Impulsive Personality Traits Mediate the Relationship Between Adult Attention-Deficit/Hyperactivity Symptoms and Alcohol Dependence Severity

Alcohol Clin Exp Res. 2018 Jan;42(1):173-183. doi: 10.1111/acer.13538. Epub 2017 Nov 27.

Abstract

Background: While the role of attention-deficit/hyperactivity disorder (ADHD) as a risk factor for developing alcohol use disorder (AUD) has been established, the underlying pathways connecting the two are still not fully understood. Overlapping constructs such as impulsivity may explain the increased risk for developing AUD in individuals with ADHD.

Methods: In this study, we assessed whether adult ADHD symptoms increase the odds of having a diagnosis of AUD. Furthermore, we tested whether facets of impulsivity explained the relationship between ADHD symptoms and alcohol dependence (AD) severity.

Results: In a logistic regression of 749 participants (464 = AD, 285 = controls), overall adult ADHD symptoms, and more specifically, symptoms of hyperactivity/restlessness and problems with self-concept, increased the odds of having a diagnosis of AD. Within the AD sample, we found that impulsivity mediated the relationship between adult ADHD symptoms and AD severity. In particular, negative and positive urgency meditated the relationship of overall adult ADHD symptoms, and symptoms of hyperactivity/restlessness and problems with self-concept with AD severity.

Conclusions: These results highlight the importance of looking at cohorts of ADHD symptoms and facets of impulsivity to assess the risk of developing AUD. They also suggest potential avenues for intervention strategies in individuals with preexisting adult ADHD symptoms who are seeking treatment for AUD.

Keywords: Alcohol Use Disorder; Attention-Deficit/Hyperactivity Disorder; Impulsivity.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology
  • Alcoholism / psychology*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Impulsive Behavior* / physiology
  • Male
  • Middle Aged
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology
  • Personality Disorders / psychology*
  • Psychomotor Agitation / diagnosis
  • Psychomotor Agitation / epidemiology
  • Psychomotor Agitation / psychology*
  • Severity of Illness Index*
  • Young Adult