Stimulant vs. Non-stimulant Treatments and Reward Processing in Drug-naive Youth at SUD Risk

Who May Qualify: - Pre-pubertal (e.g. Tanner stage 1 or 2) - Age 7-12 inclusive - Signed consent/assent - Parent communicates sufficiently in English to provide willing to sign a consent form and complete assessment instruments; - ADHD as determined by computerized DISC (C-DISC) parent interview - ADHD-Rating Scale-5 total score (interview with parent ) - SNAP ADHD total score (teacher) of 1.5 SD \> age/sex norms - CD or severe ODD: CD or ODD + 2 symptoms of CD on C-DISC - SNAP ODD/CD subscale (parent and teacher) 1.5 SD \> age/sex norms Who Should NOT Join This Trial: - Major neurological/medical illness - History of head injury - Fetal exposure to alcohol/drugs - Diagnosis of major psychiatric disorder (e.g., schizophrenia, bipolar disorder, major depression, generalized anxiety, social phobia, Tourette's Disorder, PTSD, autism spectrum disorder) - Current suicidal ideation or past history of suicide attempt - Wechsler Abbreviated Scale of Intelligence (WASI)75 score \<75 - Prior or current treatment with stimulants (prior or current treatment with non-stimulants is permitted, but participants must be off medication for 2 weeks at baseline) - Current or past alcohol/drug use (DISC interview; urine toxicology) - Psychological or medical condition which precludes being in the scanner (e.g., claustrophobia, morbid obesity) - Metal in the body that cannot be removed (e.g., braces, metal plate) - Visual disturbances that may impair task performance - Precocious puberty (e.g. Tanner stage \>2) or pregnancy Notes: - History of SUD in a 1st degree relative is permitted, and is expected in \~1/2 of the subjects - Ongoing psychosocial treatment is allowed but should not be initiated during the study Always talk to your doctor about whether this trial is right for you.