Parental warmth and risks of substance use in children with attention-deficit/hyperactivity disorder

Objective: The study examined factors in the risk trajectory for substance use disorder (SUD) over a 10-12-year period in children with attention-deficit/hyperactivity disorder (ADHD). Method: N145 children between the ages of 7 and 16 with ADHD and healthy controls (HCs) were assessed every 2 years for 10-12 years as part of a larger, longitudinal investigation. Onset of SUD was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors. Results: Low paternal warmth and maternal SUD were predictors of SUD in n=59 ADHD participants after adjusting for gender, child oppositional defiant disorder (ODD), paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder, maternal/paternal anxiety and low maternal warmth in the Cox model. Conclusions: Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted.