{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:03:46Z","timestamp":1780095826899,"version":"3.54.0"},"reference-count":25,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2013,11,30]],"date-time":"2013-11-30T00:00:00Z","timestamp":1385769600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjcapp-2014-012_s_001\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although existing literature demonstrates the association of attention-deficit\/hyperactivity disorder (ADHD) with both substance use (SU) and autism spectrum disorder (ASD), few studies have examined rates of SU among adolescents with elevated ASD symptoms, with or without comorbid ADHD. Clinic-based studies suggest a possible protective effect of ASD against SU, but this has not been confirmed in population-based studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjcapp-2014-012_s_002\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We examined alcohol, tobacco, and drug use in adolescents with either ADHD, elevated autistic traits, or both as compared with controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjcapp-2014-012_s_003\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Subjects (N = 2937) who were 13 to 17 years old from a Missouri population-based large sibship sample were assessed for ADHD, autistic traits, and SU with the use of parent-report questionnaires. The\n                      <jats:italic toggle=\"yes\">Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition<\/jats:italic>\n                      ADHD symptom criterion (Criterion A) was applied to the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN) questionnaire item responses to determine ADHD diagnosis. The presence of elevated autistic traits was defined as a raw Social Responsiveness Scale (SRS) score of 62 (95\n                      <jats:sup>th<\/jats:sup>\n                      percentile for this sample) or higher. SU was determined with the use of three items from the Child Behavior Checklist (CBCL). Statistical methods used included logistic and fractional polynomial regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjcapp-2014-012_s_004\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>As compared with controls, adolescents with ADHD were at increased risk for alcohol, tobacco, and drug use whether or not they had elevated autistic traits. Adolescents with elevated autistic traits were at significantly increased risk for drug use other than alcohol and tobacco, even if they did not have ADHD. Among those with raw SRS scores in the range of about 20 (normal) to 80 (consistent with mild to moderate ASD), adolescents with ADHD had higher levels of SU than control individuals with similar levels of autistic traits. However, strong conclusions cannot be drawn regarding individuals with very low or very high SRS scores as a result of sparse data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjcapp-2014-012_s_005\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study confirms previous research showing an increased risk of SU among adolescents with ADHD. It also provides new information indicating that adolescents with high levels of autistic traits are at elevated risk for alcohol and tobacco use if they have comorbid ADHD; in addition, they may be at high risk for other drug use, even if they do not have comorbid ADHD. Therefore, it should not be assumed that adolescents with mild to moderate ASD have a low risk of SU, especially if ADHD is also present.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.21307\/sjcapp-2014-012","type":"journal-article","created":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T03:13:39Z","timestamp":1466478819000},"page":"86-92","source":"Crossref","is-referenced-by-count":11,"title":["Attention-Deficit\/Hyperactivity Disorder, Autistic Traits, and Substance Use Among Missouri Adolescents"],"prefix":"10.2478","volume":"2","author":[{"given":"Richard C.","family":"Mulligan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Washington University in St. Louis School of Medicine , St. Louis, MO , Washington , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Reiersen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St. Louis School of Medicine , St. Louis, MO , Washington , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre A.","family":"Todorov","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St. Louis School of Medicine , St. Louis, MO , Washington , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2013,11,30]]},"reference":[{"key":"2026052922292300779_j_sjcapp-2014-012_ref_001","doi-asserted-by":"crossref","unstructured":"Elkins IJ, McGue M, Iacono WG. Prospective effects of attention-deficit\/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Arch Gen Psychiatry 2007;64(10):1145\u201352.","DOI":"10.1001\/archpsyc.64.10.1145"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_002","doi-asserted-by":"crossref","unstructured":"Molina BS, Pelham WE, Jr. Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. J Abnorm Psychol 2003;112(3):497\u2013507.","DOI":"10.1037\/0021-843X.112.3.497"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_003","doi-asserted-by":"crossref","unstructured":"Wilens TE, Biederman J, Mick E, Faraone SV, Spencer T. Attention deficit hyperactivity disorder (ADHD) is associated with early onset substance use disorders. J Nerv Ment Dis 1997;185(8):475-82.","DOI":"10.1097\/00005053-199708000-00001"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_004","doi-asserted-by":"crossref","unstructured":"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. Clin Psychol Rev 2011;31(3):328-41.","DOI":"10.1016\/j.cpr.2011.01.006"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_005","doi-asserted-by":"crossref","unstructured":"Kessler RC, Adler LA, Barkley R, Biederman J, Conners CK, Faraone SV, et al. Patterns and predictors of attention-deficit\/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biol Psychiatry 2005;57(11):1442-51.","DOI":"10.1016\/j.biopsych.2005.04.001"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_006","doi-asserted-by":"crossref","unstructured":"Glass K, Flory K. Why does ADHD confer risk for cigarette smoking? A review of psychosocial mechanisms. Clin Child Fam Psychol Rev 2010;13(3):291-313.","DOI":"10.1007\/s10567-010-0070-3"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_007","doi-asserted-by":"crossref","unstructured":"Reiersen AM, Constantino JN, Volk HE, Todd RD. Autistic traits in a population-based ADHD twin sample. J Child Psychol Psychiatry 2007;48(5):464-72.","DOI":"10.1111\/j.1469-7610.2006.01720.x"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_008","doi-asserted-by":"crossref","unstructured":"Abdallah MW, Greaves-Lord K, Grove J, Norgaard-Pedersen B, Hougaard DM, Mortensen EL. Psychiatric comorbidities in autism spectrum disorders: findings from a Danish historic birth cohort. Eur Child Adolesc Psychiatry 2011;20(11-12):599-601.","DOI":"10.1007\/s00787-011-0220-2"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_009","doi-asserted-by":"crossref","unstructured":"Santosh PJ, Mijovic A. Does pervasive developmental disorder protect children and adolescents against drug and alcohol use? Eur Child Adolesc Psychiatry 2006;15(4):183-8.","DOI":"10.1007\/s00787-005-0517-0"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_010","doi-asserted-by":"crossref","unstructured":"Ramos M, Boada L, Moreno C, Llorente C, Romo J, Parellada M. Attitude and risk of substance use in adolescents diagnosed with Asperger syndrome. Drug Alcohol Depend 2013;133(2):535-40.","DOI":"10.1016\/j.drugalcdep.2013.07.022"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_011","doi-asserted-by":"crossref","unstructured":"Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD. Sex and age differences in attention-deficit\/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11. J Am Acad Child Adolesc Psychiatry 2010;49(3):217-28 e1-3.","DOI":"10.1016\/j.jaac.2009.11.011"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_012","unstructured":"Swanson J, Shnuck S, Mann M, Carlson C, Hartman K, Sergeant J, et al. Categorical and dimensional definitions and evaluations of symptoms of ADHD: The SNAP and the SWAN rating scales. Available from: www.adhd.net."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_013","doi-asserted-by":"crossref","unstructured":"Reiersen AM, Todorov AA. Exploration of ADHD subtype definitions and co-occurring psychopathology in a Missouri population-based large sibship sample. Scand J Child Adolesc Psychiatr Psychol 2013;1(1):3-13.","DOI":"10.21307\/sjcapp-2013-002"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_014","doi-asserted-by":"crossref","unstructured":"Constantino JN, Davis SA, Todd RD, Schindler MK, Gross MM, Brophy SL, et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord 2003;33(4):427-33.","DOI":"10.1023\/A:1025014929212"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_015","unstructured":"Constantino JN, Gruber CP. Social Responsiveness Scale, Second Edition (SRS-2). Torrance, CA: Western Psychological Services; 2012."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_016","doi-asserted-by":"crossref","unstructured":"Constantino JN, Lavesser PD, Zhang Y, Abbacchi AM, Gray T, Todd RD. Rapid quantitative assessment of autistic social impairment by classroom teachers. J Am Acad Child Adolesc Psychiatry 2007;46(12):1668-76.","DOI":"10.1097\/chi.0b013e318157cb23"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_017","doi-asserted-by":"crossref","unstructured":"Rutter M, Le Couteur A, Lord C. Autism Diagnostic Interview-Revised (ADI-R). Los Angeles, CA: Western Psychological Services; 2003","DOI":"10.1037\/t18128-000"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_018","unstructured":"Lord C, Rutter M, DiLavore P, Risi S. Autism Diagnostic Observation Schedule (ADOS). Los Angeles, CA: Western Psychological Services; 2001."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_019","doi-asserted-by":"crossref","unstructured":"Reiersen AM, Constantino JN, Todd RD. Co-occurrence of motor problems and autistic symptoms in attention-deficit\/hyperactivity disorder. J Am Acad Child Adolesc Psychiary 2008;47(6):662-72.","DOI":"10.1097\/CHI.0b013e31816bff88"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_020","unstructured":"Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families; 2001."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_021","unstructured":"StataCorp. Stata Statistical Software: Release 12. College Station, TX: StataCorp LP; 2011."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_022","unstructured":"Centers for Disease Control and Prevention. Increasing prevalence of parent-reported attention-deficit\/hyperactivity disorder among children -- United States, 2003 and 2007. MMWR Morb Mortal Wkly Rep 2010;59(44):1439-43."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_023","unstructured":"Centers for Disease Control and Prevention. Youth risk behavior surveillance - United States, 2009. Surveillance Summaries, MMWR 2010;59(SS-5)."},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_024","doi-asserted-by":"crossref","unstructured":"De Alwis D, Agrawal A, Reiersen AM, Constantino JN, Henders A, Martin NG, et al. ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins. J Stud Alcohol Drugs 2014;75(2):211-21.","DOI":"10.15288\/jsad.2014.75.211"},{"key":"2026052922292300779_j_sjcapp-2014-012_ref_025","doi-asserted-by":"crossref","unstructured":"Palmqvist M, Edman G, Bolte S. Screening for substance use disorders in neurodevelopmental disorders: a clinical routine? Eur Child Adolesc Psychiatry 2013;23(5):365-68.","DOI":"10.1007\/s00787-013-0459-x"}],"container-title":["Scandinavian Journal of Child and Adolescent Psychiatry and Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.21307\/sjcapp-2014-012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:29:32Z","timestamp":1780093772000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.21307\/sjcapp-2014-012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,30]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2013,11,30]]},"published-print":{"date-parts":[[2013,11,30]]}},"alternative-id":["10.21307\/sjcapp-2014-012"],"URL":"https:\/\/doi.org\/10.21307\/sjcapp-2014-012","relation":{},"ISSN":["2245-8875"],"issn-type":[{"value":"2245-8875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,30]]}}}