A study of individuals with alcohol use disorder in France found that the negative impact of problematic alcohol use on quality of life is greater in those with attention-deficit/hyperactivity disorder (ADHD) than in those without the condition. The adverse effects on quality of life appear to be amplified by dysfunctional efforts to manage the intense emotional dysregulation associated with ADHD under the influence of alcohol. The research was published in the Journal of Psychiatric Research.
Alcohol use disorder is a chronic condition marked by an inability to control alcohol consumption despite harmful consequences, resulting in significant distress or impairment. It involves a pattern of excessive drinking, strong cravings, and a loss of control over alcohol intake. Individuals with this disorder often experience withdrawal symptoms such as tremors, anxiety, and nausea when not drinking.
The severity of alcohol use disorder can range from mild to severe, depending on the number of symptoms present. Over time, it can lead to serious health problems, including liver disease, cardiovascular complications, and cognitive decline. Social and occupational functioning often deteriorates as individuals begin to neglect responsibilities and relationships due to their drinking.
Study author Amandine Luquiens and her colleagues aimed to examine how alcohol use affects quality of life in individuals with ADHD. In particular, they focused on the roles of impulsivity, emotional dysregulation, and maladaptive emotion regulation strategies in this relationship.
ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily life. It typically begins in childhood but can continue into adulthood, affecting academic, occupational, and social functioning.
The researchers analyzed data from the beginning of the TRAIN study, a clinical trial in France investigating the efficacy of a cognitive training program for patients with alcohol use disorder. The sample included 206 individuals diagnosed with alcohol use disorder, 40 of whom also had ADHD. All participants were classified as being at high risk due to their drinking levels—defined as consuming over 60 grams of alcohol per day for men and over 40 grams per day for women during the previous four-week period. At the time of the study, participants had been abstinent for between 7 and 30 days.
Participants completed a series of assessments measuring ADHD symptoms (using the Adult ADHD Self-Report Scale), health-related quality of life specific to alcohol use disorder (using the Alcohol Quality of Life Scale), impulsivity (using the Impulsive Behavior Scale), emotion regulation strategies (using the Emotion Regulation Questionnaire), emotion regulation difficulties (using the Difficulties in Emotion Regulation Scale – Impulse Control Difficulties subscale), and alcohol-related cognitive impairment (using the Montreal Cognitive Assessment).
The results showed that alcohol use had a greater negative impact on quality of life in individuals with ADHD compared to those without the disorder. Participants who were highly impulsive or who had difficulties with emotional regulation tended to report lower quality of life as well. Individuals with ADHD were more likely to suppress emotional expression, which was associated with further declines in quality of life. Overall, the researchers concluded that dysfunctional efforts to cope with emotional dysregulation significantly contributed to reduced well-being in individuals with ADHD and alcohol use disorder.
“Our findings have direct clinical and therapeutic implications. They underscore the relevance of identifying patients’ preferred emotion regulation strategies and the need to work with them on the limits of expressive suppression in the context of ADHD in AUD [alcohol use disorder], and on more functional and less costly alternatives,” the study authors note.
The study sheds light on the specificities of the relationship between alcohol use and quality of life in individuals with alcohol use disorder who also suffer from ADHD. However, it should be noted that the design of the study does not allow any causal inferences to be derived from the results.
The paper, “ADHD and alcohol: Emotional regulation efforts pay off in quality of life points,” was authored by Amandine Luquiens, Thibault Mura, Alexandra Dereux, Patrice Louville, Helene Donnadieu, Marie Bronnec, Amine Benyamina, Pascal Perney, and Arnaud Carre.