Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLES: SPECIAL SECTION: MULTIMODAL TREATMENT STUDY OF ADHD-MTADelinquent Behavior and Emerging Substance Use in the MTA at 36 Months: Prevalence, Course, and Treatment Effects
Section snippets
Participants
Participants were 579 MTA children with DSM-IV ADHD Combined type and an additional 289 LNCG children (described below). Each of 6 sites randomized 96 to 98 children to one of four treatment groups: intensive multicomponent behavior therapy (Beh), intensive medication management (MedMgt), the combination of Beh and MedMgt (Comb), or referral to usual community care (CC). At baseline (pretreatment), participants were 7.0-9.9 years of age (mean 8.5 years, SD 0.8). The MTA recruitment strategy,
Level of Delinquency for the MTA and LNCG
Table 1 shows the percentages of MTA and LNCG children at each level of delinquency seriousness for all assessment points (recall that the LNCG began at the 24-month assessment). Following established practice (Lee and Hinshaw, 2004), the right side of Table 1 shows the percentages of children with either moderate (code 3) or serious (codes 4-5) delinquency at each of the assessments, separately for the MTA and LNCG children.
Across all of the assessments, most of the MTA children were not
DISCUSSION
We found that the majority of the MTA children were not seriously delinquent or were not experimenting prematurely with alcohol, tobacco, or illicit drugs by the 36-month assessment when most participants were 11 to 13 years old. Nevertheless, these behaviors were more prevalent among the MTA than LNCG children, with more than one fourth of the probands evidencing moderate or serious delinquency by the 36-month follow-up. The time course was quadratic: there was a significant decrease in
REFERENCES (64)
- et al.
Gestational and postnatal tobacco smoke exposure as predictor of ADHD, comorbid ODD/CD, and treatment response in the MTA
Clin Neurosci Res
(2005) - et al.
The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1990) - et al.
Pathways from ADHD to early drug use
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Multimodal treatment of ADHD in the MTA: an alternative outcome analysis
J Am Acad Child Adolesc Psychiatry
(2001) - et al.
Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: results from the National Longitudinal Epidemiologic Survey
J Subst Abuse
(1997) - et al.
Medication treatment strategies in the MTA: relevance to clinicians and researchers
J Am Acad Child Adolesc Psychiatry
(1996) - et al.
Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration
J Am Acad Child Adolesc Psychiatry
(2001) - et al.
The Services for Children and Adolescents Parent Interview (SCAPI): development and performance characteristics
J Am Acad Child Adolesc Psychiatry
(2004) - et al.
ADHD comorbidity findings from the MTA Study: comparing comorbid subgroups
J Am Acad Child Adolesc Psychiatry
(2001) - et al.
The relation between childhood attention-deficit hyperactivity disorder and adult antisocial behavior re-examined: the problem of heterogeneity
Clin Psychol Rev
(1990)
Which boys will fare worse? Early predictors of the onset of conduct disorder in a six-year longitudinal study
J Am Acad Child Adolesc Psychiatry
ADHD is associated with early initiation of cigarette smoking in children and adolescents
J Am Acad Child Adolesc Psychiatry
NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses
J Am Acad Child Adolesc Psychiatry
Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at end of treatment
J Am Acad Child Adolesc Psychiatry
Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)
NIMH collaborative Multimodal Treatment Study of Children with ADHD (MTA): design challenges and choices
Arch Gen Psychiatry
Does the treatment of attention-deficit/hyperactivity disorder with stimulants contribute to drug use/abuse? A 13-year prospective study
Pediatrics
Pharmacotherapy of attention-deficit/hyperactivity disorder reduces risk for substance use disorder
Pediatrics
Which aspects of ADHD are associated with tobacco use in early adolescence?
J Child Psychol Psychiatry
Adolescent substance use
The Teen Drinking Questionnaire
Explaining Delinquency and Drug Use
Hyperactive boys almost grown up: I. Psychiatric status
Arch Gen Psychiatry
Pattern and progression of drug use among hyperactives and controls: a prospective short-term longitudinal study
J Child Psychol Psychiatry
Does multimodal treatment of ADHD decrease other diagnoses?
Clin Neurosci Res
A random-effects ordinal regression model for multilevel analysis
Biometrics
Licit and illicit drug use patterns in stimulant-treated children and their peers
Issues of taxonomy and comorbidity in the development of conduct disorder
Dev Psychopathol
Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial
J Atten Disord
Reliability of the Services for Children and Adolescents Parent Interview (SCAPI)
J Am Acad Child Adolesc Psychiatry
Health Behavior Questionnaire
Stages of drug involvement in the U.S. population
Cited by (175)
Sensitization-based risk for substance abuse in vulnerable individuals with ADHD: Review and re-examination of evidence
2022, Neuroscience and Biobehavioral ReviewsCitation Excerpt :Naturalistic longitudinal studies in children with ADHD have been utilized to ascertain whether stimulant treatment in early life alters the probability of SUD development in later life. However, these types of studies have produced mixed results, with some showing protective effects of stimulants (Biederman et al., 1999; Wilens et al., 2003, 2008), especially if treatment was started at a younger age (Mannuzza et al., 2008), others showing risk-conferring associations (Lambert and Hartsough, 1998; Lambert, 2005) and others showing no association (Humphreys et al., 2013; Molina et al., 2013, 2007; Harty et al., 2012; Biederman et al., 2008). For example, one study, with predominantly male youths (N = 208) obtained from the Danish psychiatric registers, reported the relative risk (RR) of SUD and alcohol abuse was 7.7 (4.3–13.9) for cases with ADHD and 5.2 (2.9–9.4), for comparison youth (Dalsgaard et al., 2014).
Behavioral symptoms of child mental disorders and lifetime substance use in adolescence: A within-family comparison of US siblings
2021, Drug and Alcohol DependenceConvergent Evidence for Predispositional Effects of Brain Gray Matter Volume on Alcohol Consumption
2020, Biological PsychiatryTrajectories of Alcohol Initiation and Use During Adolescence: The Role of Stress and Amygdala Reactivity
2018, Journal of the American Academy of Child and Adolescent PsychiatryCitation Excerpt :At follow-up, the K-SADS-PL was used to assess the onset of an AUD including alcohol abuse or dependence. Quantity, frequency, and experiences of alcohol use were examined using the alcohol section of the Substance Use Questionnaire (SUQ), which was administered at baseline and all follow-up assessments.51 For this study, we focused on quantity and frequency of use, age when an adolescent consumed the first full standard drink of alcohol (eg, 5 ounces of wine, 12 ounces of beer, or 1 ounce shot of liquor), and age at first intoxication.
Attention-deficit hyperactivity disorder: A critique of the concept
2018, Irish Journal of Psychological MedicineRebuttal to Timimi's article 'Attention-deficit hyperactivity disorder: A critique of the concept'
2018, Irish Journal of Psychological Medicine
The Multimodal Treatment Study of Children with ADHD (MTA) was a National Institute of Mental health (NIMH) cooperative agreement randomized clinical trial involving six clinical sites. Collaborators from the National Institute of Mental Health: Peter S. Jensen, M.D. (currently at Columbia University, New York), L. Eugene Arnold, M.D., M.Ed. (currently at Ohio State University), Joanne B. Severe, M.S. (Clinical Trials Operations and Biostatistics Unit, Division of Services and Intervention Research), Benedetto Vitiello, M.D. (Child & Adolescent Treatment and Preventive Interventions Research Branch), Kimberly Hoagwood, Ph.D. (currently at Columbia University); previous contributors from NIMH to the early phase: John Richters, Ph.D. (currently at National Institute of Nursing Research); Donald Vereen, M.D. (currently at National Institute on Drug Abuse). Principal investigators and co-investigators from the clinical sites are University of California, Berkeley/San Francisco: Stephen P. Hinshaw, Ph.D. (Berkeley), Glen R. Elliott, M.D., Ph.D. (San Francisco); Duke University: C. Keith Conners, Ph.D., Karen C. Wells, Ph.D., John March, M.D., M.P.H., Jeffery Epstein, Ph.D.; University of California, Irvine/Los Angeles: James Swanson, Ph.D. (Irvine), Dennis P. Cantwell, M.D. (deceased, Los Angeles), Timothy Wigal, Ph.D. (Irvine); Long Island Jewish Medical Center/Montreal Children's Hospital: Howard B. Abikoff, Ph.D. (currently at New York University School of Medicine), Lily Hechtman, M.D. (McGill University, Montreal); New York State Psychiatric Institute/Columbia University/Mount Sinai Medical Center, New York: Laurence L. Greenhill, M.D. (Columbia University), Jeffrey H. Newcorn, M.D. (Mount Sinai School of Medicine); University of Pittsburgh: William E. Pelham, Ph.D. (currently at State University of New York, Buffalo), Betsy Hoza, Ph.D. (currently at University of Vermont, Burlington), Brooke Molina, Ph.D. Original statistical and trial design consultant: Helena C. Kraemer, Ph.D. (Stanford University). Follow-up phase statistical collaborators: Robert D. Gibbons, Ph.D. (University of Illinois, Chicago), Sue Marcus, Ph.D. (Mt. Sinai School of Medicine), Kwan Hur, Ph.D. (University of Illinois, Chicago). Kate Flory, Ph.D. (University of South Carolina at Columbia). Andrew Greiner, B.S. (State University of New York at Buffalo). Collaborator from the Office of Special Education Programs/U.S. Department of Education: Thomas Hanley, Ed.D. Collaborator from Office of Juvenile Justice and Delinquency Prevention/Department of Justice: Karen Stern, Ph.D.
The work reported was supported by cooperative agreement grants and contracts from the National Institute of Mental Health to the following: University of California, Berkeley: U01 MH50461 and N01MH12009; Duke University: U01 MH50477 and N01MH12012; University of California, Irvine: U01 MH50440 and N01MH 12011; Research Foundation for Mental Hygiene (New York State Psychiatric Institute/Columbia University): U01 MH50467 and N01 MH12007; Long Island-Jewish Medical Center U01 MH50453; New York University: N01MH 12004; University of Pittsburgh: U01 MH50467 and N01 MH 12010; and McGill University N01MH12008.- The Office of Special Education Programs of the U.S. Department of Education, the Office of Juvenile Justice and Delinquency Prevention of the Justice Department, and the National Institute on Drug Abuse also participated in funding.
Appreciation is extended to Dr. Patrick Curran, University of North Carolina, Chapel Hill, and Dr. Linda Muthén, Muthén & Muthén, Los Angeles, for their guidance regarding the technical aspects of the growth modeling used in this article, and to Drs. Magda Stouthamer-Loeber, Rolf Loeber, and Steven Lee for their assistance regarding the delinquency coding strategies used herein.
The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the National Institute of Mental Health, the National Institutes of Health, or the Department of Health and Human Services.