The relationship between childhood externalizing or disruptive behavior and substance use and dependence in adulthood has been well established (e.g., Robins, 1966, 1998; Caspi et al., 1996). Similar relationships have also been reported between childhood disruptive behavior and early alcohol use and alcohol dependence in adolescence (e.g., Disney et al., 1999; Kuperman et al., 2001). In particular, children with attention-deficit hyperactivity disorder (ADHD) appear to be at risk for substance use problems as they reach adolescence and adulthood (Flory et al., 2003). Several mechanisms have been postulated for this apparent association. First, children with ADHD are at risk for alcoholism because of their behavioral profiles in early childhood – profiles that include impulsivity, distractability, hyperactivity and, in general, cognitive and behavioral under-regulation (e.g., Smith et al., 2002). These symptoms not only describe ADHD, but also the larger construct of behavioral undercontrol implicated in alcoholism theory (Molina et al., 2007; Sher, 1991; Tarter et al., 1990; Zucker et al., 1995). Second, the association between ADHD and substance abuse may be merely an artifact of the overlap between ADHD and other behavioral
