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Developmental sequence from disruptive behavior diagnosis to adolescent alcohol dependence
S Kuperman1, S S Schlosser, J R Kramer
1Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1047, USA. samuel-kuperman@uiowa.edu
The American Journal of Psychiatry
|December 1, 2001
Summary
Disruptive behavior disorders like ADHD and conduct disorder often precede substance use and alcohol dependence in adolescents. These behavioral issues are key early indicators in understanding adolescent substance use progression.
Area of Science:
- Adolescent psychiatry
- Neurodevelopmental disorders
- Substance use disorders
Background:
- Disruptive behavior disorders (DBDs) are common in adolescents.
- Comorbidity between DBDs and substance use disorders (SUDs) is a significant clinical concern.
- Understanding the temporal relationship between DBDs and SUDs is crucial for early intervention.
Purpose of the Study:
- To clinically describe the relationship between disruptive behavior disorders and alcohol dependence.
- To examine the association between DBDs and the use of various substances in adolescents.
- To elucidate the developmental trajectory from DBDs to substance use and alcohol dependence.
Main Methods:
- Utilized the Child Semi-Structured Assessment for the Genetics of Alcoholism.
- Collected data from 54 adolescents diagnosed with alcohol dependence.
- Analyzed frequency and age at onset of DBDs and substance use (alcohol, tobacco, marijuana, other drugs).
Main Results:
- Nearly 75% of alcohol-dependent adolescents had at least one DBD diagnosis.
- Attention deficit hyperactivity disorder (ADHD) typically preceded conduct disorder.
- Substance use initiated with alcohol/tobacco, followed by marijuana and other drugs; alcohol dependence onset was significantly later than DBDs or tobacco use.
Conclusions:
- Disruptive behavior diagnoses, especially conduct disorder, generally precede substance experimentation in adolescents.
- The sequence of DBDs followed by substance use, and finally alcohol dependence, suggests a predictable developmental pathway.
- Early identification and treatment of DBDs may be critical in preventing future substance use and alcohol dependence.