Ortal Slobodin
Cleo L. Crunelle- 1Department of Education, Ben-Gurion University, Be'er Sheva, Israel
- 2Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
- 3Toxicological Center, Antwerp University, Antwerp, Belgium
Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development and persistence of substance use disorders (SUD). The prevalence of ADHD in patients with SUD varies across countries and cultures. So far, cross-cultural variance in ADHD prevalence rates among SUD patients was mainly ascribed to methodological differences between studies, leaving the role of societal and cultural practices in the ADHD-SUD link hardly acknowledged. The aim of the present mini review is to address this gap in the literature by providing evidence for the effect of socio-cultural practices on the ADHD-SUD link and suggesting directions for future research. To achieve this goal, we map the influence of socio-cultural factors on the ADHD-SUD link along three lines of research. The first line is concerned with the role of socio-cultural factors in the recognition, diagnosis and treatment of childhood ADHD. The second line of research is concerned with socio-cultural influences on substance use (e.g., religion, ethnic identity, acculturation, and socio-economic status). Finally, we describe potential socio-cultural factors which may operate as mechanisms for reducing or increasing access to substance abuse treatment (e.g., ethnic disparities in health care utilization). Identifying socio-cultural influences on the ADHD-SUD link may provide further insight into the bidirectional association between ADHD and SUD in different contexts and encourage future research in the field.
Introduction
Attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) are inextricably intertwined. It has been estimated that one quarter of those suffering from SUD have comorbid ADHD (1). Substance using individuals with ADHD have earlier onset of substance abuse, higher self-rated impairment across several domains of daily life, and worse prognosis in treatment compared to non-ADHD substance abusers (2, 3). To date, the mechanisms underlying the bidirectional association between ADHD and SUD are not entirely clear (4). Since both ADHD and SUD are known to be familial disorders [heritability estimate of ADHD is approximately 80% (5) and that of SUD is 40–80%, depending on substance (6, 7)], genetic contributions (8) as well as exposure to parental SUD (9) were suggested as possible explanations for their co-morbidity. Based on familial risk analysis of two longitudinal studies of probands aged 6 to 17 years, Yule et al. (10) suggested various pathways through which SUD may be transmitted in ADHD families. These include the risk associated with SUD itself, the risk conferred by ADHD, and the risk conferred by the co-segregation of ADHD and SUD. In a recent review of family, twin, and molecular ADHD genetic studies, Faraone and Larsson (11) argued that the facts that twin estimates of ADHD's heritability are <100% and that this heritability is explained by single nucleotide polymorphisms in regulatory regions rather than coding regions (12), assert quite strongly that environmental factors and gene by environment interactions account for much of ADHD's etiology.
Another explanation for the ADHD-SUD link is that ADHD-related symptoms, in particular impulsivity, lead to trying substances (13, 14). In addition, SUD and ADHD may share similar structural and functional deficits (15), particularly in relation to dopamine transmission (16, 17).
In addition to behavioral, neuropsychological, and genetic pathways, the association between ADHD and SUD is greatly influenced by socio-cultural factors. Given that drug use is often much more than a simple action performed in order to experience a physical or psychological reaction (18), culturally-relevant factors including social activities, availability, potential legal consequences, economic disparity, inadequate implementation of policies related to drug use and high-risk groups may all have a great significance to the understanding of the link between ADHD and SUD in a certain ethnic population (19).
International research revealed a wide variance in the prevalence of ADHD in SUD patients across countries and cultures (20, 21), even when controlling for diagnostic procedure (22). Among treatment seeking SUD patients, ADHD prevalence ranged between from 2% in substance abusing Icelandic adolescents (23) to 83% in Japanese methamphetamine and inhalant abusers (24). So far, cross-cultural variance in ADHD prevalence rates among SUD patients was mainly ascribed to differences in the types of abused substances and their availability, the setting (e.g., outpatient vs. inpatient), different sample sizes, and differences in the diagnostic procedure (22). While most of these studies focused on characteristics intrinsic to ADHD (e.g., impulsivity, novelty seeking, disinhibition) as risk factors for SUD, the role of societal and cultural practices in the ADHD-SUD link was hardly addressed. The aim of the present review was, therefore, to address this literature gap by describing socio-cultural influences on the ADHD-SUD link.
The associations between ADHD and SUD are usually examined in treatment-seeking SUD patients (1). Therefore, identifying socio-cultural aspects of the link between the two disorders should be investigated across the developmental trajectory that begins with ADHD and progresses to SUD (25). To achieve this goal, we map the influence of socio-cultural factors on the ADHD-SUD link along three lines of research: (1) The role of socio-cultural factors in the recognition, diagnosis and treatment of ADHD. (2) Socio-cultural influences on substance use (e.g., religion, acculturation, ethnic identity, socio-economic status), and (3) Socio-cultural factors that may operate as mechanisms for reducing or increasing access to substance abuse treatment (e.g., ethnic disparities in health care utilization).
Socio-cultural Factors in ADHD Care
Untreated childhood ADHD is a risk factor for the development of SUD (26). Therefore, cultural and ethnic diversity in the recognition, diagnosis and treatment of childhood ADHD may explain some of the obtained cross-cultural differences in the prevalence of the syndrome among SUD patients.
Culturally relevant factors, such as norms, medical approaches, beliefs, and values influence the way members of various cultural groups view and respond to problematic behavior in children (27). Cross-cultural studies, mostly from the U.S (28, 29) but also from Europe (30, 31) and Israel (32, 33), have shown that ethnic minority children are less likely to be recognized and treated for ADHD than their non-minority counterparts.
A range of perceptions and attitudes may be responsible for avoiding or delaying help seeking for ADHD, including limited knowledge about ADHD (34), fear of stigmatization (35), mistrust in school or health care systems (36), and having a higher threshold for behavioral tolerance before seeking assessment (37). In some cultures, for example, the Muslim and Christian Lebanese, hyperactivity and/or impulsivity in boys can be endorsed as typical by parents and viewed as gender preferred behavior (38). In addition, organizational, economic and environmental factors, such as language difficulties, limited insurance coverage, limited access to health care services and lack of culturally competent providers serve as barriers to adequate diagnosis and treatment among ethnic minorities and low socio-economic populations (39).
Socio-cultural barriers to accurate diagnosis and treatment of childhood ADHD may be further exacerbated in adult ADHD, especially among individuals in the criminal justice system (40). To qualify for ADHD as an adult, one must have had it as a child, making the identification of ADHD in adults a complicated task for both patients and professionals (41). Moreover, the presence of co-morbid psychiatric disorders among youth and adults with ADHD often confounds and influences treatment options (42). Currently, very little is known about cultural or ethnic diversity in adult ADHD (43). According to the American National Institute of Mental Health (44), adults of an ethnic minority background are less likely to be diagnosed with ADHD than non-minority groups. However, the efficacy of ADHD treatment in reducing psychiatric morbidity, transport accidents and criminality emphasizes the academic and clinical imperative of studying ethnic diversity in ADHD care among various ethnic and cultural groups (45, 46).
Despite growing concerns about the under-diagnosis and under-treatment of mental health problems among certain socio-cultural groups (47), cultural, racial, and language biases may also lead to over-identification of ethnic minority groups as disabled and so disproportionately over-represented in special education (48, 49).
While cultural diversity may be partly attributed to better screening, knowledge and awareness in Western cultural contexts, these factors may interact with environmental risk factors to affect ADHD risk (50). For example, immigration history and low socio-economic status have been associated with higher exposure to environmental risk factors (e.g., prenatal substance exposures, nutritional factors, and psychosocial stressors), that may increase the risk for ADHD (51). Taken together, the above-mentioned findings suggest that socio-cultural factors pertain every phase of ADHD care, affecting the likelihood that ADHD will be recognized, diagnosed and treated. Such differences across cultures and contexts, which may also be associated with geographical differences in environmental risk factors, may have a large effect on the risk of develop SUD in adulthood.
Socio-cultural Predictors of Drug Use and Abuse
Cultural norms, beliefs and attitudes, including ideologies, practices, and symbols, have a central role in forming the expectations of individuals about potential problems they may face with drug use. Such cultural norms are represented in legends, proverbs, anecdotes, and jokes, as well as in fiction and entertainment (e.g., “alcohol warms the soul,” “we do not drink, but only cure ourselves”) (52).
Among the multiple influences of socio-cultural aspects on substance use and abuse, this section focusses on the role of three cultural processes which were particularly associated with delinquency and substance use; religious affiliation, acculturation and ethnic identity.
Religious affiliations often play a protective role against drug use (53, 54). Religious involvement may inhibit adolescent risk behavior by altering behavior-influencing values or by functioning as an external control factor (55). Affiliation with religions that forbid alcohol consumption was also associated with less use of alcohol (56). Studies of European school and college students reported that first and second-generation immigrants from Muslim majority countries were less likely to drink (57, 58) and that their low levels of drinking influenced drinking overall at the schools (59).
Although lower prevalence of SUD among traditional and religious cultures may indicate compliance with socio-cultural rules or greater social control, it may also indicate a society's failure to acknowledge problems of addictions (60). For example, denial of SUD has been widely noted in Ultra-Orthodox Jews, who tend to hold the myth that Jews cannot have addictions (61). This belief results in leaders of the community failing to address the problem and discourages health professionals to conclude the diagnosis of SUD in this culture (62, 63).
Acculturation, the degree to which an individual identifies with his or her native culture, may also be related to substance use and abuse. The association between acculturation and substance use is equivocal, but overall greater levels of acculturation are associated with increased levels of substance use (64, 65). Acculturation was identified as a risk factor for alcohol use among immigrants and their children from countries with Muslim majorities in European studies (66, 67). Acculturation may increase the risk for substance use in several possible ways. According to the stress hypothesis (68), acculturated youth are particularly vulnerable to negative psychological, social, and academic outcomes due to increased psychosocial stressors, which may contribute directly and indirectly to substance use. These stressors include psychological problems such as anxiety, depression, somatic complaints, social problems, attention problems, delinquency, and aggressive behavior as well as social problems like marginalization, discrimination, oppression, and family conflicts (69, 70). Acculturation may also be associated with greater availability and accesses to substances (71) and with a greater susceptibility to peer pressure (72). In addition, acculturation is often compounded by a concomitant decrease in religiosity (73), thereby liberating individuals from cultural norms that prohibit alcohol or drug use (74, 75). Finally, acculturation can be associated with SUD because it involves a breaking of traditional, communal, spiritual, and physical circles that previously protected from delinquency. For example, several authors linked the disappearance of American Indian and Alaska Native traditions to increased substance and alcohol abuse (76, 77).
In addition to acculturation, ethnic identity may also be associated with substance use in certain cultural groups. However, its role in predicting substance use remains elusive (78). Strong ethnic identity, pride and affirmation could help immigrant adolescents to overcome hardships of immigration (79), thus contributing to better adaptation (80). On the other hand, strong ethnic identification could be a result of perceived discrimination (81), as the immigrant feeling rejected from the new host society seeks a stronger connection with his or her heritage culture. Therefore, ethnic identity would be associated with adverse outcomes. To date, studies about the relationship between ethnic identity and substance abuse revealed mixed results (82, 83).
Socio-economic status (SES) has various contradictory effects on the ADHD-SUD link. Lower SES is associated with both an increased ADHD and SUD incidence [(84), for meta-analysis]. Lower SES is also associated with reduced access to resources (e.g., proper food, housing, education), unhealthy life style, heightened family conflicts (85, 86), and higher exposure to toxic chemicals and pollution (87), which were all previously linked to increased risk for ADHD (88, 89). Low-income communities often have fewer services available, lack of health insurance coverage, limited access to mental health care and potentially increasing mental health concerns for residents in those communities (90, 91). Nevertheless, increased socio-economic status may also relate to increased access and availability of various substances (92, 93) including prescription drugs (94, 95). In regard to stimulant use, socio-cultural factors may have various effects (96). On the one hand, ethnic minorities and low-SES populations are less likely to be prescribed with stimulants and to adhere with treatment (97), therefore, more likely to develop SUD compared to those treated for the disorder. On the other hand, high SES is related to higher risk for the misuse of stimulants (giving away, trading, or selling of prescription medication (94, 95, 98).
Socio-cultural Aspects of SUD Treatment
The link between ADHD and SUD is usually investigated in treatment-seeking SUD patients (1). Therefore, socio-cultural influences on SUD treatment may have an important contribution to cultural diversity in the observed associations between the two disorders.
Overall, studies suggest that racial and ethnic minority groups are less likely than non-minority groups to enter, receive, and complete treatment for SUD (99). Ethnic disparities were identified in health care policies and regulations, provider level factors, the operation of the community system, and patient level factors (100). While the causes of the observed service gap are complex, there is an increasing recognition that poor cultural competence and/or insufficient language services are one the main reasons for ethnic minorities' underutilization of SUD treatment services (101, 102).
Treatment preference is a relatively neglected area of study in service disparities (103). Preliminary findings suggest that ethnic minorities prefer individual sessions for the treatment of SUD, probably due to the fear of negative stigma (104, 105).
Interestingly, differential referral from schools, healthcare, and government organizations may operate as mechanisms moderating access to SUD treatment (106). For example, a study of the National Survey on Drug Use and Health (N = 25,159) suggested that treatment programs that are mandated by the criminal justice system might provide access to individuals resistant to care (107).
Little is known about the role of socio-cultural factors in predicting SUD treatment adherence and outcomes. Currently, cross-cultural studies comparing treatment efficacy of intervention to reduce substance use between ethnic minorities and non-minority groups are scarce. A meta-analysis that compared the impact of cognitive behavioral therapy (CBT) in reducing substance use between studies with a predominantly White sample and studies with a predominantly Black and/or Hispanic sample (N = 17 studies), indicated that CBT, when compared to a comparison group, was equally effective in minority and non-minority studies. However, when comparing pre-posttest effect sizes from groups receiving CBT between minority and non-minority studies, CBT's impact was significantly stronger in non-minority studies (108). Several studies examining culturally competent interventions for SUD have highlighted the importance of cultural adaptation [(109, 110), for meta-analyses] and flexible, client-centered approach (111) in improving treatment outcomes. A meta-analysis by Smith et al. (112) revealed that culturally adapted interventions were frequently more effective than standard interventions and that most effective interventions included more adaptations in terms of language, content, goals, methods, context of services, etc. (113). Likewise, a recent meta- analysis (N = 7 studies) including CBT, educational, individual and family interventions for SUD, concluded that culturally sensitive treatments were associated with significantly larger reductions in post-treatment substance use levels relative to their comparison conditions (110). Nevertheless, further research is needed to determine the efficacy of culturally responsive practices in reducing ethnic disparities in SUD treatment (114).
Conclusions
This review highlights the role of socio-cultural aspects in the link between ADHD and SUD. These aspects include cultural factors such as perceptions of normal and abnormal behavior, behavioral norms, and attitudes and knowledge about mental health problems (37, 115) as well as factors related to the utilization of mental health services among certain populations (102). Interpretation of the studies integrated in this review is hindered by the limited number of included studies, small sample sizes, and ethnic heterogeneity and variability in comparison conditions across studies (110). Therefore, further large-scale research in needed in order to determine the efficacy of culturally responsive practices in reducing ethnic disparities in SUD treatment (114).
Continued research on socio-cultural aspects along with biological aspects is required to understand the interplay of all factors in the ADHD-SUD link. Understanding the role of culture and context in the ADHD-SUD link may not only shed light on the current enormous variance in the prevalence of ADHD in SUD patients across cultures (21), but also assist in early and accurate detection of ADHD in SUD patients.
Author Contributions
OS and CC contributed equally to the literature search, literature analysis, data integration, and writing the review manuscript.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The reviewer CB declared a past co-authorship with the authors to the handling editor.
References
1. van Emmerik-van Oortmerssen K, van de Glind G, van den Brink W, Smit F, Crunelle CL, Swets M, et al. Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug Alcohol Depend. (2012) 122:11–9. doi: 10.1016/j.drugalcdep.2011.12.007
2. Lee SS, Humphreys KL, Flory K, Liu R, Glass K. Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinic Psychol Rev. (2011) 31:328–41. doi: 10.1016/j.cpr.2011.01.006
3. Liao YT, Chen CY, Ng MH, Huang KY, Shao WC, Lin TY, et al. Depression and severity of substance dependence among heroin dependent patients with ADHD symptoms. Am J Addict. (2017) 26:26–33. doi: 10.1111/ajad.12487
4. Upadhyaya HP. Substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: implications for treatment and the role of the primary care physician. Prim Care Compan J Clin Psychiatry. (2008) 10:211–21. doi: 10.4088/PCC.v10n0306
5. Volkow ND, Swanson JM. Clinical practice: adult attention deficit-hyperactivity disorder. N Engl J Med. (2013) 369:1935–44. doi: 10.1056/NEJMcp1212625
6. Agrawal A, Lynskey MT. Are there genetic influences on addiction: evidence from family, adoption and twin studies. Addiction. (2008) 103:1069–81. doi: 10.1111/j.1360-0443.2008.02213.x
7. Li MD, Burmeister M. New insights into the genetics of addiction. Nat Rev Genet. (2009) 10:225–31. doi: 10.1038/nrg2536
8. Skoglund C, Chen Q, Franck J, Lichtenstein P, Larsson H. Attention-deficit/hyperactivity disorder and risk for substance use disorders in relatives. Biol Psychiatry. (2015) 77:880–6. doi: 10.1016/j.biopsych.2014.10.006
9. Yule AM, Wilens TE, Martelon MK, Simon A, Biederman J. Does exposure to parental substance use disorders increase substance use disorder risk in offspring? a 5-year follow-up study. Am J Addict. (2013) 22:460–5. doi: 10.1111/j.1521-0391.2013.12048.x
10. Yule AM, Martelon M, Faraone SV, Carrellas N, Wilens TE, Biederman J. Examining the association between attention deficit hyperactivity disorder and substance use disorders: a familial risk analysis. J Psychiatr Res. (2016) 85:49–55. doi: 10.1016/j.jpsychires.2016.10.018
11. Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychitary. (2019) 24:562–75. doi: 10.1038/s41380-018-0070-0
12. Gusev A, Lee SH, Trynka G, Finucane H, Vilhjalmsson BJ, Xu H, et al. Partitioning heritability of regulatory and cell-type-specific variants across 11 common diseases. Am J Hum Genet. (2014) 95:535–52. doi: 10.1016/j.ajhg.2014.10.004
13. Evren C, Alniak I, Karabulut V, Cetin T, Umut G. Relationship of probable attention deficit hyperactivity disorder with severity of psychopathology and impulsivity in a sample of male patients with opioid use disorder. Psychiatry Investig. (2018) 15:164–71. doi: 10.30773/pi.2017.05.14.1
14. Slobodin O, van de Glind G, Johan F, Itai B, Nir Y, Iliyan I, et al. The role of different aspects of impulsivity as independent risk factors for substance use disorders in patients with ADHD: a review. Curr.Drug Abuse Rev. (2015) 8:119–33. doi: 10.2174/1874473708666150916112913
15. Chang Z, Lichtenstein P, Larsson H. The effects of childhood ADHD symptoms on early-onset substance use: a Swedish twin study. J Abnorm Child Psychol. (2012) 40:425–35. doi: 10.1007/s10802-011-9575-6
16. Jones JD, Comer SD, Kranzler HR. The pharmacogenetics of alcohol use disorder. Alcohol Clin Exp Res. (2015) 39:391–402. doi: 10.1111/acer.12643
17. Volkow ND, Wang GJ, Telang F, Fowler JS, Thanos PK, Logan J, et al. Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: possible contributing factors. Neuroimage. (2008) 42:1537–43. doi: 10.1016/j.neuroimage.2008.06.002
18. Golub A, Johnson BD, Dunlap E. Subcultural evolution and illicit drug use. Addict Res Theory. (2005) 13:217–29. doi: 10.1080/16066350500053497
19. Wilsnack SC. The GENACIS project: a review of findings and some implications for global needs in women-focused substance abuse prevention and intervention. Subst Abuse Rehabil. (2012) 3:5–15. doi: 10.2147/SAR.S21343
20. Kousha M, Shahrivar Z, Alaghband-Rad J. Substance use disorder and ADHD: is ADHD a particularly “specific” risk factor? J Atten Disord. (2012) 16:325–32. doi: 10.1177/1087054710387265
21. Salama H, Ibrahim S, El Magd OA, Kerim AA. The impact of attention-deficit hyperactivity disorder across the lifespan on substance use disorders. Egypt J Psychiatr. (2015) 36:66–72. doi: 10.4103/1110-1105.158113
22. van de Glind G, Konstenius M, Koeter MWJ, van Emmerik-van Oortmerssen K, Carpentier PJ, Kaye S, et al. Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: results from an international multi-center study exploring DSM-IV and DSM-5 criteria. Drug Alcohol Depend. (2014) 134:158–66. doi: 10.1016/j.drugalcdep.2013.09.026
23. Hannesdottir H, Tyrfingsson T, Piha J. Psychosocial functioning and psychiatric comorbidity among substance-abusing Icelandic adolescents. Nord J Psychiatry. (2001) 55:43–8. doi: 10.1080/080394801750093742
24. Matsumoto T, Kamijo A, Yamaguchi A, Iseki E, Hirayasu Y. Childhood histories of attention-deficit hyperactivity disorders in Japanese metham-phetamine and inhalant abusers: preliminary report. Psychiatry Clin Neurosci. (2005) 59:102–5. doi: 10.1111/j.1440-1819.2005.01340.x
25. Groenman AP, Oosterlaan J, Rommelse N, Franke B, Roeyers H, Oades RD, et al. Substance use disorders in adolescents with attention deficit hyperactivity disorder: a 4-year follow-up study. Addiction. (2013) 108:1503–11. doi: 10.1111/add.12188
26. Levy S, Katusic SK, Colligan RC, Weaver AL, Killian JM, Voigt RG, et al. Childhood ADHD and risk for substance dependence in adulthood: a longitudinal, population-based study. PLoS ONE. (2014) 9:e105640. doi: 10.1371/journal.pone.0105640
27. Filipe AM. Making ADHD evident: data, practices, and diagnostic protocols in Portugal. Med Anthropol. (2016) 35:390–403 doi: 10.1080/01459740.2015.1101102
28. Morgan PL, Staff J, Hillemeier MM, Farkas G, Maczuga S. Racial and ethnic disparities in ADHD diagnosis from kindergarten to eighth grade. Pediatrics. (2013) 132:85–93. doi: 10.1542/peds.2012-2390
29. Ray GT, Levine P, Croen LA, Bokhari FA, Hu TW, Habel LA. Attention-deficit/hyperactivity disorder in children: excess costs before and after initial diagnosis and treatment cost differences by ethnicity. Arch Pediatr Adolesc Med. (2006) 160:1063–9. doi: 10.1001/archpedi.160.10.1063
30. Arat A, Ostberg V, Burström B, Hjern A. ADHD medication in offspring of immigrants — does the income level of the country of parental origin matter? BMC Psychiatry. (2018) 18:3. doi: 10.1186/s12888-017-1572-z
31. Knopf H, Hölling H, Huss M, Schlack R. Prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication of children and adolescents in Germany: results of the German Health Interview and Examination Survey (KiGGS). BMJ Open. (2012) 2:e000477. doi: 10.1136/bmjopen-2011-000477
32. Farbstein I, Mansbach-Kleinfeld I, Auerbach J, Ponizovsky AM, Apter A. The israel survey of mental health among adolescents: prevalence of attention deficit/hyperactivity disorder, comorbidity methylphenidate, use, and help-seeking patterns. Isr Med Assoc J. (2014) 16:568–73.
33. Mahajna M, Sharkia R, Shorbaji N, Zelnik N. Clinical profile of attention deficit hyperactivity disorder: impact of ethnic and social diversities in Israel. Isr Med Assoc J. (2016) 18:322–5.
34. Pham AV, Carlson JS, Kosciulek JF. Ethnic differences in parental beliefs of attention-deficit/hyperactivity disorder and treatment. J. Atten.Disord. (2010) 13:584–59. doi: 10.1177/1087054709332391
35. Olaniyan O, dosReis S, Garriett V, Mychailyszyn MP, Anixt J, Rowe PC, et al. Community perspectives of childhood behavioral problems and ADHD among African American parents. Ambul Pediatr. (2007) 7:226–31. doi: 10.1016/j.ambp.2007.02.002
36. Bailey RK, Jaquez-Gutierrez MC, Madhoo M. Sociocultural issues in African American and Hispanic minorities seeking care for attention-deficit/hyperactivity disorder. Prim Care Companion CNS Disord. (2014) 16. doi: 10.4088/PCC.14r01627
37. Bussing R, Zima BT, Mason DM, Meyer JM, White K, Garvan CW. ADHD knowledge, perceptions and information sources: perspectives from a community sample of adolescents and their parents. J Adolesc Health. (2012) 51:593–600. doi: 10.1016/j.jadohealth.2012.03.004
38. Bathiche ME. The Prevalence of ADHD Symptoms in a Culturally Diverse and Developing Country. Montreal, QC: McGill University (2007).
39. Slobodin O, Masalha R. Challenges in ADHD care for ethnic minority children: a review of the current literature. Transcult Psychiatry. (2019).
40. Young S, Gudjonsson G, Colley B, Farrag E, Forrester A, Hollingdale J, et al. Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus. BMC Psychiatry. (2018) 18:281. doi: 10.1186/s12888-018-1858-9
41. Gentile J, Atiq R, Gillig PM. Adult ADHD: diagnosis, differential diagnosis, and medication management. Psychiatry. (2006) 3:25–30.
42. Young S, Sedgwick O, Fridman M, Gudjonsson G, Hodgkins P, Lantigua M, et al. Co-morbid psychiatric disorders among incarcerated ADHD populations: a meta-analysis. Psychol Med. (2015) 45:2499–510. doi: 10.1017/S0033291715000598
43. Waite R, Ramsay JR. Adults with ADHD: who are we missing? Issues Ment Health Nurs. (2010) 31:670–8. doi: 10.3109/01612840.2010.496137
44. National Institute for Mental Health. Attention-Deficit/Hyperactivity Disorder (ADHD). (2011). Retrieved from: https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml
45. Chen Q, Sjolander A, Runeson B, D'Onofrio BM, Lichtenstein P, Larsson H. Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. BMJ. (2014) 348:3769. doi: 10.1136/bmj.g3769
46. Lichtenstein P, Larsson H. Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med. (2013) 368:776. doi: 10.1056/NEJMc1215531
47. Coker T, Elliott MN, Toomey SL, Schwebel DC, Cuccaro P, Davies SL, et al. Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics. (2016) 138:e20160407. doi: 10.1542/peds.2016-0407
48. Cooc N, Kiro EW. Disproportionality in special education: a synthesis international research trends. J Spec Educ. (2018) 52:163–73. doi: 10.1177/0022466918772300
49. U.S. Department of Education. Racial and Ethnic Disparities in Special Education: A Multi-Year Disproportionality Analysis by State, Analysis Category, and Race/Ethnicity. Washington, DC: U.S. Department of Education (2016).
50. van de Glind G, Van Emmerik-van Oortmerssen K, Carpentier PJ, Levin FR, Koeter MW, Barta C, et al. The International ADHD in Substance Use Disorders Prevalence (IASP) study: background, methods and study population. Int J Methods Psychiatr Res. (2013) 22:232–44. doi: 10.1002/mpr.1397
51. Froehlich TE, Anixt JS, Loe IM, Chirdkiatgumchai V, Kuan L, Gilman RC. Update on environmental risk factors for attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. (2011) 13:333–44. doi: 10.1007/s11920-011-0221-3
52. Sverslov LS. Cultural Aspects of the Social Attitudes Toward Alcohol in Russia: The Mythology and Cult of Alcohol. Common Health. (2001). Retrieved from: https://www.aiha.com/wp-content/uploads/2015/07/14-Cultural-Aspects-of-the-Social-Attitudes-Toward-Alcohol-in-Russia.pdf
53. Marsiglia FF, Kulis S, Nieri T, Parsai M. God forbid! Substance use among religious and non-religious youth. Am J Orthopsychiatry. (2005) 75:585–98. doi: 10.1037/0002-9432.75.4.585
54. National Center on Addiction and Substance Abuse. So help Me God: Substance Abuse, Religion, and Spirituality. New York, NY: National Center on Addiction and Substance Abuse (2001).
55. Mason A, Windle M. Family, religious, school and peer influences on adolescent alcohol use: A longitudinal study. J Stud Alcohol. (2001) 62:44 doi: 10.15288/jsa.2001.62.44
56. Merrill RM, Salazar RD, Gardner NW. Relationship between family religiosity and drug use behavior among youth. Soc Behav Personal. (2001) 29:347–57. doi: 10.2224/sbp.2001.29.4.347
57. Bradby H, Williams R. Is religion or culture the key feature in changes in substance use after leaving school? Young Punjabis and a comparison group in Glasgow. Ethn Health. (2006) 11:307–24. doi: 10.1080/13557850600628372
58. van Tubergen F, Poortman AR. Adolescent alcohol use in the Netherlands: the role of ethnicity, ethnic intermarriage, and ethnic school composition. Ethn Health. (2010) 15:1–13. doi: 10.1080/13557850903373908
59. Amundsen EJ, Rossow I, Skurtveit S. Drinking pattern among adolescents with immigrant and Norwegian backgrounds: a two-way influence? Addiction. (2005) 100:1453–63. doi: 10.1111/j.1360-0443.2005.01177.x
60. Khampang R, Assanangkornchai S, Teerawattananon Y. Perceived barriers to utilise methadone maintenance therapy among male injection drug users in rural areas of southern Thailand. Drug Alcohol Rev. (2015) 34:645–53. doi: 10.1111/dar.12268
61. Loewenthal KM. Addiction: alcohol and substance abuse in Judaism. Religions. (2014) 5:972–84. doi: 10.3390/rel5040972
62. Glass C. Addiction and recovery through Jewish eyes. In: Morgan OJ, Jordan M, editors. Addiction and Spirituality: A Multidisciplinary Approach. St. Louis, MO: Chalice Press (1999). p. 235–47.
63. Vex SL, Blume SB. The JACS study I: characteristics of a population of chemically dependent Jewish men and women. J Addict Dis. (2001) 20:71–89. doi: 10.1300/J069v20n04_07
64. Arfken CL, Kubiak SP, Farrag M. Acculturation and polysubstance abuse in Arab-American treatment clients. Transcult Psychiatry. (2009) 46:608–22. doi: 10.1177/1363461509351364
65. Unger J, Cruz TB, Rohrbach LA, Ribisl KM, Baezconde-Garbanati L, Chen X, et al. English language use as a risk factor for smoking initiation among Hispanic and Asian American adolescents: evidence for mediation by tobacco-related beliefs and social norms. Health Psychol. (2000) 19:403–10. doi: 10.1037/0278-6133.19.5.403
66. Sarasa-Renedo A, Sordo L, Pulido J, Guitart A, González-González R, Hoyos J, et al. Effect of immigration background and country-of-origin contextual factors on adolescent substance use in Spain. Drug Alcohol Depend. (2015) 153:124–34. doi: 10.1016/j.drugalcdep.2015.05.040
67. Delforterie MJ, Creemers HE, Huizink AC. Recent cannabis use among adolescent and young adult immigrants in the Netherlands: the roles of acculturation strategy and linguistic acculturation. Drug Alcohol Depend. (2014) 136:79–84. doi: 10.1016/j.drugalcdep.2013.12.014
68. Berry JW, Kim U, Minde T, Mok D. Comparative studies of acculturative stress. Int Migr Rev. (1987) 21:491–511. doi: 10.1177/019791838702100303
69. Bui HN. Immigrant generational status and delinquency in adolescence: segmented assimilation and racial ethnic differences. In: Garcia C, Marks AK, Editors. The Immigrant Paradox in Children and Adolescents: Is Becoming American a Developmental Risk? Washington, DC: American Psychological Association (2012). p. 135–58.
70. Sirin SR, Ryce P, Gupta T, Rogers-Sirin L. The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation. Dev Psychol. (2013) 49:736–48. doi: 10.1037/a0028398
71. Escobar J. Immigration and mental health: why are immigrants better off? Arch Gen Psychiatry. (1998) 55:781–2. doi: 10.1001/archpsyc.55.9.781
72. Wall JA, Power TG, Arbona C. Susceptibility to antisocial peer pressure and its relation to acculturation in Mexican-American adolescents. J Adolesc Res. (1993) 8:403–18. doi: 10.1177/074355489384004
74. Marsiglia FF, Waller M. Language preference and drug use among Southwestern Mexican American middle school students. Child School. (2002) 24:145–58. doi: 10.1093/cs/24.3.145
75. Haasen C, Sinaa M, Reimer J. Alcohol use disorders among Afghan migrants in Germany. Subst Abuse. (2008) 29:65–70. doi: 10.1080/08897070802218828
76. French LA. Alcohol and other drug addictions among Native Americans: the movement toward tribal-centric treatment programs. Alcohol Treat Q. (2004) 22:81–91. doi: 10.1300/J020v22n01_06
77. Stone RA, Whitbeck LB, Chen X, Johnson K, Olson DM. Traditional practices, traditional spirituality, and alcohol cessation among American Indians. J Stud Alcohol. (2006) 67:236–44. doi: 10.15288/jsa.2006.67.236
78. Le TN, Stockdale G. Acculturative dissonance, ethnic identity, and youth violence. Cultur Divers Ethnic Minor Psychol. (2008) 14:1–9. doi: 10.1037/1099-9809.14.1.1
79. Phinney JS, Chavira V. Ethnic identity and self-esteem: an exploratory longitudinal study. J Adolesc. (1992) 15:271–81. doi: 10.1016/0140-1971(92)90030-9
80. Benish-Weisman M. Brief report: ethnic identity and aggression in adolescence: a longitudinal perspective. J Adolesc. (2016) 47:131–4. doi: 10.1016/j.adolescence.2015.05.015
81. Branscombe NR, Schmitt MT, Harvey RD. Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being. J Pers Soc Psychol. (1999) 77:135–49. doi: 10.1037/0022-3514.77.1.135
82. Walsh SD, Edelstein A, Vota D. Suicidal ideation and alcohol use among Ethiopian adolescents in Israel: the relationship with ethnic identity and parental support. Eur Psychol. (2012) 17:131–42. doi: 10.1027/1016-9040/a000115
83. Walsh SD, Fogel-Grinvald H, Shnieder S. Discrimination and ethnic Identity as predictors of substance use and delinquency among immigrant adolescents from the FSU and Ethiopia in Israel. J Cross Cult Psychol. (2015) 46:942–63. doi: 10.1177/0022022115588951
84. Russell AE, Ford T, Williams R, Russell G. The association between socioeconomic disadvantage and attention deficit/hyperactivity disorder (ADHD): a systematic review. Child Psychiatry Hum Dev. (2016) 47:440–58. doi: 10.1007/s10578-015-0578-3
85. Conger RD, Conger KJ, Martin MJ. Socioeconomic status, family processes, and individual development. J Marriage Fam. (2010) 72:685–704. doi: 10.1111/j.1741-3737.2010.00725.x
86. Santiago CD, Wadsworth ME, Stump J. Socioeconomic status, neighborhood disadvantage, and poverty-related stress: prospective effects on psychological syndromes among diverse low-income families. J Econ Psychol. (2011) 32:218–30. doi: 10.1016/j.joep.2009.10.008
87. Duncan G, Brooks-Gunn J. Family poverty, welfare reform, and child development. Child Dev. (2000) 71:188–96. doi: 10.1111/1467-8624.00133
88. Nigg JT. Attention-deficit/hyperactivity disorder and adverse health outcomes. Clin. Psychol. Rev. (2013) 33:215–28. doi: 10.1016/j.cpr.2012.11.005
89. Weissenberger S, Ptacek R, Klicperova-Baker M, Erman A, Schonova K, Raboch J, et al. ADHD, lifestyles and comorbidities: a call for an holistic perspective - from medical to societal intervening factors. Front Psychol. (2017) 8:454. doi: 10.3389/fpsyg.2017.00454
90. Chow JC, Jaffee K, Snowden L. Racial/ethnic disparities in the use of mental health services in poverty areas. Am J Public Health. (2003) 93:792–7. doi: 10.2105/AJPH.93.5.792
91. Pastor PN, Reuben CA. Racial and ethnic differences in ADHD and LD in young school-age children: parental reports in the National Health Interview Survey. Public Health Rep. (2005) 120:383–92. doi: 10.1177/003335490512000405
92. Boyd C, McCabe SE, d'Arcy H. Ecstasy use among college undergraduates: gender, race and sexual identity. J Subst Abuse Treat. (2003) 24:209–15. doi: 10.1016/S0740-5472(03)00025-4
93. Strote J, Lee JE, Wechsler H. Increasing MDMA use among college students: results of a national survey. J Adolesc Health. (2002) 30:64–72. doi: 10.1016/S1054-139X(01)00315-9
94. McCabe SE, Knight JR, Teter CJ, Wechsler H. Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Addiction. (2005) 100:96–106. doi: 10.1111/j.1360-0443.2005.00944.x
95. McCabe SE, Teter CJ, Boyd CJ, Knight JR, Wechsler H. Non-medical use of prescription opioids among U.S. college students: prevalence and correlates from a national survey. Addict Behav. (2005) 30:789–805. doi: 10.1016/j.addbeh.2004.08.024
96. Ghosh M, Holman CDJ, Preen DB. Identifying cross-cultural variations in psychostimulant use for attention deficit hyperactivity disorder using linked data. Child Adolesc Psychiatry Ment Health. (2017) 11:16. doi: 10.1186/s13034-017-0152-9
97. Visser SN, Danielson ML, Bitsko RH, Holbrook JR, Kogan MD, Ghandouet R, et al. Trends in the parent-report of health care provider diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. J Am Acad Child Adolesc Psychiatry. (2014) 53:34–46 doi: 10.1016/j.jaac.2013.09.001
98. Luthar SS, Small PJ, Ciciolla L. Adolescents from upper middle class communities: Substance misuse and addiction across early adulthood. Dev Psychopathol. (2018) 30:315–35. doi: 10.1017/S0954579417000645
99. Guerrero EG, Marsh JC, Duan L, Oh C, Perron B, Lee B. Disparities in completion of substance abuse treatment between and within racial and ethnic groups. Health Ser Res. (2013) 48:1450–67. doi: 10.1111/1475-6773.12031
100. Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: an integrative literature review. J Subst Abuse Ttreat. (2015) 61:47–59. doi: 10.1016/j.jsat.2015.09.006
101. Hadland SE, Baer TE. The racial and ethnic gap in substance use treatment: implications for U.S. healthcare reform. J Adolesc Health. (2014) 54:627–8. doi: 10.1016/j.jadohealth.2014.03.015
102. Saloner B, Carson N, Lê Cook B. Explaining racial/ethnic differences in adolescent substance abuse treatment completion in the United States: a decomposition analysis. J Adolesc Health. (2014) 54:646–53. doi: 10.1016/j.jadohealth.2014.01.002
103. Alegria M, Carson NJ, Goncalves M, Keefe K. Disparities in treatment for substance use disorders and co-occurring disorders for ethnic/racial minority youth. J Am Acad Child Adolesc Psychiatry. (2011) 50:22–31. doi: 10.1016/j.jaac.2010.10.005
104. Arfken CL, Ahmed S. Ten years of substance use research in Muslim populations: Where do we go from here? J Muslim Mental Health. (2016) 10:13–24. doi: 10.3998/jmmh.10381607.0010.103
105. D'Amico EJ, Anderson KG, Metrik J, Frissell KC, Ellingstad T, Brown SA. Adolescent self-selection of service formats: implications for secondary interventions targeting alcohol use. Am J Addict. (2006) 15:58–66. doi: 10.1080/10550490601003722
106. Acevedo A, Garnick DW, Lee MT, Horgan CM, Ritter G, Panas L, et al. Racial and ethnic differences in substance abuse treatment initiation and engagement. J Ethn Subst Abuse. (2012) 11:1–21. doi: 10.1080/15332640.2012.652516
107. Cook BL, Alegría M. Racial-ethnic disparities in substance abuse treatment: the role of criminal history and socioeconomic status. Psychiatr Serv. (2011) 62:1273–81. doi: 10.1176/ps.62.11.pss6211_1273
108. Winsdor LC, Jemal A, Alessi E. Cognitive behavioral therapy: a meta-analysis of race and substance use outcomes. Cultur Divers Ethnic Minor Psychol. (2015) 21:300–13. doi: 10.1037/a0037929
109. Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychother Theo Res Prac Train. (2006) 43:531–48. doi: 10.1037/0033-3204.43.4.531
110. Steinka-Fry KT, Tanner-Smith EE, Dakof GA, Henderson C. Culturally sensitive substance use treatment for racial/ethnic minority youth: a meta-analytic review. J Subst Abuse Treat. (2017) 75:22–37. doi: 10.1016/j.jsat.2017.01.006
111. Norcross JC, Wampold BE. Evidence-based therapy relationships: research conclusions and clinical practices. In: Norcross JC, editor. Psychotherapy Relationships That Work: Evidence-Based Responsiveness. New York, NY: Oxford University Press (2011). p. 423–430.
112. Smith TB, Domenech Rodríguez M, Bernal G. Culture. J Clin Psychol. (2011) 67:166–75. doi: 10.1002/jclp.20757
113. Bernal G, Saez-Santiago E. Culturally centered psychosocial interventions. J Commu Psychol. (2006) 34:121–32. doi: 10.1002/jcop.20096
114. Guerrero EG, Cook B, Kong Y. Does the implementation of evidence-based and culturally competent practices reduce disparities in addiction treatment outcomes? Addict Behav. (2017) 73:119–23. doi: 10.1016/j.addbeh.2017.05.006
Keywords: ADHD, culture, ethnicity, socio-economic status, SUD
Citation: Slobodin O and Crunelle CL (2019) Mini Review: Socio-Cultural Influences on the Link Between ADHD and SUD. Front. Public Health 7:173. doi: 10.3389/fpubh.2019.00173
Received: 11 February 2019; Accepted: 10 June 2019;
Published: 26 June 2019.
Edited by:
Patrik Roser, Psychiatric Services Aargau, SwitzerlandReviewed by:
Regina Lai Tong Lee, University of Newcastle, AustraliaCsaba Barta, Semmelweis University, Hungary
Copyright © 2019 Slobodin and Crunelle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Ortal Slobodin, b3J0YWwuc2xvYm9kaW4mI3gwMDA0MDtnbWFpbC5jb20=