Search

Black drinkers experience more alcohol problems compared to White drinkers at comparable levels of alcohol use (Mulia et al., 2009; Witbrodt et al., 2014; Zapolski et al., 2014). Research has found that Black compared to White drinkers endorse drinking to cope more frequently via retrospective report (Bradizza et al., 1999; Cooper et al., 2008). Additional research is needed to understand contributors to these racial differences. The primary aim of the present study was to examine how quality and frequency of cross-group contact at work and/or school relates to experiencing discrimination and, in turn, drinking to cope. Seventy-two young adult drinkers (Mage = 25, 72% female, 28% male; 64% Black, 36% White) completed baseline questionnaires and a subset (n = 50) completed a 17-day ecological momentary assessment (EMA) protocol. Cross-group contact frequency and quality was assessed at baseline while discrimination and coping motives were assessed via retrospective report at baseline and acutely via EMA. Accounting for sociodemographic covariates, path analyses utilizing retrospective measures revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact and discrimination experiences related to assumptions of inferiority. Identical path analyses utilizing the acute EMA data revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact. Improving cross-group contact at work and school may reduce drinking to cope. Additional research examining multiple domains of discrimination, quality of cross-group contact, and alcohol problems over time is needed to further understanding of social determinants of health inequities in alcohol problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

To test whether adolescents' perceived ADHD symptoms may improve while monitoring them throughout the day.In a sample of 90 adolescents (Multilevel regression analyses showed that, on average, adolescents' perceived ADHD symptoms (inattention, hyperactivity, impulsivity, and total across domains) decreased across 17 days of EMA. Within person, symptoms were lower following completed versus missed EMA surveys. Significant moderating effects showed that the effect of completing the prior EMA survey weakened across the day and over the course of the 17 days.This study is the first to document acute improvements in self-rated ADHD symptoms using EMA in adolescents' naturalistic environments. Symptom monitoring throughout the day may help adolescents improve their day-to-day ADHD, at least acutely, and holds promise as one component of mobile-health ADHD interventions.

OBJECTIVE: It is estimated that childhood ADHD remits by adulthood in approximately 50% of cases; however, this conclusion is typically based on single endpoints, failing to consider longitudinal patterns of ADHD expression. We investigated the extent to which children with ADHD experience recovery and variable patterns of remission by adulthood. METHOD: Children with ADHD (N=558) in the Multimodal Treatment Study of ADHD (MTA) were administered eight assessments from 2-year (M age=10.44) to 16-year follow-up (M age=25.12). We identified participants with fully remitted, partially remitted, and persistent ADHD at each timepoint based on parent, teacher, and self-reports of ADHD symptoms and impairment, treatment utilization, and substance use and mental disorders. Longitudinal patterns of remission and persistence were identified that considered context and timing. RESULTS: Approximately 30% of children with ADHD experienced full remission at some point during the 14-year follow-up period; however, a majority (60% of these) experienced recurrence of ADHD after the initial period of remission. Only 9.1% of the sample demonstrated recovery (sustained remission) by study endpoint and only 10.8% demonstrated stable ADHD persistence across study timepoints. Instead, most participants with ADHD (63.8%) had fluctuating periods of remission and recurrence over time. CONCLUSIONS: The MTA findings challenge the notion that approximately 50% of children with ADHD outgrow the disorder by adulthood. Most cases demonstrated fluctuating symptoms between childhood and young adulthood. Although intermittent periods of remission can be expected in most cases, 90% of children with ADHD continued to struggle with residual ADHD through young adulthood. Clinical Trial Number: NCT00000388, Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (MTA). https://clinicaltrials.gov/ct2/show/NCT00000388

Longitudinal observational data pose a challenge for causal inference when the exposure of interest varies over time alongside time-dependent confounders, which often occurs in trauma research. We describe marginal structural models (MSMs) using inverse probability weighting as a useful solution under several assumptions that are well-suited to estimating causal effects in trauma research.We illustrate the application of MSMs by estimating the joint effects of community violence exposure across time on youths' internalizing and externalizing symptoms. Our sample included 4,327 youth (50% female, 50% male; 1.4% Asian American or Pacific Islander, 34.7% Black, 46.9% Hispanic, .8% Native American, 14.3%, White, 1.5%, Other race/ethnicity;Wave 3 internalizing symptoms increased linearly with increases in Wave 2 and Wave 3 community violence exposure, whereas effects on externalizing symptoms were quadratic for Wave 2 community violence exposure and linear for Wave 3. These results fail to provide support for the desensitization model of community violence exposure.MSMs are a useful tool for researchers who rely on longitudinal observational data to estimate causal effects of time-varying exposures, as is often the case in the study of psychological trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Although community violence and the deleterious behavioral and psychological consequences that are associated with exposure to community violence persist as serious public health concerns, identifying malleable factors that increase or decrease adolescents’ risk of exposure to community violence remains a significant gap in our knowledge base. This longitudinal study addresses this research gap by investigating adolescents’ endorsement of familismo values and participation in three types of after-school activities, specifically home-, school-, and community-based activities, as potential precursors to adolescents’ risk for experiencing community violence. The sample consists of 416 Latino high school students (53% female) with a mean age of 15.5 years (SD = 1.0) and with 85% qualifying for free and reduced school lunch. Cross-sectional results demonstrated that adolescents’ endorsement of the Latino cultural value of familismo was associated with lower rates of personal victimization. The frequency of non-structured community-based activities and part-time work were concurrently associated with higher rates of witnessing community violence and being personally victimized by violence. Only the frequency of non-structured community-based activities was related to witnessing more community violence and greater victimization one year later while controlling for prior exposure to violence. These findings underscore the importance of providing structured, well supervised after-school activities for low-income youth in high-risk neighborhoods.

Objective: To test whether smoking-specific risk factors in early adulthood mediate prediction to daily smoking from childhood ADHD. Methods: Participants were 237 with and 164 without childhood ADHD. A smoking risk profile score comprising smoking-specific factors measured between ages 18 to 25 (e.g., craving severity) and age of initiation was tested as mediator of the association between childhood ADHD and age 29 daily smoking. Results: Childhood ADHD predicted age 29 smoking (β = −.15, p = .019), 35% of ADHD versus 17% of nonADHD, and the profile score (β = −.07, p = .004), which in turn mediated prediction to age 29 daily smoking (β = −.03; p = .007). When tested individually, three profile variables (# cigarettes/day, difficulty concentrating during abstinence, and nicotine dependence) were significant mediators ( ps = 0.005–0.038), above and beyond early adult smoking, ADHD persistence, and delinquency. Conclusions: These behavioral smoking characteristics help explain later daily cigarette smoking for adults with ADHD histories and may need to be targeted in intervention.

BACKGROUND ADHD poses risk for problematic alcohol use through adulthood. Perceived peer alcohol use, one of the strongest correlates of individuals' own alcohol use, is especially salient for adolescents with ADHD. The extent to which this risk extends into young adulthood is unknown, as well as how change in these constructs is associated throughout young adulthood. METHODS In the Pittsburgh ADHD Longitudinal Study, 358 individuals with childhood-diagnosed ADHD and 239 without were prospectively followed from ages 18 to 29. Piecewise, bivariate longitudinal growth modeling was used to examine the change in both peer alcohol use and individuals' heavy drinking (binge-drinking frequency), their between-person associations, and differences by ADHD group. The addition of structured residuals probed within-person year-to-year change in peer and personal alcohol use and their prospective associations. RESULTS Perceived peer alcohol use and individuals' heavy drinking frequencies changed together over time concurrently-from ages 18 to 21 (piece 1) and 21 to 29 (piece 2). Prospectively, individuals who increased the most in heavy drinking from ages 18 to 21 reported more friends using alcohol at age 29, regardless of ADHD history. Within-person increases in personal alcohol use likewise predicted increased perceived peer use the subsequent year within each age group (piece), regardless of ADHD history. However, while decreasing perceived peer use from ages 21 to 29 was related to more frequent heavy drinking at age 29 for those without ADHD, increasing perceived peer use from ages 18 to 21 predicted more frequent heavy drinking at age 29 for those with ADHD. CONCLUSIONS Young adult heavy drinking changes in tandem with perceived peer alcohol use across individuals and predicts selection of alcohol-using peers from year to year within individuals, further into adulthood than previously documented. Findings suggest the centrality of relationships with alcohol-consuming friends in relation to one's heavy drinking, especially for young adults with ADHD histories, through the twenties.

OBJECTIVE: Research on attention-deficit/hyperactivity disorder (ADHD) points to the possibility that contextual factors (e.g., time of day, school vs. home) may be related to symptoms and impairment. This prior research has relied on laboratory-based or retrospective, global approaches which has limited ecological validity. The present study substantively contributes to the extant literature by examining adolescents’ ADHD symptoms in the real world across the day on both school and non-school days to test whether symptoms worsened throughout the day and were higher on school days relative to non-school days. METHOD: As part of a larger study, 83 adolescents taking stimulant medication for ADHD (M(age) = 14.7, 66% identified as boys/men, 78% White) completed a 17-day ecological momentary assessment protocol that included wake-up and bedtime reports and two reports in the afternoon and evening. These assessments asked about ADHD symptoms and stimulant medication usage since the last report. Hypotheses were tested using multilevel modeling. RESULTS: Accounting for demographic covariates and medication usage, ADHD symptoms worsened quadratically, peaking at the afternoon report and subsequently declining, across school days but not non-school days. Mean-level ADHD symptoms were also worse on school days relative to non-school days. Results did not differ across gender. CONCLUSIONS: Our study is the first to examine important environmental factors (school, time of day) in real time in relation to level of naturalistically occurring ADHD symptoms. Our findings highlight the importance of advancing treatments to support adolescents with ADHD on school days and in the afternoon.

This study tested whether early and developmentally atypical substance use mediates risk for adult substance use among children with attention-deficit/hyperactivity disorder (ADHD), and whether that risk is substance-specific. Participants were children with ADHD previously enrolled in a randomized controlled trial (RCT), and a demographically similar non-ADHD group, assessed at 2 through 16 years after the original RCT baseline. Self-reports of heavy drinking, marijuana use, daily smoking, and other illicit drug use were collected at follow-ups to establish atypically early and frequent use. Models estimated statistically mediated effects of childhood ADHD on adult substance use via early substance involvement, with planned comparisons to evaluate substance specificity. Results supported the mediation hypothesis, showing that childhood ADHD was associated with more frequent adult substance use via early substance involvement for marijuana, cigarettes, illicit drugs, and to a lesser extent, alcohol. Mediation was not escalated by comorbid childhood conduct disorder or oppositional defiant disorder except for early use of nonmarijuana illicit drugs. Substance-specificity in the mediational pathway was largely absent except for cigarette use, where ADHD-related early smoking most strongly predicted adult daily smoking. Findings from this study provide new evidence that atypically early substance use associated with childhood ADHD signals important cross-drug vulnerability by early adulthood, but cigarette use at a young age is especially associated with increased risk for habitual (daily) smoking specifically. Efforts to prevent, delay, or reduce substance experimentation should occur early and focus on factors relevant to multiple drugs of abuse in this at-risk population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

BACKGROUND AND AIMS Black drinkers compared with white drinkers experience more alcohol-related problems. Examination of social determinants of inequities in alcohol problems is needed. The current study measured (1) associations between acute stress and alcohol craving in the naturalistic environment for self-identified Black and White individuals who drink alcohol and (2) whether a history of attention deficit hyperactivity disorder (ADHD) moderated these associations. DESIGN AND SETTING Observational study using ecological momentary assessment (EMA) to collect data from participants at six semi-random time-points throughout the day during a 10-day period. A series of three-level multi-level models examined between- and within-person associations for stress and alcohol and tested if these associations differed for Black and White adults. PARTICIPANTS Participants were 229 adult drinkers (aged 21-35 years) who completed a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD. MEASUREMENTS Momentary stress and alcohol craving, ADHD history and socio-demographic characteristics (i.e. racial identity, sex, age, current education level, household income) were assessed. Participants were required to self-identify as either 'African American or Black' or 'European American or White'. FINDINGS Significant racial identity × stress interactions indicated that associations between stress and craving were stronger for black compared with white adults across the 10-day period (between-person: B = 0.14, P = 0.007), concurrently within a given EMA time-point (within-person: B = 0.04, P = 0.001) and prospectively from time-point to time-point (within-person: B = 0.05, P = 0.001). Results remained while accounting for income × stress interactions. CONCLUSIONS Acute stress appears to be more strongly related to alcohol craving in self-identified black compared with self-identified white individuals. This provides support for policy changes to eliminate structural inequities that increase stress exposure and the development of just-in-time culturally responsive interventions focused on coping with acute stress for black individuals.

OBJECTIVE The General Life Functioning Scale (GLF) was developed to provide a complementary alternative to existing measures of impairment. We examined the psychometric properties of the GLF-Parent version (GLF-P), given the known value of informant ratings. METHODS The GLF-P was administered to parents of adults with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and a nonADHD comparison group in the Pittsburgh ADHD Longitudinal Study. GLF-P ratings described 334 participants (ADHD = 186; comparison = 148) rated at age 25 (Mage = 24.80 years, SDage = 0.46, range = 24-26) and 401 participants (ADHD = 237; comparison = 164) rated at age 30 (Mage = 29.30, SDage = 0.64, range = 28-33). Exploratory (EFA) and confirmatory (CFA) factor analyses were used. RESULTS EFAs suggested and CFAs confirmed a five-factor solution. We found measurement invariance across diagnostic and age groups, satisfactory internal consistency, construct validity, and known-group validity. CONCLUSION Psychometric results suggest the GLF-P as a helpful adjunctive measure of functioning. Further research is needed to determine the utility of the GLF across diverse settings.

Aims This study examines whether the relational proximity to the victim or perpetrator of witnessed community violence is associated with youth symptoms. Methods Data come from the Longitudinal Studies of Child Abuse and Neglect, a national high-risk sample. The sample included 12-year-old youth (N = 720) who had witnessed violence in their lifetimes. Ordinary least squares (OLS) regressions tested whether relationship proximity differentiated youth functioning (social competency, withdrawal, anxiety/depression, delinquency, and aggression), and whether gender moderated these effects. Results Witnessing violence toward a parent was associated with greater withdrawal, delinquency, and aggression symptoms. Witnessing violence perpetrated by a stranger was associated with lower social competency, higher anxiety/depression, and higher delinquency. Two perpetrator associations differed by gender. Conclusion Findings suggest important differences in outcomes based on relational proximity to victims and perpetrators. The particularly widespread associations between witnessing violence against a parent and youth functioning underscore the importance of targeting interventions toward youth with parent victims.

Objective: Recent studies suggest attention-deficit/hyperactivity disorder (ADHD) may emerge post-childhood. We integrate qualitative methods to systematically characterize contextual factors that may (a) delay identification of ADHD in childhood and (b) inform why ADHD symptoms emerge post-childhood. Method: Suspected late-onset ADHD cases from the local normative comparison group of the Multimodal Treatment Study of ADHD completed a qualitative interview (14 young adults and 7 caregivers). Interviews were qualitatively analyzed. Results: We identified five themes. Three themes may attenuate or delay identification of childhood ADHD: external factors (e.g., supportive adults), internal factors (e.g., strong intellectual functioning), and other factors (e.g., dismissive attitudes toward ADHD). Two themes may accompany an increase in ADHD symptoms post-childhood: external factors (e.g., increased external demands) and internal factors (e.g., perceived stress). Conclusion: Clinicians should probe these factors in suspected late-onset cases to address (a) whether, how, and to what extent ADHD was attenuated in childhood and (b) why symptoms emerge post-childhood.

Despite high heritability, no research has followed children with ADHD to parenthood to study their offspring and parenting behaviors. Given greater prevalence of ADHD in males and lack of research involving fathers, this study evaluated offspring of fathers with and without ADHD histories for ADHD and disruptive behavior and compared fathers' parenting behaviors. Male fathers (N = 29) from the Pittsburgh ADHD Longitudinal Study (PALS) participated with their preschool-aged offspring. Fathers completed self-reported measures, and father-child dyads completed an interaction task. ADHD offspring had elevated ADHD symptoms and behavior dysregulation. All fathers displayed positive parenting. ADHD fathers reported lower supportive responses to their child's negative emotions than comparison fathers, yet rated their parenting as more efficacious. ADHD offspring were distinguishable as early as age 3; thus, earlier diagnosis and intervention may be feasible for this at-risk population. Future research should investigate the acceptability and efficacy of parent training for fathers with ADHD.

Introduction Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for smoking cigarettes, but there is little longitudinal research on the array of smoking characteristics known to be prognostic of long-term smoking outcomes into adulthood. These variables were studied into early adulthood in a multisite sample diagnosed with ADHD combined type at ages 7-9.9 and followed prospectively alongside an age- and sex-matched local normative comparison group (LNCG). Methods Cigarette smoking quantity, quit attempts, dependence, and other characteristics were assessed in the longitudinal Multimodal Treatment Study of Children with ADHD (MTA) eight times to a mean age of 24.9 years: ADHD n = 469; LNCG n = 240. Results In adulthood, the ADHD group had higher rates of daily cigarette smoking, one or more quit attempts, shorter time to first cigarette of the day, and more severe withdrawal than the LNCG. The ADHD group did not appear to have better smoking cessation rates despite a higher proportion quitting at least once. Smoking quantity and nicotine dependence did not differ between groups. The ADHD group reported younger daily smoking onset and faster progression from smoking initiation to daily smoking across assessments. Finally, ADHD symptom severity in later adolescence and adulthood was associated with higher risk for daily smoking across assessments in the ADHD sample. Conclusions This study shows that ADHD-related smoking risk begins at a young age, progresses rapidly, and becomes resistant to cessation attempts by adulthood. Prevention efforts should acknowledge the speed of uptake; treatments should target the higher relapse risk in this vulnerable population. Implications Although childhood ADHD predicts later smoking, longitudinal studies of this population have yet to fully characterize smoking behaviors into adulthood that are known to be prognostic of long-term smoking outcome. The current study demonstrates earlier and faster progression to daily smoking among those with a childhood ADHD diagnosis, as well as greater risk for failed quit attempts. Prevention efforts should address speed of smoking uptake, while treatments are needed that address smoking relapse risk. The current study also demonstrates ADHD symptom severity over development increases daily smoking risk, implicating the need for continuous ADHD symptom management.

Childhood attention-deficit/hyperactivity disorder (ADHD) is prospectively linked to substance use and disorder. Depression emerging in adolescence is an understudied risk factor that may explain some of this risk. In the present study, we considered mediating and moderating roles of adolescent depression in explaining this association by using longitudinal data from the prospective 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA). Participants were 547 children diagnosed with DSM-IV ADHD Combined Type, and 258 age- and sex-matched comparison children. In adolescence, depressive symptoms did not exacerbate effects of childhood ADHD on any substance use. For both groups, time-varying and average depressive symptoms were associated with more frequent use of all substances. Prospectively, we found no evidence of depression mediation to adult substance use. However, adolescent depression moderated the association between childhood ADHD and adult marijuana use. Although adults without ADHD histories used marijuana more frequently if they had elevated depressive symptoms in adolescence, marijuana use by adults with ADHD histories was independent of their adolescent depression. In adulthood, depression diagnoses and ADHD persistence continued to operate as independent, additive correlates of substance use risk. Our findings suggest a circumscribed role for depression in substance use risk that adds to, but does not alter or explain, ADHD-related risk.

Community violence exposure (CVE) is associated with numerous psychosocial outcomes among youth. Although linear, cumulative effects models have typically been used to describe these relations, emerging evidence suggests the presence of curvilinear associations that may represent a pattern of emotional desensitization among youth exposed to chronic community violence. This study uses longitudinal data to investigate relations between CVE and both internalizing and externalizing symptoms among 3,480 youth ages 3 to 12 at baseline and 9 to 18 at outcome. Results support desensitization models, as evidenced by longitudinal quadratic associations between Wave 2 CVE and Wave 3 anxiety/depressive symptoms, alongside cross-sectional linear associations between Wave 3 CVE and Wave 3 aggression. Neither age nor gender moderated the associations between CVE and well-being. (PsycINFO Database Record

AIMS We examined the protective role of academic mentors for Latino/a youth exposed to community violence. We tested whether the mentor facilitation of positive growth and mentor school involvement moderated the relations between exposure to violence and Latino/a youth's educational values, school effort, and academic efficacy. METHODS We used hierarchical linear regressions to examine these relations among 210 Latino/a high school students. RESULTS Witnessing violence and personal victimization was negatively related to all three educational outcomes. Mentor school involvement was positively related to all three educational outcomes, whereas mentor facilitation of growth was positively related to educational values only. A significant interaction between witnessing violence and mentor school involvement indicated that the negative relation between witnessing violence and educational values weakened at high levels of mentor school involvement. CONCLUSION We discuss the benefits of academic mentoring and exploring effective mentoring characteristics with Latino/a youth exposed to violence.

The rates of suicidal ideation and completed suicide among adolescents have become increasingly alarming in recent years. Epidemiological studies indicate that a large portion of adolescents suffer from chronic pain, which research supports as a risk factor for suicidal ideation and behaviors. Further, psychological factors may account for the associations between chronic pain and suicidality. The current study sought to fill gaps in the literature on chronic pain and suicidality in adolescents, by examining whether depression mediates the links between various chronic amplified pain symptoms and suicidal ideation. Retrospective medical record reviews were conducted of 453 adolescents ages 11-17 (M = 14.34, SD = 1.83), who presented to a tertiary pain clinic and received a diagnosis of amplified pain. Prior to their initial appointment, participants completed measures assessing pain symptoms, disability, depression, and suicidality. We found pain duration was significantly related to suicidal ideation, however, this association was mediated by depressive symptoms. These results highlight the need for early screening and intervention for depressive symptoms among adolescents suffering from amplified pain. Clinical recommendations for mental health and medical providers are discussed. (PsycINFO Database Record

Background Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. Methods Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. Results In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. Conclusions Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.

Adolescents and young adults without childhood attention deficit hyperactivity disorder (ADHD) often present to clinics seeking stimulant medication for late-onset ADHD symptoms. Recent birth-cohort studies support the notion of late-onset ADHD, but these investigations are limited by relying on screening instruments to assess ADHD, not considering alternative causes of symptoms, or failing to obtain complete psychiatric histories. The authors address these limitations by examining psychiatric assessments administered longitudinally to the local normative comparison group of the Multimodal Treatment Study of ADHD.Individuals without childhood ADHD (N=239) were administered eight assessments from comparison baseline (mean age=9.89 years) to young adulthood (mean age=24.40 years). Diagnostic procedures utilized parent, teacher, and self-reports of ADHD symptoms, impairment, substance use, and other mental disorders, with consideration of symptom context and timing.Approximately 95% of individuals who initially screened positive on symptom checklists were excluded from late-onset ADHD diagnosis. Among individuals with impairing late-onset ADHD symptoms, the most common reason for diagnostic exclusion was symptoms or impairment occurring exclusively in the context of heavy substance use. Most late-onset cases displayed onset in adolescence and an adolescence-limited presentation. There was no evidence for adult-onset ADHD independent of a complex psychiatric history.Individuals seeking treatment for late-onset ADHD may be valid cases; however, more commonly, symptoms represent nonimpairing cognitive fluctuations, a comorbid disorder, or the cognitive effects of substance use. False positive late-onset ADHD cases are common without careful assessment. Clinicians should carefully assess impairment, psychiatric history, and substance use before treating potential late-onset cases.

US Statement of Purpose Youth exposure to community violence is associated with adverse outcomes, yet not all exposed youth respond adversely. Dimensions of exposure may relate to response; evidence suggests that having a relationship with the victim and perpetrator of community violence is connected to worse outcomes, yet is limited by cross-sectional designs and sparse attention to the perpetrator of violence. This study examined the relationship proximity to the victim and perpetrator of violence and adolescent outcomes in a high-risk sample. Sex differences in these relations are also explored. Methods We used the LONGSCAN dataset, a 5-site, pooled sample of children. Our sample was limited to youth ages 12 and 14 who reported some lifetime violence exposure (n=720). This sample was approximately half male, predominantly low-income, and of diverse ethnic backgrounds. Six items assessed witnessed violence, including details about the victim and perpetrator. The Child Behaviour Checklist assessed internalising and externalising symptoms. Regression analyses determined whether relationship proximity to the perpetrator and victim of community violence differentiated youth outcomes and whether sex moderated these associations. Results Witnessed violence perpetrated by a stranger was associated with lower social competency, but only among females. Witnessed parental victimisation predicted higher externalising and internalising problems among both males and females. Conclusions That witnessed community violence against a parent negatively impacted both males and females underscores the traumatic nature of seeing a parent harmed. In contrast, the female-specific relation between witnessed violence perpetrated by a stranger and social competency may reflect that males are desensitised to witnessing violence by strangers given their higher rates of involvement in violence. Contributions to Prevention Science Together, our results suggest that understanding relationships with victims and perpetrators of community violence is an important to understanding response. Future research should further elucidate sex differences in youths’ responses to witnessed violence.

Purpose Community violence exposure (CVE) places youth at risk for developing aggressive/externalising behaviour, perpetuating the cycle of violence. One pathway may occur through the adoption of normative beliefs accepting of violence ‘“ a malleable, feasible intervention target for preventing community violence. This pathway is not well understood among Latino adolescents, despite their elevated CVE rates. This study examined whether positive attitudes toward violence mediates the link between CVE and externalising behaviours among Latino youth. Methods This sample comprised 193 low-income Latino adolescents (Mage=15.5, 53% female), primarily Mexican-American (81%), living in urban neighbourhoods; 90% received free/reduced lunch. Youth completed survey measures of past-year CVE (adapted Things I Have Seen and Heard scale), attitudes toward violence (Youth Attitudes toward Guns and Violence Questionnaire), and externalising behaviours (Youth Self Report). Results Hierarchical OLS regressions indicated that both community violence victimisation (AŸ=0.30) and witnessing (AŸ=0.28) was associated with positive attitudes about the use of violence (p Conclusions Latino youth with high levels of CVE tend to endorse positive attitudes about the use of violence, which in turn predicts externalising behaviours. A cycle of violence may explain these findings, with CVE leading youth to value violence as normative and acceptable, prompting their own aggression. Longitudinal data collection is pending to more rigorously test this potential mechanism. Significance/contributions to injury/violence prevention science Violence prevention interventions should target youths’ malleable attitudes toward violence that have developed to normalise their violence exposure in high-crime neighbourhoods. Such interventions would offer low-cost, feasible, and potentially high-impact solutions for preventing community violence.

Purpose Childhood ADHD increases risk for maladaptive adult outcomes, including substance abuse and violence perpetration (Buitelaar et al., 2015). However, ADHD risk for violence victimisation is not well understood. ADHD is cross-sectionally associated with interpersonal victimisation in childhood (Lewis et al., 2015), and longitudinally predicts adult intimate partner victimisation (Wymbs et al., 2016). ADHD may prompt victimisation via impulsive involvement in violence/delinquency (Low & Espelage, 2014), but support for mediation is absent (Gibson, 2011). This study tests: (1) Whether childhood ADHD predicts adult interpersonal victimisation; and (2) Whether aggression/delinquency mediates this association. Methods Participants were 579 children rigorously diagnosed with ADHD-Combined Type (ages 7–9.9) and 289 age- and sex-matched comparison children from the Multimodal Treatment of ADHD Study (MTA). Prospective assessments followed baseline and a 14 month randomised controlled treatment trial. Six victimisation types (e.g., attacked with weapon; theft) were assessed 12, 14, and 16 years post-enrollment (Mage 20–25) and totaled for analysis. Conduct was assessed with the caregiver-report Aggression and Conduct Problems Scale (Mage 10), and the Self-Reported Delinquency scale (Mage 18). Results One-third of participants experienced any victimisation as adults. Poisson regression indicated that probands experienced significantly more victimisation types (OR=1.32, p=0.009), controlling for demographics (sex, race, SES, familial psychopathology, grade retention) and neighbourhood quality. Mage 10 aggression predicted more adult victimisation (OR=2.26, p=0.001) and fully mediated the ADHD-victimisation association. Separately, Mage 18 delinquency predicted adult victimisation (OR=1.14, p Conclusions Childhood ADHD prospectively forecasts adult victimisation mediated by childhood, but not young-adult, aggression/delinquency. Significance/contributions to injury/violence prevention science ADHD is a double whammy: it increases risk for both violence perpetration and victimisation, making ADHD a critical violence prevention target. Researchers should elucidate how this risk unfolds developmentally and isolate malleable ADHD-related intervention priorities.

A plethora of research on the psychological consequences of community violence exposure among youth has conceptualized and measured community violence as a single, homogenous construct that indiscriminately gives rise to a wide range of outcomes. However, it is increasingly recognized that community violence exposure is comprised of many disparate characteristics. Thus, a more dimensional theoretical approach to the study of community violence exposure is proposed; such an approach will more precisely clarify how community violence exposure is differentially associated with specific outcomes. In particular, the dimensions of type, severity, physical proximity, relational proximity (familiarity with the persons involved), and chronicity of community violence exposure are suggested as potential moderating factors that may each, individually and in interaction, differentially impact youths’ well-being. In order to account for greater contextual complexity in children's experiences of community violence, several recommendations for new methodological approaches and research directions are proposed and discussed. Such a theoretical shift is critical to advance our understanding of the processes underlying the links between community violence exposure and youth outcomes, as well as to inform more targeted and effective interventions for youth exposed to community violence.

Peer substance use strongly predicts adolescent and young adult substance use, but its role in ADHD-related risk for substance use, especially in adulthood, is unclear. In a sample with (n = 516) and without (n = 249) childhood ADHD from the Multimodal Treatment Study of ADHD, we compared associations between change over time in peer substance use and personal substance use (alcohol, cigarettes, marijuana, illicit drugs) from age 14–26 by ADHD status. Developmentally typical peer substance use trajectories across adolescence and young adulthood coincided with similar changes in personal use – but less so for those with ADHD histories. Concurrent associations between peer and personal use in adolescence and young adulthood were weaker for those with ADHD histories than without for commonly used substances (alcohol, marijuana). Prospectively, escalating peer use during adolescence forecasted adulthood declines for commonly used substances, yet persistently high substance use at age 25, regardless of ADHD history. In the reverse direction, growth in adolescent substance use predicted developmentally normative young adult declines in peer use – but for the ADHD group, adolescent heavy drinking predicted increases in young adult peer use. Findings suggest that individuals with ADHD may have difficulty emulating their peers' developmentally normative declines in substance use, highlighting the importance of social factors when treating young adults affected by ADHD and substance abuse.

Low-income, urban adolescents are exposed to extremely high rates of witnessing and being victimized by community violence. Such violence exposure presents serious implications for youth’s development and psychological well-being. In a sample of 223 ninth-grade Latino adolescents, we examine: (1) what types of after-school activity participation increase or reduce adolescents’ risk for violence exposure and (2) the role of the cultural value of familismo in moderating the impact of violence exposure on adolescents’ psychological well-being. Our results indicate that spending unstructured leisure time with peers and participating in non-school sports and non-school clubs were associated with higher levels of community violence exposure, whereas adhering to the cultural value of familismo was associated with lower levels of violence exposure. Additionally, familismo moderated the positive association between violence exposure and depressive symptoms, but not posttraumatic stress disorder symptoms. Implications of these results are discussed.

Poor mothers contend with numerous economic and environmental stressors that may severely tax their resources for parenting. This study relied on qualitative interviews with 49 low-income Latina mothers to examine how parenting practices are used when facing neighborhood poverty and the threat of community violence. Several themes emerged in the interviews regarding mothers' approaches to parenting. First, Latina mothers in our sample relied on three strategies previously identified in the literature: (a) strict monitoring, (b) physical and/or social withdrawal from the neighborhood, and (c) engagement in positive, enriching activities for children. In concert with these strategies, these mothers also emphasized the importance of (d) establishing strong parent-child communication as essential to effective parenting in challenging environments. Furthermore, two overarching, culturally salient parental goals were identified: (a) fostering principles of educacion in their children and (b) maintaining astute parental awareness (estar pendiente) of children's physical as well as emotional states. Our findings illuminated culturally specific meanings that accompany parenting practices for low-income Latina mothers and underscored the importance of adapting culturally sensitive interventions for parents. (PsycINFO Database Record (c) 2012 APA, all rights reserved). Language: en