Van Eck Kathryn, Markle Robert S, Dattilo Lauren, Flory Kate
Division of Child & Adolescent Psychiatry, School of Medicine, University of Maryland.
Department of Psychology, University of South Carolina.
Psychol Addict Behav. 2014 Jun;28(2):431-42. doi: 10.1037/a0036226.
Although extensive research suggests that attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP; symptoms of oppositional defiant disorder, conduct disorder, and antisocial personality disorder) contribute to risk for substance use, why these symptoms increase risk for substance use remains unclear. Given that research indicates that perceived peer tolerance and perceived peer substance use affect substance use, we evaluated the degree to which these peer-perception constructs mediated the association that ADHD symptoms, CP symptoms, and their interaction share with substance use (i.e., alcohol use, marijuana use, and illicit drug use). Participants were college students (N = 627; 60% female; 47% European American) with a mean age of 20.23 years. Results indicated that perceived peer use significantly mediated the association of ADHD symptoms with alcohol, marijuana, and illicit drug use, whereas perceived peer use only mediated the association between CP symptoms and alcohol use. Perceived peer tolerance significantly mediated the association that both CP and ADHD symptoms had with marijuana use, but not alcohol or illicit drug use. Finally, CP symptoms moderated the indirect effect that ADHD symptoms had on alcohol use through perceived peer tolerance. At low levels of CP symptoms, increases in ADHD symptoms corresponded to increases in perceived peer tolerance, which was related to increased alcohol use. However, at high levels of CP symptoms, increases in ADHD symptoms corresponded to decreases in perceived peer tolerance, which was associated with decreased alcohol use. Implications of findings are discussed.
尽管大量研究表明注意力缺陷多动障碍（ADHD）和品行问题（CP；对立违抗障碍、品行障碍和反社会人格障碍的症状）会增加物质使用的风险，但这些症状为何会增加物质使用风险仍不清楚。鉴于研究表明同伴的可接受度和同伴的物质使用认知会影响物质使用，我们评估了这些同伴认知因素在多大程度上介导了ADHD症状、CP症状及其相互作用与物质使用（即酒精使用、大麻使用和非法药物使用）之间的关联。参与者为大学生（N = 627；60%为女性；47%为欧裔美国人），平均年龄为20.23岁。结果表明，同伴使用认知显著介导了ADHD症状与酒精、大麻和非法药物使用之间的关联，而同伴使用认知仅介导了CP症状与酒精使用之间的关联。同伴可接受度认知显著介导了CP症状和ADHD症状与大麻使用之间的关联，但未介导与酒精或非法药物使用之间的关联。最后，CP症状调节了ADHD症状通过同伴可接受度认知对酒精使用产生的间接影响。在CP症状水平较低时，ADHD症状的增加与同伴可接受度认知的增加相对应，这与酒精使用的增加有关。然而，在CP症状水平较高时，ADHD症状的增加与同伴可接受度认知的降低相对应，这与酒精使用的减少有关。本文讨论了研究结果的意义。
