This pilot project embodied two concurrent and synergistic efforts that exemplified the intent of the C-StARR to conduct innovative transdisciplinary research which brings together investigators from a range of areas of expertise to explore how genetic variability, sex, and ADHD symptoms and related behaviors confer risk for the development of substance use outcomes.

The goal of this pilot project and accompanying Faculty Working Group (FWG) was to examine the associations among genotype, ADHD and related symptoms, sex, and smoking/substance use outcomes in prospective, longitudinal samples. This project took advantage of several existing datasets to address the research questions.

A clear understanding of the multiple factors associated with substance use and related negative outcomes and how these factors interact in predicting adverse outcomes would be valuable for informing targeted interventions for substance use prevention. As most prevention programs are predicted on a single-factor conceptualization, we believe that this approach will promote the creation of and testing of multi-level prevention programs in which psychosocial, behavioral, and genetic markers define populations at risk.

Meetings of the FWG facilitated this study entitled “Obesity and stage II hypertension in early adulthood are associated with Attention Deficit/Hyperactivity (ADHD) symptoms” which examined the association between dimensionally defined ADHD symptoms and obesity (measured via BMI) and hypertension as measured in wave IV of the AddHealth dataset. Part of the rationale for observing obesity inheres in providing an understanding of developmentally emergent mechanisms and processes involved in self-regulatory failure. The presumption was that these mechanisms –particularly those connected to inhibitory breakdown bear clear importance for understanding co-morbid substance abuse. Analyses resulted in a peer-reviewed publication as noted below.

Fuemmeler, B.F., Ostbye, T., Yang, C., McClernon, F.J., & Kollins, S.H. (2010). Association between Attention Deficit/Hyperactivity (ADHD) symptoms and obesity and hypertension in early adulthood: A population-based study. International Journal of Obesity, Epub ahead of print.

Three of the initial members of the FWG, Drs. Kollins, McClernon and Fuemmeler worked with two of the postdoctoral fellows from the Methodology and Statistics Core, Drs. Ranby and Boynton, and C-StARR statistician Dr. Yang to plan and initiate several sets of analyses. The discussions and analyses led to an R01 grant that was funded by NIDA. An application for a minority supplement on this R01 was also funded on this R01.The grant is entitled “Elucidating Links Between ADHD and Symptoms and Tobacco/Alcohol Use Trajectories”, PI: Fuemmeler. The aim is to examine how ADHD symptoms measured both at single time points and longitudinally are related to the patterns of substance use across time. Several large, epidemiological datasets will be utilized to explore these questions. Analyses as part of the grant have so far focused on these areas:

Factor mixture modeling, latent class analysis and factor analysis was conducted to characterize ADHD symptom phenotypes in the Add Health data set. A paper titled “Understanding the Phenotypic Structure of Adult Retrospective ADHD symptoms during Childhood in the United States” was developed based on these analyses. The lead author is Krista Ranby. Results from the analyses were presented at the 2011 annual meeting of the Society for Behavioral Medicine by Bernard Fuemmeler. Marcy Boynton also presented findings in an oral presentation at the 2011 Modern Modeling Methods Conference at the University of Connecticut.
Led primarily by Marcy Boynton, ADHD-related data was also analyzed from the Panel Study of Income Dynamics (PSID) database. Presently, Marcy Boynton is examining items from the Problem Behavior and Positive Behavior Scales—looking at their factor structure across childhood and adolescence. Specifically, she is examining smoking and alcohol initiation and how ADHD symptoms predict age of initiation of smoking.

Led by Bernard Fuemmeler and Krista Ranby, the trajectories of smoking behavior in the AddHealth data set have been analyzed across time. These analyses will be important since subsequently the relationship between ADHD phenotypic classes and the smoking trajectories will be studied. Results to date are consistent with other reports in the literature regarding different patterns of smoking behavior. By using the Wave IV data, the trajectory analyses will be uniquely suited to examine trajectories into the late 20s and early 30s, which will be a novel contribution to the literature.