ADHD as a Risk Factor for Substance Use Disorder

Running head: ENGLISH ESSAY (RESEARCH PAPER)
English essay (research Paper)
Name of the Student
Name of the University
Author Note

1ENGLISH ESSAY (RESEARCH PAPER)
Introduction
In the 1960s, substance use among youth in the United States was on the rise and headed
toward its zenith in the late 1970s. In an effort to understand this trend, longitudinal studies of
children and adolescents were launched to uncover the possibility of early dispositional
vulnerabilities to later drug abuse. These studies improved upon the methodology limitations of
their less-compelling cross-sectional predecessors. Theories of drug addiction readily emerged to
emphasize the role of personality and temperament traits as well as the contribution of other
individual difference variables such as differential sensitivity to alcohol, cognitive factors, and
attitudes As studies of these contributing factors rapidly multiplied, findings revealed that drug
abuse vulnerability is multifaceted, with individual factors accounting for additive and
interactive influences on substance use initiation, escalation, and course (including progression
to addiction and sometimes recovery). One of these findings, replicated across many studies, is
the prediction of substance use from a constellation of temperament and personality traits that
overlap almost entirely with the defining symptoms of Attention-Deficit/Hyperactivity Disorder
(ADHD).
ADHD: history, definition, and course
ADHD has been variably named and defined over the past 60 years in which it has been
studied. In the 1960’s the terms “minimal brain damage or dysfunction” were commonly used to
describe the children, who would ultimately be labeled in Diagnostic and Statistical Manual of
Mental However, through the decades of research on diagnosis/identification and in all versions
of the DSM, the core characteristics of the disorder have been the same--levels of inattention,
impulsivity, and hyperactivity that were substantially different from typically developing

2ENGLISH ESSAY (RESEARCH PAPER)
children and that are accompanied by problems in daily living (impairment). Prior to the
publication of DSM III and beginning in the early 1960’s, ADHD was defined with child
behavior rating scales that included items reflecting the core characteristics of ADHD, conduct
problems and aggression, peer relationships, and internalizing problems. These scales included
the early Behavior Problem Checklist, the Connors Teacher Rating Scale (CTRS), and the Child
Behavior Checklist and were typically completed by parents or teachers or both. The developers
of these scales had started in part with item pools that were derived from clinic-based records of
children with behavior or emotional problems, were typically factor analyzed to produce scales,
and had response formats based on frequency or severity of behaviors. With respect to ADHD,
the one that became most commonly employed was the CTRS—particularly the short form or the
Abbreviated Conners.For more than a decade, a score of 15 on the ACTRS was the most
common way of diagnosing ADHD .
A child can meet criteria on the inattention list, the hyperactive/impulsive list, or both,
and be diagnosed with an inattentive (or impulsive) subtype or with a combined subtype. There
is debate regarding whether structured interviews with parents are needed to buttress parent and
teacher ratings, but the procedures for symptom counting are similar for interviews and rating
scales. It turns out that DSM symptom scales and the empirically derived scales that predated
DSM III are very highly correlated and identify the same children – particularly the combined
subtype, the most common diagnosis.
It is now well established that ADHD is a chronic condition that begins in early
childhood and continues through life. Indeed, the vast majority of children diagnosed with
ADHD continue to have symptoms of ADHD and related impairments into adulthood .There has
been debate about this point for some time, but recent longitudinal studies have made it clear that