Introduction: There is a frequent comorbidity of amphetamine-type stimulants (ATS) use disorders and attention-deficit/hyperactivity disorder (ADHD). The assumption that this patient group “self-medicate” suggests that there are different use motives for ATS addicted patients with and without ADHD. Objective: Our study investigates these potential differences in use motives. Methods: Within a mixed-method approach, we examined the use motives of adults with ATS use disorder with and without ADHD in the first and latest month of their use. For this purpose, we used the 12-item Amphetamine-Type Stimulants Motive Questionnaire (AMQ) and a mind mapping technique after verifying that these tools are applicable to adults with ADHD. Results: The mixed-method approach showed that enhancement motives were the most important motives in the first month of use (e.g., fun/kick/rush/desire, and curiosity/interest in the drug/appeal), and over time, the incidence of coping motives increased (e.g., repression and freeing the mind/not having to think/switching off). There were no differences between adults with and without ADHD in the AMQ data, while the qualitative data showed that adults with ADHD used ATS less often out of social motives. In particular, the results showed no differences in the coping dimension and, thus, did not suggest that self-medication is an important factor for patients with ADHD. Conclusions: Patients with and without ADHD show very similar motive patterns for ATS use. This indicates that ATS treatment programs addressing use motives do not necessarily have to be different for patients with and without ADHD.

1.
United Nations Office on Drugs and Crime (UNODC). World Drug Report 2018
.
2.
Darke
S
,
Kaye
S
,
McKetin
R
,
Duflou
J
.
Major physical and psychological harms of methamphetamine use
.
Drug Alcohol Rev
.
2008
;
27
(
3
):
253
62
.
3.
European Monitoring Center for Drugs and Drug Addiction (EMCDDA). Problem amphetamine and methamphetamine use in Europe; 2010
.
4.
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
.
5.
Wilens
TE
,
Martelon
M
,
Joshi
G
,
Bateman
C
,
Fried
R
,
Petty
C
, et al.
Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD
.
J Am Acad Child Adolesc Psychiatry
.
2011
;
50
(
6
):
543
53
.
6.
Crunelle
CL
,
van den Brink
W
,
Moggi
F
,
Konstenius
M
,
Franck
J
,
Levin
FR
, et al.
International consensus statement on screening, diagnosis and treatment of substance use disorder patients with comorbid attention deficit/hyperactivity disorder
.
Eur Addict Res
.
2018
;
24
(
1
):
43
51
.
7.
Zulauf
CA
,
Sprich
SE
,
Safren
SA
,
Wilens
TE
.
The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders
.
Curr Psychiatry Rep
.
2014
;
16
(
3
):
436
.
8.
Daigre
C
,
Roncero
C
,
Grau-López
L
,
Martínez-Luna
N
,
Prat
G
,
Valero
S
, et al.
Attention deficit hyperactivity disorder in cocaine-dependent adults: a psychiatric comorbidity analysis
.
Am J Addict
.
2013
;
22
(
5
):
466
73
.
9.
Rodgers
S
,
Müller
M
,
Rössler
W
,
Castelao
E
,
Preisig
M
,
Ajdacic-Gross
V
.
Externalizing disorders and substance use: empirically derived subtypes in a population-based sample of adults
.
Soc Psychiatry Psychiatr Epidemiol
.
2015
;
50
(
1
):
7
17
.
10.
Torok
M
,
Darke
S
,
Kaye
S
.
Attention deficit hyperactivity disorder and severity of substance use: the role of comorbid psychopathology
.
Psychol Addict Behav
.
2012
;
26
(
4
):
974
9
.
11.
Young
JT
,
Carruthers
S
,
Kaye
S
,
Allsop
S
,
Gilsenan
J
,
Degenhardt
L
, et al.
Comorbid attention deficit hyperactivity disorder and substance use disorder complexity and chronicity in treatment-seeking adults
.
Drug Alcohol Rev
.
2015
;
34
(
6
):
683
93
.
12.
Arias
AJ
,
Gelernter
J
,
Chan
G
,
Weiss
RD
,
Brady
KT
,
Farrer
L
, et al.
Correlates of co-occurring ADHD in drug-dependent subjects: prevalence and features of substance dependence and psychiatric disorders
.
Addict Behav
.
2008
;
33
(
9
):
1199
207
.
13.
Wilens
TE
,
Biederman
J
,
Mick
E
.
Does ADHD affect the course of substance abuse? Findings from a sample of adults with and without ADHD
.
Am J Addict
.
1998
;
7
(
2
):
156
63
.
14.
Obermeit
LC
,
Cattie
JE
,
Bolden
KA
,
Marquine
MJ
,
Morgan
EE
,
Franklin
DR
, et al.
Attention-deficit/hyperactivity disorder among chronic methamphetamine users: frequency, persistence, and adverse effects on everyday functioning
.
Addict Behav
.
2013
;
38
(
12
):
2874
8
.
15.
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
(
1–2
):
11
9
.
16.
Groß
S
,
Philipsen
A
.
Konzeptualisierung der Psychotherapie bei ADHS und Sucht
.
SUCHT
.
2015
;
61
(
5
):
311
8
.
17.
Khantzian
EJ
.
The theory of self-medication and addiction
.
Psychiatr Times
.
2017
;
34
:
2
.
18.
Khantzian
EJ
,
Albanese
MJ
.
Understanding addiction as self medication. Finding hope behind the pain
.
Lanham
:
Rowman & Littlefield
;
2008
.
19.
Wurdak
M
,
Dörfler
T
,
Eberhard
M
,
Wolstein
J
.
Diary-based study concerning drinking motives, affectivity, and alcohol consumption among adolescents
.
SUCHT
.
2010
;
56
(
3–4
):
175
82
.
20.
Bischof-Kastner
C
,
Kuntsche
E
,
Wolstein
J
.
Identifying problematic internet users: development and validation of the Internet Motive Questionnaire for Adolescents (IMQ-A)
.
J Med Internet Res
.
2014
;
16
(
10
):
e230
.
21.
Stewart
SH
,
Zack
M
.
Development and psychometric evaluation of a three-dimensional gambling motives questionnaire
.
Addiction
.
2008
;
103
(
7
):
1110
7
.
22.
Cooper
ML
,
Shapiro
CM
,
Powers
AM
.
Motivations for sex and risky sexual behavior among adolescents and young adults: a functional perspective
.
J Pers Soc Psychol
.
1998
;
75
(
6
):
1528
58
.
23.
Kuntsche
E
,
Le Mével
L
,
Berson
I
.
Development of the four-dimensional Motives for Listening to Music Questionnaire (MLMQ) and associations with health and social issues among adolescents
.
Psychol Music
.
2014
;
44
(
2
):
219
33
.
24.
Thurn
D
,
Kuntsche
E
,
Weber
JA
,
Wolstein
J
.
Development and validation of the amphetamine-type stimulants motive questionnaire in a clinical population
.
Front Psychiatry
.
2017
;
8
:
183
.
25.
Kuntsche
E
,
Kuntsche
S
.
Development and validation of the Drinking Motive Questionnaire Revised Short Form (DMQ-R SF)
.
J Clin Child Adolesc Psychol
.
2009
;
38
(
6
):
899
908
.
26.
Cooper
ML
.
Motivations for alcohol use among adolescents: development and validation of a four-factor model
.
Psychol Assess
.
1994
;
6
(
2
):
117
28
.
27.
Cox
WM
,
Klinger
E
.
A motivational model of alcohol use
.
J Abnorm Psychol
.
1988
;
97
(
2
):
168
80
.
28.
Thurn
D
,
Wolstein
J
.
Erhebung der Motive für den Konsum amphetaminartiger Substanzen anhand von Mind Maps
.
Suchttherapie
.
2020
;
21
(
01
):
43
50
.
29.
Nückles
M
,
Gurlitt
J
,
Pabst
T
,
Renkl
A
.
Mind maps und concept maps: visualisieren, organisieren, kommunizieren. originalausgabe
.
München
:
Deutscher Taschenbuch Verlag
;
2004
. (
Dtv Beck-Wirtschaftsberater; vol 50877
).
30.
Gehl
D
.
Vom Betrachten zum Verstehen: Die Diagnose von Rezeptionsprozessen und Wissensveränderungen bei multimodalen Printclustern
.
Wiesbaden
:
Springer
;
2013
.
31.
Terry-McElrath
YM
,
O’Malley
PM
,
Johnston
LD
.
Reasons for drug use among American youth by consumption level, gender, and race/ethnicity: 1976–2005
.
J Drug Issues
.
2009
;
39
(
3
):
677
714
.
32.
Ohlmeier
M
.
Pathogenesis of the comorbidity of ADHD and substance use disorders: a clinical perspective and implications for pharmacotherapy
.
SUCHT
.
2015
;
61
(
5
):
303
9
.
33.
Wilens
TE
,
Adamson
J
,
Sgambati
S
,
Whitley
J
,
Santry
A
,
Monuteaux
MC
, et al.
Do individuals with ADHD self-medicate with cigarettes and substances of abuse? Results from a controlled family study of ADHD
.
Am J Addict
.
2007
;
16
(
Suppl 1
):
14
3
.
34.
Kuntsche
E
,
Knibbe
R
,
Gmel
G
,
Engels
R
.
Replication and validation of the Drinking Motive Questionnaire Revised (DMQ-R, Cooper, 1994) among adolescents in Switzerland
.
Eur Addict Res
.
2006
;
12
(
3
):
161
8
.
35.
Kline
RB
, editor.
Principles and practice of structural equation modeling
.
New York
:
The Guilford Press
;
2005
.
36.
Nunnally
JC
,
Bernstein
IH
.
Psychometric theory
.
New York
:
McGraw-Hill
;
1994
.
38.
Hayes
AF
.
Answering the call for a standard reliability measure for coding data
.
Commun Methods Measures
.
2007
;
1
(
1
):
77
89
.
39.
Krippendorff
J
.
A coefficient of agreement for nominal scales
.
Educ Psychol Meas
.
1960
;
20
(
1
):
37
46
.
40.
Cronbach
LJ
.
Coefficient alpha and the internal structure of tests
.
Psychometrica
.
1951
;
16
:
297
334
.
41.
Levin
FR
,
Upadhyaya
HP
.
Diagnosing ADHD in adults with substance use disorder: DSM-IV criteria and differential diagnosis
.
J Clin Psychiatry
.
2007
;
68
(
7
):
e18
.
42.
McQuade
JD
.
Peer relationships of children with ADHD
. In:
RA
Barkley
, editor.
Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment
.
New York
:
The Guilford Press
;
2015
. p.
210
22
.
43.
Hoza
B
.
Peer functioning in children with ADHD
.
Ambul Pediatr
.
2007
;
7
(
Suppl 1
):
101
6
.
44.
Soucisse
M
,
Maisonneuve
M-F
,
Normand
S
.
Friendship problems in children with ADHD: what do we know and what can we do?
Perspect Lang Lit
;
2015:29–34
.
45.
Coughlin
SS
.
Recall bias in epidemiologic studies
.
J Clin Epidemiol
.
1990
;
43
(
12
):
1431
2
.
46.
Kuntsche
E
,
Stewart
SH
,
Cooper
ML
.
How stable is the motive-alcohol use link? A cross-national validation of the Drinking Motives Questionnaire Revised among adolescents from Switzerland, Canada, and the United States
.
J Stud Alcohol Drugs
.
2008
;
69
(
3
):
388
96
.
47.
Kuntsche
E
,
Gabhainn
SN
,
Roberts
C
,
Windlin
B
,
Vieno
A
,
Bendtsen
P
, et al.
Drinking motives and links to alcohol use in 13 European countries
.
J Stud Alcohol Drugs
.
2014
;
75
(
3
):
428
37
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.