How ADHD and time perspective shape addiction severity in young adults

Symptoms of attention-deficit/hyperactivity disorder (ADHD) are commonly observed in individuals with substance use disorders (SUD) and may be associated with increased addiction severity. Time perspective is a potential psychological mechanism that could explain the association between retrospectively reported childhood ADHD symptoms and addiction severity. In this study, we examined whether the five dimensions of the Zimbardo Time Perspective Inventory (ZTPI) statistically accounted for cross-sectional indirect associations between retrospectively reported childhood ADHD symptoms and addiction severity. This cross-sectional study included 226 inpatients aged 18-25 years with SUD. retrospectively reported childhood ADHD symptoms was assessed using the Wender Utah Rating Scale (WURS), adult ADHD symptoms using the ASRS, time perspective using the ZTPI, general psychological distress using the DASS-21, and addiction severity using the Addiction Profile Index (API). Group comparisons were analyzed using the Kruskal-Wallis test with Bonferroni-corrected pairwise comparisons, while interrelationships between variables were examined using Spearman's rank correlation. A parallel indirect-effect model was estimated to examine whether ZTPI dimensions statistically accounted for the association between WURS and API, controlling for age, gender, and DASS-21 total scores. The stimulant-predominant group showed higher WURS, ASRS, and Present Hedonistic scores than both the cannabis and pregabalin/gabapentin groups. It also showed higher API scores and lower Future scores than the cannabis group. Higher WURS scores were significantly associated with an earlier onset of substance use, as well as higher ASRS, Past-Negative, Present-Hedonistic, Present-Fatalistic, and API scores; and lower Future scores. In the cross-sectional indirect-effect model, WURS was significantly associated with all five ZTPI subscales. In the final model, the Past-Negative, Present-Hedonistic, Present-Fatalistic, and Future subscales were significantly associated with API scores, whereas the Past-Positive subscale was not significant. The total and direct associations of WURS with API remained significant, and the total indirect effect was also significant. The model explained 58.8% of the variance in addiction severity. In this cross-sectional inpatient sample, retrospectively reported childhood ADHD symptoms were associated with addiction severity, and this association was statistically accounted for in part by specific time perspective dimensions, particularly higher Present Hedonistic and lower Future orientation. These findings should be interpreted as cross-sectional indirect associations rather than evidence of temporal or causal mediation. If supported by longitudinal studies, time-perspective-informed interventions may represent clinically relevant targets in ADHD-SUD comorbidity. Not applicable. Not applicable.