Tandon Mini, Tillman Rebecca, Spitznagel Edward, Luby Joan
Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110.
Department of Mathematics, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130.
Addict Res Theory. 2014 Jun 1;22(3):239-250. doi: 10.3109/16066359.2013.830713.
The study examined factors in the risk trajectory for Substance Use Disorder (SUD) over a 10-12 year period in children with ADHD.
N=145 children between the ages of 7 and 16 with ADHD and healthy controls were assessed every 2 years for 10-12 years as part of a larger, longitudinal investigation. Onset of substance use disorder was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors.
Low paternal warmth and maternal SUD were predictors of SUD in n=59 ADHD participants after adjusting for gender, child ODD, paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder (MDD), maternal/paternal anxiety, and low maternal warmth in the Cox model.
Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted.
本研究考察了注意力缺陷多动障碍(ADHD)儿童在10至12年期间物质使用障碍(SUD)风险轨迹中的相关因素。
作为一项更大规模纵向研究的一部分,对145名年龄在7至16岁之间的ADHD儿童及健康对照进行了为期10至12年、每两年一次的评估。使用Cox比例风险模型考察物质使用障碍的发病情况,纳入的因素包括儿童和父母的精神病理学状况、父母的温情以及其他关键因素。
在Cox模型中,在对性别、儿童对立违抗障碍(ODD)、父亲的物质使用障碍、母亲/父亲的ADHD、母亲/父亲的重度抑郁症(MDD)、母亲/父亲的焦虑症以及母亲的低温情进行校正后,父亲温情较低和母亲的物质使用障碍是59名ADHD参与者中物质使用障碍的预测因素。
纵向研究结果表明,除了ADHD和母亲的物质使用障碍在儿童物质使用障碍发展过程中已确定的风险外,父亲温情较低也与物质使用障碍的发病有关。在控制了相关的父母和儿童精神病理学因素后,这一点很明显。这些发现表明,父亲温情作为预防ADHD儿童物质使用障碍新干预措施的关键靶点值得进一步研究。现在有必要进行更有针对性的调查,除了父母和儿童精神病理学因素外,还要考察从ADHD到物质使用障碍风险轨迹中的父亲养育因素。