Spirits and the Fi
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Total Dysfunction, n (%) 11 (28.9) 21 (43.8) 0.07 26 (38.8) 13 (38.2) 0.98 Anhedonia, n (%) 8 (21.1) 8 (16.7) 0.56 11 (16.4) 2 (5.8) 0.06 Restricted Affect, n (%) 6 (15.8) 9 (18.8) 0.77 11 (16.4) 3 (8.8) 0.24 Emotional Dysregulation, n (%) 5 (13.2) 8 (16.7) 0.68 9 (13.4) 2 (5.8) 0.23 Antisocial Behavior, n (%) 2 (5.3) 3 (6.3) 0.88 4 (6.0) 0 (0.0) 0.31 Cognitive Dysfunction, n (%) 11 (28.9) 18 (37.5) 0.46 25 (36.8) 12 (35.3) 0.85     Concentration problem, n (%) 4 (10.5) 7 (14.6) 0.61 9 (13.4) 2 (5.8) 0.23     Short-term memory problem, n (%) 2 (5.3) 6 (12.5) 0.23 6 (8.9) 1 (2.9) 0.32     Long-term memory problem, n (%) 2 (5.3) 3 (6.3) 0.86 3 (4.4) 1 (2.9) 0.75 Discussion {#s4} ========== The main findings of this study is that the prevalence of self-reported impulsive behavior and risk behavior among young adults are not different in the adult ADHD+ and the ADHD- groups, after adjustment for multiple variables. When ADHD symptom criteria are further adjusted for, the risk of self-reported impulsivity is higher in the ADHD+ group, although still not significantly so. Firstly, since impulsivity is a feature of ADHD in adults, it was expected that impulsivity would be more common among the ADHD+ group. However, we found no statistically significant difference in overall impulsivity between the ADHD+ and ADHD- groups, after adjusting for multiple covariates. When the risk of impulsive behavior was divided into categories of the SPSRQ, we found a higher risk of having 'often' made impulsive choices as well as a 'high' risk of a lack of persistence in finishing things among the adult ADHD+ group. This does not mean that the adult ADHD+ group were always more impulsive than the adult ADHD- group, since the odds ratios of high risk of making impulsive choices and high risk of a lack of persistence were not significant. This shows that even though the adult ADHD+ group were more impulsive overall, many still had average or low risk of impulsive behavior. Thus, it is possible that some of the ADHD+ patients were able to compensate their impulsive behavior with persistence, which might explain the lack of significance in our final model. However, further studies should be conducted to clarify this issue. Secondly, we examined the association between self-reported impulsivity and substance use among the young adults. No association between substance use and self-reported impulsivity was found among the young adults in the ADHD+ and the ADHD- groups. Thus, it seems that substance use does not explain differences in self-reported impulsivity between the ADHD+ and ADHD- groups. It is also interesting to note that the self-reported number of used substances was lower than the self-reported number of symptoms among the adult ADHD+ group. One reason for this may be that some people may remember their first use of a substance, while others may remember their last use of a substance. Hence, those participants who only had less symptoms of ADHD might have misjudged their own number of symptoms. Finally, impulsive behavior was measured by self-reports, and it can therefore not be ruled out that self-reported impulsivity is partly due to an underreporting of behavior. In conclusion, the prevalence of self-reported impulsivity and risk behavior is not higher in the ADHD+ group in young adults compared to a group of young adults with ADHD. Also, it seems unlikely that these differences are explained by substance use in either the ADHD+ or ADHD- groups, which may be a way to compensate impulsive behavior. Further studies are needed to investigate why ADHD+ and ADHD- individuals report similar levels of impulsive behavior. Supporting Information {#s5} ====================== ###### **STROBE checklist for this observational study.** (DOCX) ###### Click here for additional data file. We would like to thank the ADHD participants and the team at the ADHD Outpatient Clinic for participation in the study and Prof. Terrie E. Moffitt and Anna Nordenskjöld for discussions on statistical models. **Competing Interests:**The authors have declared that no competing interests exist. **Funding:**This study was supported by research grants from Region Skåne and from the Strategic Research Area Neuroscience (AMH). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. [^1]: Conceived and designed the experiments: AMH. Analyzed the data: AMH. Contributed reagents/materials/analysis tools: AMH. Wrote the paper: AMH.