ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.     

Associations among sleep problems,executive dysfunctions,and attention-deficit/hyperactivity disorder symptom domains in college students

Objective: The present study examined whether executive functions (EFs) and sleep problems operate together to predict four attention-deficit/hyperactivity disorder (ADHD) symptom domains. Methods: A sample of 306 college students completed ratings of sleep quality, EFs, and ADHD symptoms from January to December 2014. Simultaneous multiple regressions were used to examine (a) the unique contribution of EFs and sleep problems to ADHD symptoms, (b) the relations among EFs, sleep problems, and GPA, and (c) the relations between specific EF facets (i.e., time management, emotion regulation, problem solving, self-restraint, and self-motivation) and ADHD symptoms. Results: While approximately 52.8% of participants were categorized as poor-quality sleepers, 10.6% of the sample reported an ADHD diagnosis. EF ratings were associated uniquely with ADHD symptoms after controlling for sleep quality. All EF facets were related to ADHD symptoms. Conclusion: ADHD symptoms are associated with all EF facets even after controlling for sleep quality.     

Prevalence and predictors of suicidal ideation,plan, and attempts,in first-year college students with ADHD

Abstract

Objective. The present study evaluated the prevalence of past suicidal ideation (SI), plan, and attempt in college students with ADHD (N?=?102) compared to a matched control (N?=?102). Predictors of SI, plan, and attempts, were examined. Participants. Study participants were first year college students at a large Southeastern university who completed measures during August or September of 2014 or January of 2015. Methods. Measures were completed by first year students via an online survey. Results. Prevalence rates for SI and related behaviors were higher among the ADHD group than the matched control, with suicide attempts rates four times higher in the ADHD group (13.7% vs. 2.9%). Results showed that ADHD predicted rates of SI and suicide attempt accounting for depression and key demographic variables. Conclusions. Findings have implications for suicide risk assessments conducted with college students with ADHD.     

Assessing adult attention deficit hyperactivity disorder (ADHD) in the university setting

Objective: To address the increasing demand for assessments of Adult Attention Deficit Hyperactivity Disorder (ADHD), the primary author developed a protocol for Counseling and Psychological Services (CAPS) at Stanford University's Vaden Student Health Center to improve the efficiency of such evaluations. Participants: As part of quality assurance, we reviewed the charts of Stanford students who sought assessment for ADHD before the protocol was implemented (September 2011–June 2013) and after the protocol was established (October 2013–August 2014). An IRB exemption was obtained. Methods: The protocol includes questionnaires that solicit detailed clinical information from a variety of sources prior to the student's initial visit. Results: A peer chart review of 35 randomly selected charts showed that students completing the protocol are receiving a more thorough assessment. Conclusion: The new Stanford ADHD protocol, designed to improve clinic efficiency, also increases the availability of relevant clinical information.     

Associations among trauma,depression, and alcohol use profiles and treatment motivation and engagement in college students

ABSTRACT

Objective: This study examined how profiles of alcohol use and symptoms of common mental health disorders (depression and posttraumatic stress disorder [PTSD]) influenced the perceived need for and actual seeking of different types of treatment (for alcohol versus psychological distress) in college student drinkers. Participants: Undergraduate students (n = 164) were assessed between September 2009 and August 2015. Methods: We classified students into different symptom profiles using model-based clustering and compared these profiles on a variety of variables. Results: The cluster model yielded three profiles: Low Risk (n = 66), Concomitant (n = 35), and Heavy Drinking (n = 63). Students in these profiles significantly differed in alcohol consumption, alcohol-related cognitions and problems, and perceptions of need and prior engagement in treatment. Conclusion: A variety of strategies can be used to engage students experiencing heavy drinking and/or mental health problems into treatment on campus.     

Beliefs underlying stress reduction and depression help-seeking among college students: An elicitation study

Objective: This study illustrates how a theory-based approach can identify college students’ beliefs about stress reduction activities and help-seeking for depression. These beliefs are the basis for intervention design. Participants: A sample of 53 undergraduate students at a public university in the Midwest participated in this research during March 2016. Methods: An open-ended belief elicitation survey was administered online. Beliefs were identified through qualitative thematic analyses. Results: Exercise was students’ most preferred stress reduction activity. Beliefs about exercise emphasized physical benefits yet also not having time for exercise. Beliefs about help-seeking for depression emphasized treatment efficacy, support from others, stigma, and time constraints. Conclusions: Whereas beliefs about positive outcomes inform educational and motivational messages, beliefs about time constraints underscore the need to also consider structural factors that can help students find time to attend to their well-being.     

Attention-deficit hyperactivity disorder symptomatology,binge eating disorder symptomatology,and body mass index among college students

Abstract

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.     

A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students

Objective: This study investigated associations between adverse childhood experiences (ACE) prior to age 18 years and multiple health behaviors (eg, cigarette and other substance use) and outcomes (eg, obesity, depression) for a large college sample. Participants: 2,969 college students from seven universities in the state of Georgia were included in the analysis. Methods: Web-based surveys were completed by students (45–60 minutes) during the spring semester, 2015. Results: Findings indicate that more ACEs are associated with higher levels of depressive symptoms, ADHD symptoms, cigarette use, alcohol use, marijuana use, and BMI, in addition to lower levels of fruit and vegetable intake, and sleep. Conclusion: ACEs may carry forward in the lifespan to influence a range of unhealthy outcomes among college students. College intervention programs may benefit by recognizing the pervasiveness of ACEs and their associations with health behaviors and outcomes, and include interventions across more than one health behavior.     

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.     

Racial/ethnic differences in body weight perception among U.S. college students

Objective: To examine racial/ethnic differences in weight perception by sex among U.S. college students. Participants: a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. Methods: This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. Results: Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). Conclusions: Weight-related interventions should take into account racial/ethnic differences in body weight perception.     

Adverse childhood experiences,post-traumatic stress disorder symptoms,and self-reported stress among traditional and nontraditional college students

Abstract

Objective: To investigate the relationships between adverse childhood experiences (ACEs), post-traumatic stress disorder symptoms (PTSD-S), and self-reported stress among college students. Participants: A total of 236 undergraduate students enrolled in nursing courses participated. Method: Using a correlational design, participants completed questionnaires online. To examine PTSD moderation between ACE and self-reported stress, multiple regression was employed. Stress outcomes were examined using a 4-group variable. Mean differences in stress response between these four groups were examined. Differences in ACE, PTSD-S, and stress response between traditional and nontraditional students were also examined. Results: PTSD-S moderated the relationship between ACEs, and self-reported stress. This indicates that students who report PTSD-S following childhood adversity perceive higher levels of stress. Nontraditional and traditional students differed in their responses to the ICLRE scale. Conclusion: Individuals who report PTSD-S following childhood adversity perceive higher levels of stress later in life. Stress reduction programs may be beneficial for students.     

Microaggressions,perceptions of campus climate,mental health,and alcohol use among first-year college students of color

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all.     

Racial and sex differences of fruit and vegetable self-efficacy and intake among college students in a rural,southern location

Abstract

Objective: To examine fruit and vegetable intake and self-efficacy among U.S. college students in a rural, Southern location. Participants: Undergraduate students (n?=?1503) enrolled in a university-wide health class at one large public institution during the spring 2017 semester. Methods: Cross-sectional survey data were collected online and analyzed using independent samples t test, one-way ANOVA, and regression. Results: On average, participants did not meet fruit or vegetable intake recommendations. Mean self-efficacy scores were 17.2 (SD?=?3.4) and 16.42 (SD?=?3.7) for fruit and vegetables, respectively, with statistically significant differences observed by sex and race (p?<?0.05). Hierarchical multiple regression results indicated self-efficacy explained 20.9% (fruit) and 29.3% (vegetables) of the variance in consumption. Similar patterns were found for meeting daily fruit and vegetable intake recommendations. Conclusions: Health campaigns are needed to address sex and racial disparities in college student fruit and vegetable intake and self-efficacy.     

Depression,anxiety, and tobacco use: Overlapping impediments to sleep in a national sample of college students

ABSTRACT

Objectives: To examine how tobacco use and depression/anxiety disorders are related to disturbed sleep in college students. Participants: 85,138 undergraduate respondents (66.3% female, 74.5% white, non-Hispanic, ages 18–25) from the Spring 2011 American College Health Association–National College Health Assessment II database. Methods: Multivariate analyses of tobacco use (none, intermediate, daily) and mental health (diagnosed and/or symptomatic depression or anxiety) were used to predict sleep disturbance. Results: Daily tobacco use was associated with more sleep problems than binge drinking, illegal drug use, obesity, gender, and working >20 hours/week. Students with depression or anxiety reported more sleep disturbances than individuals without either disorder, and tobacco use in this population was associated with the most sleep problems. Conclusions: Tobacco use and depression/anxiety disorders are both independently associated with more sleep problems in college students. Students with depression and/or anxiety are more likely to be daily tobacco users, which likely exacerbates their sleep problems.     

Time and support do not heal all wounds: Mental health correlates of past bullying among college students

Abstract

Objective: We examined whether perceptions of being bullied during middle and high school were associated with depressive, anxiety, and posttraumatic stress disorder (PTSD) symptoms during college. We also examined whether perceived social support (PSS) mediated the association between bullying and symptoms, and explored whether parental, peer, or other sources of support was most beneficial. Participants: Undergraduates (N?=?270) from an urban commuter college in the Northeast participated during Spring 2013 or Fall 2015. Methods: Psychometrically sound self-report measures were used to assess symptoms and perceptions of bullying and social support. Results: As hypothesized, bullying was associated with more symptoms, and PSS significantly mediated the associations between bullying and symptoms of PTSD and depression. Conclusion: The college years provide another opportunity to address the effects of middle and high school bullying. Receiving current support for past bullying is beneficial but is not enough, college counseling services are needed to reduce symptoms.     

Subjective evaluations of alcohol-related consequences among college students: Experience with consequences matters

Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience. Participants: Participants were 269 undergraduate students enrolled at a large, public, Midwestern university. Methods: Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey. Results: Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences. Conclusions: Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions.