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By Sam Goldstein, Ph.D.
Although at this time there is limited scientific research concerning the sexual behavior of teenagers with AD/HD, preliminary studies that have followed teenagers with AD/HD into young adulthood have found a higher rate of sexual activity at a younger age and with more sexual partners. The young adults with AD/HD studied reported that, throughout their teen years and into young adulthood, they were less likely to use contraception and more likely to have conceived a teenage pregnancy. In the Milwaukee study just cited, nearly 40% of teens with AD/HD were involved in an unwed pregnancy. They were also more likely to have contracted a sexually transmitted disease (not HIV).
It has been demonstrated that up to 50 percent of teens with AD/HD, particularly in the late teen years, abuse substances such as alcohol, marijuana, and cocaine; many of them become dependent upon such substances. Some of these youth may be self-medicating in an effort to improve their attention span while others may be trying to escape their unhappiness. Still others, due to their lack of inhibition, may be unable to stop doing something that provides pleasure.
However, youth consistently treated for AD/HD with medication have been found to be less vulnerable for subsequent substance use and dependence. This may be the added protection offered by medication treatment or may reflect other variables such as factors that predict which families will take the time and spend the resources to make certain their teens with AD/HD receive the appropriate treatment.
The exact relationship between AD/HD and antisocial and criminal behavior has not been well studied. Early studies found a high incidence of such behavior in teens with AD/HD. However, many of those studies did not take into consideration co-existing problems such as Conduct Disorder (CD) or chronic delinquency. When these variables are controlled for, AD/HD may be one of many risk factors leading to juvenile justice problems. For the moment it can be reported that teenagers with AD/HD, either because of the AD/HD alone or because of a combination of AD/HD and other disorders, are much more likely to find their way into juvenile court repeatedly. Unfortunately, the penal system generally provides punishment but little support to help these youth develop more effective and efficient life skills and success in daily life and thus the ability to stay out of trouble.
AD/HD appears to be associated with significant risk for global impairment in all major areas of life for affected teenagers. Yet some teens with AD/HD fare significantly better than others. The key appears to be approaching treatment from a long-term perspective, balancing symptom relief with strategies to help teens with AD/HD develop stress management skills and resilient qualities. Symptom relieving treatments for AD/HD, including medication, educational, and therapeutic interventions are necessary to ensure present day success for teens with AD/HD.
However, symptom relief, while necessary, is not sufficient to help these teenagers transition happily and successfully into adult life. Teenagers with AD/HD also need help if they are to develop safe and sound driving habits, learn responsible sexual behavior, and achieve educational success. Such help is often provided by multiple professionals (e.g., counselors and educators) in a variety of settings. Best of all, parents can play a large part in helping their teens with AD/HD develop a resilient mindset and avoid high-risk behaviors. I will explore effective parenting strategies in the next article in this series.
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