Master of Science
Epidemiology and Biostatistics
Objective: 1) Estimate the prevalence of self-reported ADHD symptoms in sample of youth (grades 9-12) in Ontario schools, by sex; and 2) Assess the relationship between ADHD symptoms and substance use (alcohol, tobacco cigarettes, cannabis, stimulants) by sex, controlling for socio-economic status, internalizing and externalizing problems.
Methods: Data from 2015 and 2017 (n = 6,923) Centre for Addiction and Mental Health Ontario Student Drug Use and Health Survey, included self-reports of ADHD symptomatology and substance use. Statistical analyses included bivariate tables and multinomial regressions.
Results: Prevalence for ADHD symptoms was 20.22%, 95% CI [18.52, 22.03] (males = 16.42%, 95% CI [14.66, 18.34]; females = 24.06%, 95% CI [21.79, 26.49]). Females reporting ADHD symptoms showed increased risk of tobacco cigarette use and cannabis use when accounting for covariates.
Conclusion: The ADHD symptom screener found a large proportion of self-reported ADHD symptoms, especially in females. ADHD symptoms were associated with few substances.
Summary for Lay Audience
The goal of this current study was to present the prevalence of ADHD symptoms in a sample of youth in Ontario and to assess the relationship between ADHD symptoms and substance use. Substances that were examined include alcohol, tobacco cigarettes, cannabis and stimulants. Stimulants included cocaine, crack-cocaine, ecstasy, and methamphetamine. It is posited that socio-economic status and social, emotional, and behavioural problems play a part in the relationship between ADHD symptoms and substance use. Social, emotional, and behavioural problems include internalizing problems (refers to the internal psyche and include depression, anxiety, etc.) and externalizing problems (distress that results in outward behaviour and include aggressive and delinquent behaviours).
Methods include the use of two cycles of survey data from schools across Ontario. The age group of interest includes students that were in grade 9 through 12 at the time of the survey. Sampling weights insured that results from the study reflected students that make up the Ontario population. Importantly, the measurement used to assess ADHD symptoms was a self-report symptom checklist, not a full diagnostic assessment administered by a physician.
The overall prevalence for self-reported ADHD symptoms was 20.22%, with 16.42% of males self-reporting ADHD symptoms and 24.06% of females self-reporting ADHD symptoms. These percentages are high compared to studies that used actual diagnostic measurements; however, these percentages are comparable to studies that used the same symptom checklist that was used in this current study. Without the consideration of socio-economic status and social, emotional, and behavioural problems, it would seem as if ADHD symptoms were a risk factor for alcohol use, tobacco cigarette use, cannabis use, and stimulant use for females. For males, the findings suggest that ADHD symptoms were a risk factor for tobacco cigarette use and stimulant use. However, after controlling for socio-economic status and social, emotional, and behavioural problems, it is evident that ADHD symptoms only presented an increased risk for tobacco cigarette use and cannabis use for females. Due to the limitations, findings should be interpreted cautiously. Future studies should explore what is being captured by the self-report symptom checklist used in this current study.
Wong, Shannon W., "ADHD Symptoms and Substance Use Among Adolescents in Ontario: A Cross-Sectional Study Examining Sex Differences and Covariates" (2020). Electronic Thesis and Dissertation Repository. 7347.
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