Bidwell L C, Henry E A, Willcutt E G, Kinnear M K, Ito T A
Center for Alcohol and Addition Studies, Department of Psychiatry and Human Behavior, Brown University, Box G-S121-4, Providence, RI 02912, United States; Rhode Island Hospital, Department of Psychiatry, Division of Behavioral Genetics, 1 Hoppin Street, Providence, RI 02903, United States.
Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, United States.
Drug Alcohol Depend. 2014 Feb 1;135:88-94. doi: 10.1016/j.drugalcdep.2013.11.013. Epub 2013 Nov 25.
Numerous studies have shown that attention deficit/hyperactivity disorder (ADHD) is associated higher risk of cannabis use disorders (CUD). However, these studies are limited in that most did not: (a) differentiate the role of hyperactivity-impulsivity (HI) and inattention (IN); (b) control for associated psychopathology; and (c) consider more fine-grained CUD-related measures. Our aim was to clarify the unique and interactive contributions of inattention and hyperactivity symptoms to age of cannabis initiation and DSM-IV cannabis dependence, craving, and severity of problems related to cannabis use while statistically controlling for symptoms of comorbid psychopathology in a non-clinical sample of young adults.
Cannabis variables, current use of cigarettes and alcohol, current and childhood ADHD, and comorbid internalizing and externalizing psychopathology were assessed in 376 male and female undergraduates.
Results indicate that current and childhood IN were independently associated with more severe cannabis use, craving, and problem use-related outcomes in young adulthood (p's<.01) and that childhood HI symptoms were associated with earlier initiation of cannabis (p<.01). Further, current IN symptoms moderated the relationships between level of use and more severe outcomes (p's<.01), such that higher IN strengthened positive associations among use and problem cannabis use. Associations with ADHD symptom dimensions and current use of alcohol and cigarettes were also present.
Thus, current and childhood inattention symptoms as well as childhood hyperactive-impulsive symptoms emerged as significant factors in cannabis-related outcomes in young adults, even after statistically controlling for important confounding variables.
大量研究表明，注意力缺陷/多动障碍（ADHD）与大麻使用障碍（CUD）的风险较高相关。然而，这些研究存在局限性，因为大多数研究没有：（a）区分多动冲动（HI）和注意力不集中（IN）的作用；（b）控制相关的精神病理学因素；（c）考虑更细化的与CUD相关的测量指标。我们的目的是在对非临床样本的年轻成年人的共病精神病理学症状进行统计控制的同时，阐明注意力不集中和多动症状对大麻使用起始年龄、DSM-IV大麻依赖、渴望以及与大麻使用相关问题严重程度的独特和交互作用。
对376名男女本科生评估了大麻变量、当前香烟和酒精使用情况、当前和童年期的ADHD以及共病的内化和外化精神病理学症状。
结果表明，当前和童年期的注意力不集中与年轻成年期更严重的大麻使用、渴望以及与问题使用相关的结果独立相关（p值<0.01），童年期的多动冲动症状与更早开始使用大麻相关（p<0.01）。此外，当前的注意力不集中症状调节了使用水平与更严重结果之间的关系（p值<0.01），即更高的注意力不集中强化了使用与问题大麻使用之间的正相关。还存在与ADHD症状维度以及当前酒精和香烟使用的关联。
因此，即使在对重要的混杂变量进行统计控制之后，当前和童年期的注意力不集中症状以及童年期的多动冲动症状仍是年轻成年人中与大麻相关结果的重要因素。
