Developmental Trajectories of ADHD Symptoms to Adolescent Substance Use: What Influence Do Peer, Family and Neighborhood Factors Have?

Attention-Deficit/Hyperactivity Disorder (ADHD) has been consistently linked to risk for early substance use. However, the potential mediating mechanisms and moderators of this association remain unclear. The current study examined peer rejection, school bonding and internalizing problems as potential mediators of the association between childhood ADHD symptoms and adolescent substance use in a longitudinal study following children from fourth to ninth grade. Results suggest that ADHD symptoms follow a path to early initiation of tobacco use through the combined effects of peer rejection and internalizing problems as well as through internalizing problems alone. ADHD symptoms did not follow developmental pathways to overall frequency of substance use or initiation of alcohol or marijuana use. Neighborhood problems, family activities and parenting styles did not moderate the developmental pathways from ADHD symptoms to substance use frequency. Results identify important development factors in children with ADHD symptoms that highlight the need for primary prevention and psychological interventions that target these factors and thus minimize substance use during adolescence.