether these mediators contributed beyond mediating effects of early-adolescent substance use was also considered. Twin difference analyses further illuminated which mediators might be potentially causal. Results: Direct effects of childhood ADHD on age-17 tobacco and marijuana problems (i.e., independent of included mediators) as well as effects of adolescent ADHD symptoms were significant only for females. By contrast, mediation by peer impairment, evident particularly for marijuana, was relatively stronger for males than females. Depression and anxiety were not prospectively associated with age-17 substance problems when earlier substance problems were considered. Consistent with causal influence of early substance use on later problems, monozygotic twins with more severe tobacco or marijuana problems at age 14 than their co-twins were also more likely to have substance problems later in adolescence. Conclusions: Mediation through peer impairment, continued presence of ADHD symptoms, and early substance use may alter development so that childhood ADHD indirectly contributes to problems with tobacco and marijuana. Targeting gender-sensitive interventions prior to mid-adolescence, before these patterns become established, is essential.

AB - Background: We examined whether increased risk for adolescent tobacco and marijuana problems associated with childhood ADHD is explained by key intermediary influences during adolescence and differs by gender. Methods: Longitudinal structural equation models examined mediating effects on problems with both substances (or each substance separately) through age-14 peer impairment, internalizing, and adolescent ADHD symptoms in two twin samples, prospectively assessed since age 11 (N = 2,164). Whether these mediators contributed beyond mediating effects of early-adolescent substance use was also considered. Twin difference analyses further illuminated which mediators might be potentially causal. Results: Direct effects of childhood ADHD on age-17 tobacco and marijuana problems (i.e., independent of included mediators) as well as effects of adolescent ADHD symptoms were significant only for females. By contrast, mediation by peer impairment, evident particularly for marijuana, was relatively stronger for males than females. Depression and anxiety were not prospectively associated with age-17 substance problems when earlier substance problems were considered. Consistent with causal influence of early substance use on later problems, monozygotic twins with more severe tobacco or marijuana problems at age 14 than their co-twins were also more likely to have substance problems later in adolescence. Conclusions: Mediation through peer impairment, continued presence of ADHD symptoms, and early substance use may alter development so that childhood ADHD indirectly contributes to problems with tobacco and marijuana. Targeting gender-sensitive interventions prior to mid-adolescence, before these patterns become established, is essential.

KW - ADHD

KW - gender difference

KW - longitudinal studies

KW - substance use

KW - twins

UR - http://www.scopus.com/inward/record.url?scp=85053798586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053798586&partnerID=8YFLogxK

U2 - 10.1111/jcpp.12977

DO - 10.1111/jcpp.12977

M3 - Article

C2 - 30255500

AN - SCOPUS:85053798586

VL - 59

SP - 1083

EP - 1093

JO - Journal of Child Psychology and Psychiatry and Allied Disciplines

JF - Journal of Child Psychology and Psychiatry and Allied Disciplines

SN - 0021-9630

IS - 10

ER -