ADHD AND CHRONIC COCAINE ABUSE
Introduction
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In general, Attention-Deficit and Disruptive Behavior Disorders consist of three socially disruptive behavioral patterns which are: attention-deficit hyperactivity disorder (ADHD), conduct disorder, and oppositional defiant disorder (Davison & Neale, 2000). The diagnostic criteria for ADHD must be present for at least six months prior to the diagnosis. These criteria, according to the American Psychiatric Association (APA, 1994), include: short-attention span or easy distractibility; impulsivity; repeated tendency to interrupt or intrude; excessive movement as seen in restlessness and fidgeting behavior; and failures in listening. Although there are subtypes of ADHD, all of these reflect, to varying extents, the basic pattern of poor concentration, excessive movement, and frequent interruption (APA, 1994). Interestingly, a good deal of research has indicated that a substantial proportion of the population of teens and adults diagnosed with ADHD are also chronic cocaine abusers (Carroll & Rounsaville, 1993). This fairly consistent finding has lead many psychologists and psychiatrists to formulate explanative models of the nature of the association between a diagnosis of ADHD and chronic abuse of cocaine (Davison & Neale, 2000). The review of literature presented here examines one of the these models, namely the Self-Medication Hypothesis which was originally developed by Khantzian (1995). The presented review first delineates a
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ication.
The authors reported that their findings showed that stimulants were associated with significantly higher self-esteem. Specifically, it was found that children with ADHD prescribed stimulants reported feeling more intelligent and more popular than unmedicated children with ADHD. Further, it was found that higher doses were actually associated with higher self-esteem. This study shows not only that stimulants (of which cocaine is one) can operate to reduce ADHD symptoms; it also suggests that ADHD adults who are abusing cocaine may well be doing so to alleviate self-esteem problems.
Khantzian (1985) himself presents several case studies to support the Self-Medication Hypothesis. These studies indicate that in terms of both self-report and neurological data, the use of cocaine calms ADHD patients. Also, it helps them to reduce their excessive movement and to experience fairly normal sleeping and eating patterns. Further, it reduces their impulsive behavior and thoughts.
Literature That Does Not Support The Self-Medication Hypothesis
What needs to be recognized is that while there is some support for the self-medication hypothesis, there are some results from studies that do not support it. One of the non-supportive
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Approximate Word count = 2509
Approximate Pages = 10 (250 words per page)
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