Does Childhood Attention-Deficit/Hyperactivity Disorder Predict Risk-Taking and Medical Illnesses in Adulthood?

Drs. Ramos Olazagasti, Klein, and Castellanos, and Ms. Lashua-Shriftman are with the New York University Medical Center. Dr. Castellanos is also with the Nathan S. Kline Institute for Psychiatric Research. Ms. Belsky is with Columbia University. Ms. Hutchison is with American University. Dr. Mannuzza is retired.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 02/2013; 52(2):153-162.e4. DOI: 10.1016/j.jaac.2012.11.012
Source: PubMed


To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of conduct disorder (CD) in childhood (mean = 8 years), have elevated risk-taking, accidents, and medical illnesses in adulthood (mean = 41 years); whether development of CD influences risk-taking during adulthood; and whether exposure to psychostimulants in childhood predicts cardiovascular disease. We hypothesized positive relationships between childhood ADHD and risky driving (in the past 5 years), risky sex (in the past year), and between risk-taking and medical conditions in adulthood; and that development of CD/antisocial personality (APD) would account for the link between ADHD and risk-taking. We report causes of death.
Prospective 33-year follow-up of 135 boys of white ethnicity with ADHD in childhood and without CD (probands), and 136 matched male comparison subjects without ADHD (comparison subjects; mean = 41 years), blindly interviewed by clinicians.
In adulthood, probands had relatively more risky driving, sexually transmitted disease, head injury, and emergency department admissions (p< .05-.01). Groups did not differ on other medical outcomes. Lifetime risk-taking was associated with negative health outcomes (p = .01-.001). Development of CD/APD accounted for the relationship between ADHD and risk-taking. Probands without CD/APD did not differ from comparison subjects in lifetime risky behaviors. Psychostimulant treatment did not predict cardiac illness (p = .55). Probands had more deaths not related to specific medical conditions (p = .01).
Overall, among children with ADHD, it is those who develop CD/APD who have elevated risky behaviors as adults. Over their lifetime, those who did not develop CD/APD did not differ from comparison subjects in risk-taking behaviors. Findings also provide support for long-term safety of early psychostimulant treatment.

Download full-text


Available from: Rachel G Klein, Mar 13, 2014
  • Source
    • "Shaw and Brown (1999) report that students who show higher levels of ADHD-like behavior indicate to have more interest in searching for stimulating and ''risky'' types of activities . Other studies provide evidence of a positive relationship between the occurrence of ADHD in childhood and the level of sensation seeking as a college student (Shaw and Giambra 1993) and the level of risk taking in adulthood (Olazagasti et al. 2013). This may lead (young) adults who exhibit ADHD-like behavior to be attracted to more risky jobs such as sales, stock brokerage and entrepreneurship (Weiss and Murray 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about the relation between entrepreneurship and the extent of psychiatric symptoms. Validated psychiatric symptom scores are seldom used for non-clinical reasons. One prevalent symptom that deserves our interest is Attention Deficit and Hyperactivity Disorder (ADHD). ADHD is a developmental disorder characterized by inattentiveness and hyperactivity that has been linked to occupational choice and performance. Building on the person–environment fit literature, we hypothesize that individuals who exhibit behavior associated with ADHD are more likely to have entrepreneurial intentions. Using a sample of 10,104 students enrolled in higher education, we can confirm our prediction that students with a higher level of ADHD-like behavior are more likely to have entrepreneurial intentions. Additionally, we show that risk taking propensity is a mediator that partly explains this positive effect. Our study points to the importance of behavioral tendencies associated with developmental disorders, when making entrepreneurship decisions. Our study contributes to the literature on the determinants of entrepreneurship, which so far has largely neglected the effects of psychiatric symptoms on entrepreneurship.
    Full-text · Article · Jun 2015 · Small Business Economics
  • Source
    • "The effect sizes for the detected correlations between pathological Internet use and ADHD symptoms were split between two large (Ko et al., 2008; Yoo et al., 2004) and two small (Ko et al., 2009; Yen et al., 2007), with one reporting moderate (Yen et al., 2009), results. Meanwhile, it has been speculated that ADHD could be correlated with poorer physical health and a poorer lifestyle (Ramos Olazagasti et al., 2013; Semeijn et al., 2013). The aims of this study were to explore the physical, social/behavioral , and mental factors among incoming university students associated with higher self-reported ADHD scores. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study was designed to explore physical, social/behavioral, and mental health factors among incoming university students with elevated self-reported ADHD symptoms. Method: A total of 5,240 incoming university students were recruited. The test battery included the ADHD Self-Report Scale, the Measurement of Support Functions, the Chinese Internet Addiction Scale-Revision, Quality of Life assessment, the Brief Symptoms Rating Scale, and the 10-item Social Desirability Scale. Results: ADHD symptoms were elevated in 8.6% of the sample. Only individuals with a lower social desirability score, however, were recruited for further analysis. Significant influential factors for higher self-reported levels for ADHD symptoms included greater suicidal ideation and emotional disturbance, as well as a higher Internet addiction tendency, lower levels of social support, and a greater amount of exercise. Conclusion: Given the elevated prevalence of self-reported ADHD symptoms among this sample of university students, screening for these kinds of problems to detect early challenges before students fail in college as well as identify youth with undiagnosed ADHD should be considered.
    Full-text · Article · Sep 2014 · Journal of Attention Disorders
    • "The potential association between ADHD and mTBI is of potential interest for several reasons. ADHD is a persistent childhood onset neurobiological, neurodevelopmental disorder associated with impulsivity, risk-taking behavior, accidents , and injuries (Barkley, Guevremont, Anastopoulos, DuPaul, & Shelton, 1993; Barkley, Murphy, & Fischer, 2010; Biederman & Faraone, 2005; Fischer, Barkley, Smallish, & Fletcher, 2007; Lambert, 1995; Ramos Olazagasti et al., 2013). Thus, ADHD might place individuals at greater risk of mTBI. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study investigated the association between mild traumatic brain injury (mTBI) and ADHD, which increases risk of injuries and accidents. Method: We conducted a systematic review and meta-analysis of studies that examined the relationship between mTBI and ADHD. Results: Five studies, comprising 3,023 mTBI patients and 9,716 controls, fit our a priori inclusion and exclusion criteria. A meta-analysis found a significant association between ADHD and mTBI, which was significant when limited to studies that reported on ADHD subsequent to mTBI and when the direction of the association was not specified, but not for studies that reported mTBI subsequent to ADHD. Heterogeneity of effect size and publication biases were not evident. Conclusion: The literature documents a significant association between mTBI and ADHD. Further clarification of the relationship and direction of effect between mTBI and ADHD and treatment implications could have large clinical, scientific, and public health implications.
    No preview · Article · Jul 2014 · Journal of Attention Disorders
Show more