TY - JOUR
T1 - Attention-deficit/hyperactivity disorder subtypes in adolescents with comorbid substance-use disorder
AU - Tamm, Leanne
AU - Adinoff, Bryon
AU - Nakonezny, Paul A.
AU - Winhusen, Theresa
AU - Riggs, Paula
N1 - Funding Information:
A study performed in the Clinical Trials Network (CTN) funded by the National Institute on Drug Abuse entitled Osmotic-Release Methylphenidate (OROS-MPH) for ADHD in Adolescents with SUD (CTN0028) evaluated the efficacy of OROS-MPH, relative to placebo, in treating ADHD and decreasing substance use in adolescents with ADHD-SUD. All participants received weekly cognitive behavioral therapy (CBT) focusing on SUD. CBT consisted of approximately one 60-minute session per week during study weeks 1–16 and focused on the treatment of the adolescent’s SUD. The CBT manual utilized was based a manual that was developmentally adapted for adolescents from a standard, published, empirically supported adult CBT manual (17). It was not adapted for ADHD. Motivational enhancement techniques were used in conjunction with behavioral and cognitive behavioral techniques to help adolescents reduce their drug use by improving coping strategies and problem-solving and decision-making skills. Results of the primary study showed that both medication and placebo groups had significant reductions in ADHD and substance-use outcomes and will be reported elsewhere (18). The study provides an excellent opportunity to investigate the ADHD subtypes in a comorbid ADHD-SUD population.
Funding Information:
Dr. Riggs is supported by grants U10 DA012732 and NIDA K12 DA 000357; Dr. Adinoff by grants U10 DA012732 and CTN U10DA020024; and Dr. Winhusen by grant U10-DA013732.
PY - 2012/1
Y1 - 2012/1
N2 - Background: Little is known about the relationship between attention-deficit/hyperactivity disorder (ADHD) subtypes and substance-use disorder (SUD). As there is literature suggesting different subtype phenotypes, there may be subtype differences in regard to the risk for developing SUD and substance treatment response. Objectives: To characterize the sample in a Clinical Trials Network (CTN) study according to ADHD subtypes and baseline psychosocial and substance-use characteristics and to compare subtypes on response to treatment. Methods: Secondary analyses on data collected from adolescents (n = 276) diagnosed with ADHD and SUD (non-nicotine) and treated with stimulant medication or placebo and cognitive behavioral therapy (CBT) for substance use. Participants were characterized as inattentive or combined ADHD subtype and compared on baseline characteristics and treatment outcome. Results: The combined subtype presented with more severe SUDs and higher rates of conduct disorder. There were a greater proportion of boys with inattentive subtype. The inattentive subtype appeared less ready for treatment (greater University of Rhode Island Change Assessment precontemplation scores) with poorer coping skills (poorer problem-solving and abstinence focused coping) at baseline. However, the two subtypes responded equally to treatment even after controlling for baseline differences. Conclusions: Findings from this large community sample indicate that there were no subtype differences in treatment response, although there were differences in terms of substance use, antisocial behavior, readiness for treatment, and gender prior to treatment. Scientific Significance: This study is the first to report on subtype differences for treatment response for non-nicotine SUD in a comorbid ADHD-SUD population. Despite some baseline differences, both subtypes responded equally to treatment, suggesting limited relevance for subtype designation on treatment planning.
AB - Background: Little is known about the relationship between attention-deficit/hyperactivity disorder (ADHD) subtypes and substance-use disorder (SUD). As there is literature suggesting different subtype phenotypes, there may be subtype differences in regard to the risk for developing SUD and substance treatment response. Objectives: To characterize the sample in a Clinical Trials Network (CTN) study according to ADHD subtypes and baseline psychosocial and substance-use characteristics and to compare subtypes on response to treatment. Methods: Secondary analyses on data collected from adolescents (n = 276) diagnosed with ADHD and SUD (non-nicotine) and treated with stimulant medication or placebo and cognitive behavioral therapy (CBT) for substance use. Participants were characterized as inattentive or combined ADHD subtype and compared on baseline characteristics and treatment outcome. Results: The combined subtype presented with more severe SUDs and higher rates of conduct disorder. There were a greater proportion of boys with inattentive subtype. The inattentive subtype appeared less ready for treatment (greater University of Rhode Island Change Assessment precontemplation scores) with poorer coping skills (poorer problem-solving and abstinence focused coping) at baseline. However, the two subtypes responded equally to treatment even after controlling for baseline differences. Conclusions: Findings from this large community sample indicate that there were no subtype differences in treatment response, although there were differences in terms of substance use, antisocial behavior, readiness for treatment, and gender prior to treatment. Scientific Significance: This study is the first to report on subtype differences for treatment response for non-nicotine SUD in a comorbid ADHD-SUD population. Despite some baseline differences, both subtypes responded equally to treatment, suggesting limited relevance for subtype designation on treatment planning.
KW - ADHD combined subtype
KW - ADHD inattentive subtype
KW - Substance-use disorder
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U2 - 10.3109/00952990.2011.600395
DO - 10.3109/00952990.2011.600395
M3 - Article
C2 - 21834613
AN - SCOPUS:84857623319
SN - 0095-2990
VL - 38
SP - 93
EP - 100
JO - American Journal of Drug and Alcohol Abuse
JF - American Journal of Drug and Alcohol Abuse
IS - 1
ER -