Topical Review

ADHD and Health-Risk Behaviors: Toward Prevention and Health Promotion

Erin N. Schoenfelder, PHD; Scott H. Kollins, PHD

Disclosures

J Pediatr Psychol. 2016;41(7):735-740. 

In This Article

Abstract and Introduction

Abstract

Across the lifespan, attention deficit/hyperactivity disorder (ADHD) is associated with increased health risk behaviors including substance abuse, binge eating and obesity, and unsafe sexual behavior. These risks are directly linked to the neurocognitive deficits associated with ADHD, and are also mediated by the cascade of psychosocial impairments and stressors caused by ADHD across development. However, little is known about optimal approaches to improve health outcomes in this high-risk population. This topical review provides an overview of health risks associated with ADHD and the limited existing research relevant to health promotion for children and adolescents with ADHD. Future research questions and implications for clinicians are also addressed—especially how psychologists and medical practitioners may improve child health through early screenings, increasing medication adherence, and treating psychosocial impairments.

Introduction

Attention deficit/hyperactivity disorder (ADHD) is a neurocognitive disorder affecting 5–10% of children and conferring risk for numerous long-term health problems. Beginning in childhood and adolescence, ADHD is associated with risk behaviors that contribute to chronic health problems, including substance use, binge eating and obesity, and risky sexual behavior. Thus, young people with ADHD have twice the health care costs of those without that disorder (Leibson, Katusic, Barbaresi, Ransom, & O'Brien, 2001), and ADHD is associated with a marked increase in morbidity and mortality rates for children and adults (Dalsgaard, Ostergaard, Leckman, Mortensen, & Pedersen, 2015). Despite these known risks, few studies have investigated methods of improving health behavior for individuals with ADHD, and most ADHD treatment studies have not examined effects on health behaviors.

The purpose of this topical review is to (a) provide a brief overview of the health risks associated with ADHD and underlying mechanisms; (b) identify unanswered questions related to improving this population's health, and (c) explore the implications of these risks for pediatric psychologists and medical practitioners and propose initial steps toward health promotion. Though an association between certain health risks and ADHD has been noted previously in the literature (Barkley, 2002), we are unaware of prior reviews exploring mechanisms underlying multiple risks or offering implications for health promotion and prevention.

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