ADHD, bruxism and psychiatric disorders: does bruxism increase the chance of a comorbid psychiatric disorder in children with ADHD and their parents?

There is an association between bruxism and ADHD. No published data on psychiatric comorbidities in attention-deficit/hyperactivity disorder (ADHD) children with bruxism were found. There is no satisfying treatment method for children with bruxism. If we understand its comorbidities well, a better treatment method could come out. This study was conducted to compare the frequency of comorbid psychiatric disorders in the parents and their ADHD children with and without teeth grinding. It was hypothesized that there is no association between bruxism and prevalence of comorbid psychiatric disorders in children with ADHD and their parental psychopathology. Eighty-nine ADHD children without teeth grinding were compared with 32 ADHD children with teeth grinding. Their parental psychiatric disorders were also compared. Structured interviews were used to diagnose comorbid psychiatric disorders. The demographic characteristics of the children and their parents were not different between the groups. The only psychiatric disorder in children, which was associated with the groups was oppositional defiant disorder. The rate of conduct disorder, tic disorder, major depressive disorder, separation anxiety disorder, generalized anxiety disorder, enuresis, and obsessive compulsive disorder were not different between the two groups of children. The rate of major depression was more in the mothers of children with teeth grinding than those without such children. These finding were not reported before. ADHD children with teeth grinding have a high prevalence of oppositional defiant disorder. Lack of association between anxiety disorder and presence of teeth grinding might not support the idea that anxiety is associated with teeth grinding. The association of ODD and teeth girding might be a clue about etiology of bruxism. Perhaps, this clue can probably lead to the development of a more satisfying treatment. With consideration of this clue, further studies should survey if there is any association between ODD and sleep micro-arousals.     

Attention problems among children with a positive family history of alcohol abuse or dependence and controls. Prevalence and course for the period from preteen to early teen years

This longitudinal study investigated the scope and course of attention problems over a period of time from preteen (ages 7-12 years) to early teen years (ages 13-17 years). We compared symptoms in subjects with and without a family history (FH) of alcohol abuse or dependence from among families without evidence of antisocial personality disorder. Evaluations of attention problems for the offspring were based on the Child Behavior Checklist and a validated semistructured interview carried out with the mother. The findings indicate no higher risk for attention problems and attention-deficit hyperactivity disorder (ADHD)-like symptoms in the children of families with an alcohol use disorder. Regarding the course of problems, the ADHD symptom count tended to decrease over time, especially for children without a FH of alcohol abuse or dependence. Further research will be needed to determine whether results can be replicated with families from different social strata and including subjects with the antisocial personality disorder.     

Influence of parental SUD and ADHD on ADHD in their offspring: preliminary results from a pilot-controlled family study

As part of a pilot-controlled family-based study of the children of parents with and without substance use disorders (SUD), the influence of parental SUD and ADHD on the risk for ADHD in offspring was evaluated. Using structured psychiatric interviews, 96 families (183 youth; mean age 11.6 years) were assessed. To evaluate the effect of parental ADHD and SUD, the offspring were stratified into four groups based on parental status: children of parents with neither ADHD nor SUD, children of parents with SUD only, children of parents with ADHD only, and children of parents with both ADHD and SUD. Using generalized estimating equation models, parental SUD and ADHD were used to predict ADHD in the offspring. The rate of children with ADHD increased among children of parents with neither disorder (3%), children of parents with SUD (13%), children of parents with ADHD (25%), and children of parents with both ADHD and SUD (50%) (p = .001). Children of parents with ADHD or ADHD plus SUD were more likely to have ADHD in comparison to children of parents with neither diagnosis (p < 0.05). Children of parents with ADHD plus SUD were at greater risk of ADHD in comparison to children of parents with SUD only (p = 0.01). Despite the small sample size, the results of this study seem to suggest that the offspring of SUD or ADHD parents are at elevated risk for ADHD compared to controls. The offspring of parents with both ADHD and SUD appear to be at the highest risk for ADHD, highlighting the need for careful screening of this group of youth for ADHD. Replication studies clarifying the nature and strength of the association are necessary.     

Comparison of verbal learning and memory in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder

Background: Children with fetal alcohol spectrum disorders (FASD) have deficits in verbal learning and recall. However, the specificity of these deficits has not been adequately tested. In the current study, verbal learning and memory performance of children with heavy prenatal alcohol exposure was compared to children with attention‐deficit/hyperactivity disorder (ADHD), a disorder commonly seen in alcohol‐exposed children. Methods: Performance on the California Verbal Learning Test—Children’s Version (CVLT‐C) was examined in 3 groups of children (N = 22/group): (i) heavy prenatal alcohol exposure and ADHD (ALC), (ii) nonexposed with ADHD (ADHD), and (iii) nonexposed typically developing (CON). Groups were matched on age, sex, race, ethnicity, handedness, and socioeconomic status (SES). Results: Group differences were noted on learning trials (CON > ADHD > ALC). On the delayed recall trial, CON children performed better than both clinical groups, who did not differ from each other. Children in the ALC group demonstrated poorer recognition than children in the CON and ADHD groups, who did not differ from each other. Marginally significant group differences were noted on retention of previously learned material. Post hoc analyses indicated that ADHD children showed worse retention relative to the CON group, whereas retention in the ALC children remained intact. Conclusions: These data suggest that children with heavy prenatal alcohol exposure and nonexposed children with ADHD show differential patterns of deficit on the CVLT‐C. Performance of alcohol‐exposed children reflects inefficient encoding of verbal material, whereas performance of the ADHD group may be better characterized by a deficit in retrieval of learned material. Differences noted between clinical groups add to a growing neurobehavioral profile of FASD that may aid in differential diagnosis.     

Alcohol Expectancies and Drinking Characteristics in Parents of Children with Attention Deficit Hyperactivity Disorder

Alcohol expectancies, drinking characteristics, and their association were examined in 587 adults: 431 parents of children with attention deficit hyperactivity disorder (ADHD) and 156 parents of children without ADHD. In addition to examining both traditional and parenting-specific alcohol expectancies for these adults, risk variables cutting across the two groups were considered: single parenthood and male gender. Few differences in mean expectancy levels were found between parents of children with and without ADHD, between single and married mothers, and between men and women. Furthermore, expectancies did not predict drinking differently across groups. However, there was some support for the utility of assessing parental expectations of alcohol's effects on interactions with children, and there were robust and interesting effects of socioeconomic status on expectancies and drinking. Single mothers also reported consuming higher quantities of alcohol than married mothers. Findings are discussed in terms of the link between ADHD and alcoholism, the ability of alcohol expectancies to explain drinking differences between high risk groups, the effect of socioeconomic status on these variables, and single motherhood as a vulnerability factor for increased drinking.     

Comparison of Adaptive Behavior in Children With Heavy Prenatal Alcohol Exposure or Attention-Deficit/Hyperactivity Disorder

Background: Adaptive behavior, the ability to respond successfully to everyday demands, may be especially sensitive to the effects of heavy prenatal alcohol exposure. Similar adaptive dysfunction is common in other developmental disorders including attention‐deficit/hyperactivity disorder (ADHD). ADHD is frequently present in alcohol‐exposed children and this overlap in clinical presentation makes identification of alcohol‐exposed children difficult. Direct comparison of children with prenatal alcohol exposure and ADHD may yield distinct patterns of cognitive and behavioral performance and add to growing knowledge of the neuropsychological and behavioral profile of prenatal alcohol exposure. Therefore, the aim of the current study was to compare adaptive behavior in children with histories of heavy prenatal alcohol exposure (ALC), nonexposed children with ADHD (ADHD), and typically developing controls (CON). Methods: Sixty‐five children (ALC = 22, ADHD = 23, CON = 20) were selected from a larger ongoing study of the behavioral teratogenicity of alcohol. Alcohol‐exposed and control participants were selected to match the ADHD subjects on age, sex, socioeconomic status, and race/ethnicity. Caregivers were administered the Vineland Adaptive Behavior Scales, a semi‐structured interview, and were asked to rate their child’s behavior on 3 domains of adaptive function. Data were analyzed using regression techniques. Results: Relative to controls, children in both the ALC and ADHD groups showed adaptive behavior deficits on all 3 domains and children in the ALC group were significantly more impaired than the ADHD group on the daily living skills domain. Within the ALC group, socialization standard scores were lower at older ages. This negative relationship between age and standard scores in the ALC group was also observed on the communication domain, a finding not previously reported. Conclusions: This study suggests that both children with prenatal alcohol exposure and children with ADHD show impairments in adaptive function relative to controls, but that the pattern of impairment differs between these clinical groups. Adaptive ability in children with prenatal alcohol exposure is characterized by an arrest in development, as evidenced by a lack of improvement with age in socialization and communication scores. In contrast, children with ADHD exhibit a developmental delay in adaptive ability as their scores continued to improve with age, albeit not to the level of control children. Continued research focused on elucidating the patterns of deficits that exist in alcohol‐exposed children ultimately will lead to improved differential diagnosis and effective interventions.     

Knowledge of attention-deficit hyperactivity disorder among the general public,parents, and primary school teachers

We compared the knowledge of attention-deficit hyperactivity disorder (ADHD) among the general public, parents of children with ADHD, and primary school teachers and identified factors associated with ADHD knowledge in each group, separately.Secondary data analysis was made on the pre-lecture data from those (122 from the general public, 64 parents of children with ADHD, and 515 primary school teachers) attending education lectures by the Department of Public Health, New Taipei City Government, Taiwan, 2014.ADHD onset age was least known in these 3 groups. Knowledge of ADHD was significantly better among teachers (test score, 75.3%) than among parents (65.5%) and the general public (59.2%). Among the general public, the test score significantly decreased with age and was worst in those who did not know their friends or relatives with ADHD. Among parents, service workers, and retired/unemployed knew significantly less about ADHD than housewife did. Among teachers, men knew significantly less than women; those who taught children with ADHD knew significantly more than those who did not.Primary school teachers knew more about ADHD than parents and the general public. Factors associated with ADHD knowledge varied among the 3 groups.     

A Comparison of Children Affected by Prenatal Alcohol Exposure and Attention Deficit, Hyperactivity Disorder

Behavioral deficits are often noted in children with fetal alcohol syndrome (FAS) and other individuals with prenatal alcohol exposure, including mental retardation, learning problems, social problems, and deficits in attention. Because attention deficit, hyperactivity disorder (ADHD) has been diagnosed so frequently in children with FAS and other alcohol related birth defects, there has been speculation that alcohol is an etiological factor in ADHD. To examine the relationship between behavior characteristics of children with fetal alcohol exposure and those seen in children with a diagnosis of ADHD, 149 low socioeconomic status (SES), African-American children (mean age = 7.63 years) were given a battery of neuropsychological and behavioral tests. One hundred and twenty-two were a sub-sample from a longitudinal study of prenatal alcohol exposure, whereas twenty-seven were identified in an ADHD Clinic. Children were given two sets of tests: (1) “traditional model” of conventional behavioral and psychiatric measures of ADHD and externalizing behavior; and (2) measures of neurocognitive functioning reflecting a four-factor model of the neurological basis of the components of attention (Mirsky AF, in Integrated Theory and Practice in Clinical Neuropsychology, Hillsdale, NJ, Lawrence Erlbaum Associates, 1989). Results indicated that children with the physical characteristics associated with prenatal alcohol exposure and those with a diagnosis of ADHD had equivalent intellectual abilities with both clinical groups performing more poorly than contrast children from the same SES and ethnic groups. However, there were clear distinctions on behavioral and neurocognitive measures between the two clinical groups with those with ADHD performing more poorly on conventional tests sensitive to attentional problems and conduct disorder. When these two groups were compared on measures designed to measure the model of the four factors of attention by Mirsky, they were noted to have distinct patterns of deficits. These results suggested that the alcohol-affected children did not have the same neurocognitive and behavioral characteristics as children with a primary diagnosis of ADHD.     

Novel spacer device does not improve adherence in childhood asthma

The Funhaler (FH) is a novel spacer device (holding chamber) that has been designed to improve adherence and aerosol delivery in young asthmatic children using a metered dose inhaler. A pilot study reported a 38% increase in parent-reported adherence over 2 weeks compared with the child's normal spacer. The aim of this study was to investigate whether the FH would be associated with superior adherence in the medium term (3 months) using an objective assessment. Forty-seven children aged 18 months to 7 years were randomised to a FH or control small volume spacer. Participants were reviewed monthly for 3 months. Adherence was measured using an electronic monitoring device (Smartinhaler). Disease control was based on symptom scores and exacerbation rates. Twenty-six children were randomised to the FH and 21 to the control spacer. Three children withdrew (FH = 2). Median adherence each month for the 3 months was 74%, 54%, and 46% for the FH and 70%, 73%, and 54% for the control spacer. The difference in adherence was not statistically significant (P = 0.47, 0.37, and 0.23, respectively). There was also no significant difference in exacerbation rates or symptom scores. Seven of the FHs broke during the study. The FH was preferred by 21/24 parents randomised to the FH compared with their child's normal spacer. Despite the FH being popular with children and parents its use was not associated with improved adherence or disease control.     

Effects of Alcohol Administration on the Disinhibition of Racial Prejudice

Eighty-two white male undergraduate social drinkers were selected from high and low scorers on the Modern Racism Scale. Subjects were randomly assigned to 1 of 3 balanced placebo design conditions. After consuming their beverages, subjects viewed a videotape interaction between a Black and a White confederate. The subjects were told to rate the behaviors of the confederates, including an ambiguous shove of the White confederate by the Black confederate. It was expected, according to attribution theory, that high racism subjects would label the shove as more aggressive when they believed they had consumed alcohol, because alcohol could be used as an excuse for the socially unacceptable behavior of racial discrimination. A mood measure was also administered. Significant main effects of racism group and alcohol dosing were found for seriousness of aggression ratings, with high racism subjects and those expecting alcohol reporting more serious aggression, but the racism group by dosing condition interaction was not significant. A significant racism group by dosing condition interaction was found for the tension/anxiety mood scale, with greater tension being reported by high racism subjects who received alcohol. The results were related to theories of alcohol's disinhibiting and attention-limiting properties.     

Is Attention Deficit Hyperactivity Disorder (ADHD) Symptom Severity Associated with Tobacco Use?

Several studies report a strong link between ADHD and tobacco use; however, the nature of this relationship is not entirely clear. We examined the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and tobacco use within a sample of college students. Although tobacco use was the main focus, we also examined alcohol and marijuana use. We examined the association between the number of ADHD symptoms endorsed (severity), and tobacco, alcohol, and marijuana use in a convenience sample of 334 college students in the southeastern United States. Survey data were based on the annual Core Alcohol and Drug Survey for substance use, and the Current Symptom Scale (CSS) for ADHD, conduct disorder (CD), and antisocial personality disorder (ASPD) symptoms. Among ever users of a substance, the number (severity) of current ADHD symptoms, including inattentive and hyperactive symptoms, were significantly associated with the frequency of tobacco and marijuana use in the past month and past year, as well as to the frequency of alcohol use in the past month. The results suggest that the number of ADHD symptoms is proportionally associated with tobacco, alcohol, and marijuana use.     

Reduced apolipoprotein E-rich high-density lipoprotein level at birth is restored to the normal range in patients with familial hypercholesterolemia in the first year of life

BACKGROUND: High-density lipoprotein (HDL) consists of apolipoprotein E (apoE)-rich and apoE-poor HDL particles. ApoE-rich HDL level is high at birth but decreases after birth with reciprocal elevation in low-density lipoprotein (LDL)-cholesterol. OBJECTIVES: The objective of the study was to clarify whether apoE-rich HDL decreases after birth in children with familial hypercholesterolemia (FH), a disorder caused by impaired LDL clearance. METHODS: We measured apoE-rich HDL-cholesterol and LDL-cholesterol during the first year of life in 10 FH children (one homozygote and nine heterozygotes), 12 non-FH siblings, and 75 healthy controls. RESULTS: At birth, apoE-rich HDL-cholesterol was undetectable in a homozygous FH child and lower in heterozygous FH children than non-FH siblings and controls (4+/-2 vs. 12+/-4 and 11+/-4 mg/dl, P<0.001). At 3-4 months, apoE-rich HDL-cholesterol increased in homozygous and heterozygous FH children and decreased in non-FH siblings and controls. At 12 months, apoE-rich HDL-cholesterol levels were similar among these four groups (6-7 mg/dl). In contrast, LDL-cholesterol concentration was always twice as high in heterozygous FH children as non-FH siblings and controls (at birth, 50+/-15 vs. 25+/-7 and 25+/-5 mg/dl, P<0.001; at 3-4 months of age, 159+/-29 vs. 71+/-16 and 73+/-15 mg/dl, P<0.001; at 12 months of age, 156+/-29 vs. 75+/-18 and 76+/-17 mg/dl, P<0.001). CONCLUSION: ApoE-rich HDL level is low at birth in FH children and increases to the normal level in the first year of life, opposite to the change in normal children.     

Is attention‐deficit/hyperactivity disorder associated with illicit substance use disorders in male adolescents? A community‐based case–control study

AIMS: This study aims at evaluating the association between attention-deficit/hyperactivity disorder (ADHD) and illicit substance use disorders (SUD) (marijuana, cocaine and inhalants), controlling for the association with conduct disorder (CD), in a community-based sample of adolescents. DESIGN: Case-control, community-based study. SETTING: A delimited geographical area in the South of Brazil, served by four public health clinics. PARTICIPANTS: A total of 968 male adolescents (15-20 years of age) were screened for SUD in their households. Of the subjects who were screened positive, we selected 61 cases with illicit SUD. For each case we selected, from the group which was screened negative, three controls without illicit or alcohol SUD, matched by age and proximity with the case's household. MEASUREMENTS: The screening instrument was the Alcohol Smoking and Substance Screening Test (ASSIST). SUD diagnoses were assessed by the drug section of the Mini International Neuropsychiatry Interview (MINI). Other psychiatric diagnoses were based on semistructured (Schedule for Affective Disorders and Schizophrenia for School-Age Children-epidemiological version; MINI) and clinical interviews. FINDINGS: Adolescents with ADHD presented a significantly higher odds ratio (OR) for illicit SUD than youths without ADHD, even after adjusting for potential confounders (CD, ethnicity, religion and estimated IQ) (OR = 9.12; 95% CI = 2.84-29.31, P < 0.01). CONCLUSIONS: Our results suggest an association between ADHD and illicit SUD in Brazilian adolescents that is not mediated by CD. These findings are potentially important from a prevention perspective because treatments are available for ADHD.     

An Event‐Related Potential Study of Response Inhibition in ADHD With and Without Prenatal Alcohol Exposure

Background: The attention and cognitive problems seen in individuals with a history of prenatal alcohol exposure often resemble those associated with attention deficit hyperactivity disorder (ADHD), but few studies have directly assessed the unique influence of each on neurobehavioral outcomes. Methods: We recorded event‐related potentials (ERPs) during a Go/No‐go response inhibition task in young adults with prospectively obtained histories of prenatal alcohol exposure and childhood ADHD. Results: Regardless of prenatal alcohol exposure, participants with childhood ADHD were less accurate at inhibiting responses. However, only the ADHD group without prenatal alcohol exposure showed a markedly diminished P3 difference between No‐go and Go, which may reflect a more effortful strategy related to inhibitory control at the neural processing level. Conclusion: This finding supports a growing body of evidence suggesting that the manifestation of idiopathic ADHD symptoms may stem from a neurophysiologic process that is different from the ADHD symptomatology associated with prenatal alcohol exposure. Individuals who have been prenatally exposed to alcohol and present with ADHD symptomatology may represent a unique endophenotype of the disorder, which may require different treatment approaches from those found to be effective with idiopathic ADHD.     

注意缺陷多动障碍不同亚型儿童行为问题和社会生活能力分析

目的 分析注意缺陷多动障碍(ADHD)不同亚型儿童的行为问题和社会生活能力的差异,为临床治疗提供依据.方法 根据DSM-Ⅴ诊断标准纳入225例ADHD儿童,其中混合型(ADHD-C)103例,注意缺陷型(ADHD-I)90例,多动/冲动型(ADHD-HI)32例,纳入同期正常儿童112名,分别采用Conners父母症状...     

The effect of parental alcohol problems on rates of adolescent psychiatric disorders

The relationships between parental alcohol problems and risks of psychiatric disorders including substance abuse, conduct, attention deficit, mood and anxiety disorders were examined in a birth cohort of New Zealand children studied to the age of 15 years. This analysis showed that children exposed to alcoholic parents had risks of adolescent psychiatric disorders that were between 2.2 (95% Confidence Interval (CI) = 1.4; 3.3) to 3.9 (95% CI=2.40; 6.0) times higher than children whose parents did not report alcohol problems. After adjustment for a range of confounding factors these associations tended to reduce but even after adjustment, children of alcoholic parents had rates of disorder that were between 1.6 (95% CI = 1.1; 2.6) to 3.0 (95% CI= 1.8; 4.5) times higher than the offspring of parents who did not have alcohol problems. The analysis suggested approximately linear relationships between the extent of reported parental alcohol problems and risks of disorder. There was no evidence to suggest that, in general, males responded to parental alcohol problems in a way that differed from the response of females.     

龙岗区儿童注意缺陷多动障碍特征及影响因素的研究

目的分析儿童注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）的特征及相关影响因素,为开展龙岗区学龄儿童ADHD控制与干预工作提供科学依据。方法采用整群随机抽样方法,对深圳市龙岗区23所幼儿园3826名3～6岁儿童进行横断面研究,共检出多动行为492人,采用1：1配对病例对照研究分析儿童ADHD的影响因素。结果在492例ADHD儿童中,男女童之比为1．1：1,经单因素条件Logistic回归分析,儿童ADHD的影响因素分别为男性。低年龄,母亲文化程度低,父亲抽烟、饮酒,非父母带养,溺爱,无玩伴等。经多因素条件Logistic回归分析,儿童ADHD的影响因素按贡献大小依次为儿童孤独、儿童每周尿床次数和儿童健康有关。结论建议以社区为单位,以ADHD儿童、家长、老师和医生为沟通团队,针对其不同影响因素进行关注,能有效开展儿童ADHD的控制与干预工作。     

The influence of dose, beverage type, and sex of interactor on female bar patrons' verbal aggression

This field study is an investigation of the influence of dose, type of beverage, and the sex of the confederate on female verbal aggression. The results showed no consistent effects attributable to dose; drinking liquor resulted in less aggressive responses but only when subjects interacted with a female confederate. The results show that studies of alcohol and aggression that use only male subjects do not generalize to females in natural settings and suggest that nonpharmacological factors need more attention in this area.     

The association between attention deficit hyperactivity disorder in adolescence and smoking in adulthood

This longitudinal study examined the interrelationships between early and/or middle adolescent attention deficit hyperactivity disorder (ADHD), middle adolescent conduct disorder (CD), and later adult smoking behavior. This is a prospective longitudinal study. Data were collected via structured interviews of representative families in the northeastern United States (N = 641). The mean ages of the offspring were as follows: 14 years (T2, 1983), 17 years (T3, 1985-1986), and 32 years (T6, 2002). The dependent variable was the participants' daily cigarette smoking in their early thirties. Logistic regression analyses indicated that the relationship between ADHD and daily smoking behavior was mediated by CD with control on gender, age, SES, and adolescent smoking. CD had a direct effect on daily smoking in adulthood. Our findings suggest that ADHD is related to CD, which in turn is associated with daily smoking. Therefore, interventions with ADHD adolescents who have ADHD at an early age might lead to some reduction in later smoking provided that the intervention has a positive effect on CD. For those adolescents who never had ADHD, our findings suggest that prevention or treatment aimed at reducing CD may be most successful in reducing daily smoking later in adulthood.     

Teenagers are right--parents do not know much: an analysis of adolescent-parent agreement on reports of adolescent substance use, abuse, and dependence

BACKGROUND: Previous studies have shown that when assessing child psychopathology, parents tend to report more symptoms than children for externalizing disorders such as attention deficit hyperactivity disorder (ADHD), whereas children tend to report more symptoms for internalizing disorders such as major depression. Whether for clinical or research purposes, parents are also frequently asked to report on their children's experiences with alcohol and drugs. The purpose of this study was to analyze correspondence between adolescent and parent reports of adolescent substance use and abuse or dependence. METHODS: In the current study, 591 subjects 12 to 17 years old were interviewed using the child version of the Semi-Structured Assessment for the Genetics of Alcoholism (C-SSAGA) as part of the Collaborative Study on the Genetics of Alcoholism (COGA). One parent was also interviewed about each adolescent using the parent version of the C-SSAGA. Sensitivities, specificities, and kappa coefficients were calculated to assess parental agreement with adolescent reports of lifetime substance use and Diagnostic and Statistical Manual of Mental Disorders-Third Revision substance abuse or dependence. RESULTS: The results indicate that parents are somewhat knowledgeable about their children's use of substances, particularly those that are used most commonly. For example, 55% of adolescents who had smoked cigarettes, 50% who had used alcohol, and 47% who had used marijuana had a parent who knew that they used. However, parents were less aware of substance-related problems experienced by their offspring, agreeing with adolescent reports only 27% of the time for diagnoses of alcohol abuse or dependence and 26% of the time for diagnoses of marijuana abuse or dependence. Parent reports added few cases of substance use for 12- to 13 year-olds and essentially no cases for 16- to 17-year-olds. Parent reports added a nominal number of diagnoses of substance abuse or dependence for older adolescents. CONCLUSIONS: Whether for clinical or research purposes, the results emphasize the importance of directly assessing adolescents regarding alcohol and other substance use disorders. Furthermore, investigators should consider the specific disorder(s) being investigated and the ages of the children being studied when determining whether to include parent reports as part of study design.