Attention-Deficit/Hyperactivity Disorder in Community College Students

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is often unrecognized and infrequently treated in community college students. Since students with disabilities including ADHD are more likely to attend a 2-year rather than a 4-year college and to drop out before graduating, this article describes current conceptualizations of adult ADHD for community college social workers, psychologists, faculty, counselors, and staff. It presents counseling and educational interventions, which can result in greater academic success and an increase in self-esteem for individual students, as well as an increase in retention rates for the college.     

Re-Visioning Attention Deficit Hyperactivity Disorder (ADHD)

Constructionist notions have become commonplace in theoretical discussions of the self, but are seldom translated into consideration of specific social work practice concerns such as ADHD. Explorations of ADHD, on the other hand, typically emphasize a narrow, medically-oriented symptom picture that is devoid of the psychosocial context in which the so-called symptoms emerge. A transactional approach to the understanding of ADHD is advanced. This article promotes a link between constructionism and social work's psychosocial or person-in-environment perspective. Such a perspective supports approaches to the assessment of ADHD that illuminate larger cultural messages and their constraining influence on individual meaning-making. Intervention, conducted at multiple levels, must be geared to the establishment of more hopeful and affirming narratives.     

College Students and the Diagnosis of Attention Deficit Hyperactivity Disorder

Abstract

Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better understand how students perceived their susceptibility to and the severity of H1N1, which preventive behaviors they engaged in, and if policies impacted their preventive health decisions. Results: Preventive health behavior messaging had a mixed impact on students. Students made simple behavior changes to protect themselves from H1N1, especially if they perceived a high personal risk of contracting H1N1. Although policies were instituted to enable students to avoid classes when ill, almost no student self-isolated for the entire duration of their illness. Conclusions: These findings can help inform future decision making in a university setting to best influence preventive health behaviors.     

Attention Deficit Hyperactivity Disorder (ADHD) and Diverse Populations

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood. Given the high prevalence of ADHD and its significant impact on children and families, it is important for social workers to understand and know how to respond. This paper looks at Attention Deficit Hyperactivity Disorder, explores its causes, and gives special attention to its effect on diverse populations. In addition, it discusses empirically supported treatment interventions used for children with ADHD, particularly the role of parent training in the management of ADHD. Finally, it discusses the applicability of using parent-training programs with diverse populations.     

Building partnerships with low-income families of students with Attention Deficit Hyperactivity Disorder: Implications for professional school counselors

Parental involvement is vital in helping students with attention deficit hyperactivity disorder (ADHD) perform successfully in schools. Often, low-income families are not involved in their children's education. Therefore, the school counselor's role in partnering with families of students with ADHD to work for their children's academic and social success in school is addressed. Effective ways professional school counselors can encourage parental involvement, such as trainings and family education programs, are also explored.     

Gambling Behavior Among Adolescents with Attention Deficit/Hyperactivity Disorder

Impulsivity is inherent to both problem gambling and ADHD. The purpose of this study is to examine ADHD key symptoms, and gambling behaviors and problem severity among adolescents. Additionally, internalizing and externalizing behaviors exhibited among these individuals and the role of these symptoms in gambling are examined. We used a cross-sectional study design and survey 1,130 adolescents aged 12–19. Results indicated that adolescents who screened positive for ADHD were significantly more likely than non-ADHD adolescents to engage in gambling and significantly more likely to develop gambling problems. Those who screened positive as predominantly inattentive and those who screened positive for ADHD Combined (Inattention and Hyperactivity–Impulsivity) were equally likely to gamble, but the latter were twice as likely to have gambling problems. However, we found no significant interaction between the key ADHD symptoms and gambling as the severity of hyperactivity–impulsivity or inattention did not significantly differ with respect to gambling pathology. Emotional problems and depressive affect were the only variables that could significantly differentiate the ADHD types and gambling severity. Our Results highlight the clinical importance of considering the subtype of ADHD among gamblers and the greater association of depressive affect and emotional problems with gambling among adolescents.     

The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder

Recent studies indicate that treatment-seeking problem gamblers display elevated rates of ADHD and that adolescents who screen positive for ADHD are more likely to engage in gambling, develop gambling problems, and experience a greater severity in gambling problems. This study aimed to (a) compare the prevalence of ADHD in treatment-seeking problem gamblers to the general population; (b) investigate the relationships between ADHD and problem gambling severity, cluster B personality disorders, motor impulsivity, alcohol use, substance use, gender, and age; and (c) investigate the degree to which these factors moderate the relationship between ADHD and problem gambling severity. Participants included 214 adults (154 males, 58 females, 2 unspecified) who sought treatment for their gambling problems at a specialist gambling agency in Melbourne, Australia. Almost one-quarter (24.9 %) of treatment-seeking problem gamblers screened positively for ADHD, which was significantly higher than the 14 % prevalence in a community sample. ADHD was significantly positively correlated with problem gambling severity, motor impulsivity, and cluster B personality disorders, but was not associated with alcohol and substance use, gender or age. None of the factors significantly moderated the relationship between ADHD and problem gambling severity. These findings suggest that a considerable proportion of treatment-seeking problem gamblers report ADHD and that their clinical profile is complicated by the presence of high impulsivity and cluster B personality disorders. They highlight the need for specialist gambling agencies to develop screening, assessment, and management protocols for co-occurring ADHD to enhance the effectiveness of treatment.     

Pemoline in Adult Attention Deficit Hyperactivity Disorder: Predictors of Nonresponse

Abstract

The psychostimulants are the most widely used treatment modality for attention deficit/hyperactivity disorder (ADHD). Although positive responses to psychostimulants have been demonstrated, 46% of adults with ADHD, on average, are nonresponsive or cannot tolerate the medications because of adverse effects. We reviewed the charts of 43 students treated with pemoline and studied parameters of nonresponse. Sixteen (37%) met the study definition of nonresponse. Of these, 5 (12%) were symptom nonresponders and 11 (25%) were nonresponders because of adverse effects. We found a significant relationship between age and nonresponse resulting from adverse effects, yet no other factors predicted nonresponse to pemoline. Clinicians should consider using smaller starting doses of pemoline in adults to minimize adverse effects.     

A New Understanding of Attention Deficit Hyperactivity Disorder: Alternate Concepts and Interventions

This paper explores alternate concepts for increasing our understanding of the intra/interpersonal difficulties that are observed in those with Attention Deficit Hyperactivity Disorder (ADHD). Language theory in correlation with under inhibition of responses, (not inattention, impulsivity, and hyperactivity), is explained, and demonstrates how those with ADHD are more vulnerable for developing intra/interpersonal struggles. Comorbidity as it presents with ADHD is examined as the resulting psychopathological symptomolgy possibly caused by untreated psychological, social and cognitive distress. This is in contrast to the prevailing idea that comorbid symptoms are always separate and distinct diagnoses. The psychoanalytic theories of object relations and affect attunement are defined and are linked to under inhibition of responses via dynamic intra/interpersonal processes and the presenting psychological, social and cognitive problems. Interventions are proposed that are behavioral and psychopharmacological, with a systems approach. Two cases are presented to illustrate how these treatment techniques translate into actual practice. All proposed interventions are aimed to address and anticipate the potential that individuals and families with ADHD experience under inhibition of responses with accompanying, maladaptive intra/interpersonal functioning.     

Grappling with the Medicated Self: The Case of ADHD College Students

Drawing on interview data, this article is a case study of the “medicated self.” Specifically, we analyze how ADHD‐diagnosed college students construct how they are shaped by the behavioral effects of medicine. Students may perceive that pharmaceutical enhancement is necessary in the context of a competitive academic ethic. In this context something akin to Lareau's concept of concerted cultivation thrives as students practice what we call concerted medicalization in an attempt to literally embody the academic ideal. However, while medicine may enable students to manage academic performance and take control of “disordered bodies,” many remain uneasy about the extent to which they feel controlled by a drug. In the context of medical ambivalence, ADHD students engage in reflexive identity management and strategic pharmaceutical use to achieve some semblance of self‐control and self‐preservation during their college years. As their college education comes to a close, many prepare to return to what they construct as their “authentic,” nonmedicated selves as they enter the work world.     

Self-esteem,Self-focused Attention,and the Mediating Role of Fear of Negative Evaluation in College Students With and Without Asthma

Abstract

Objective: The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Participants: Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population. Methods: Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Results: Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Conclusions: Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of self-esteem regarding participation in social activities among college students appears warranted.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part II

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of ADHD. Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. The purpose of the current meta-synthesis was to conduct a comprehensive review of both the published and unpublished qualitative studies involving the experience of parents raising children diagnosed with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to eighty studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. Results of the first part of the analysis were reported in Corcoran et al. (2016) and had to do with the personal impact on parents. The themes in Part II have to do with the processes parents go through in accepting the diagnosis of ADHD and in deciding whether their children should take medication. Parents struggled to make sense of their child’s problems and came to terms with the diagnosis in a series of stages. Regarding medication use, parental attitudes varied greatly, with both costs and benefits noted. Though there was considerable ambivalence towards medication use, some parents reported relief after their child began using medication. Implications from this study are that providers should recognize the processes involved in making decisions about an ADHD diagnosis and the use of medication. Social workers should allow sensitive exploration of parents’ attributions and understanding of their children’s behavior and level of acceptance of the diagnosis. Keeping an ethical and critical stance toward the use of medication, social workers should also have full exploration with parents around the potential benefits and risks associated with the treatment of their children’s ADHD, taking into account parents’ preferences.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part I

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of Attention-deficit/hyperactivity disorder (ADHD). Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. This meta-synthesis compiled and analyzed a systematic review of the qualitative studies of parents’ lived experience of having a child with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to seventy-three studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. One major finding involved the emotional burden of caring for a child with ADHD. Parents struggled with a variety of intense and painful emotions as they attempted to manage family routines. Disciplining children only worked in a limited way and took constant effort throughout the day. The challenges of parenting spilled into other areas of the parents’ lives, such as their health, psychological, marital, and occupational functioning. Implications for practitioners are discussed, including the need to validate parental stress and the difficulty of applying behavioral management strategies with their children, the need for increased support of partner relationships, and the need to connect parents with support to prevent poorer outcomes for the child.     

Weight Loss Practices and Body Weight Perceptions Among US College Students

Objective: The authors assessed associations between body weight perception and weight loss strategies. Participants: They randomly selected male and female college students (N = 38,204). Methods: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. Results: Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. Conclusions: These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.     

Understanding Weight Management Perceptions in First-Year College Students Using the Health Belief Model

Abstract

Objective: To examine weight management barriers, using the Health Belief Model, in first-year college students. Participants: First-year college students (n = 45), with data collected in April, May, and November 2013. Methods: Nominal group technique sessions (n = 8) were conducted. Results: First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management). Conclusions: College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.     

Risk Factors Associated With Overweight and Obesity in College Students

College obesity is increasing, but to the authors' knowledge, no researchers to date have evaluated risk factors in this population. Objective: The authors assessed whether abnormal eating perceptions and behaviors were associated with overweight in college students. Participants and Methods: A sample of undergraduates (N = 4,201) completed an online survey containing demographic questions and the Eating Attitudes Test-26 (EAT-26) questionnaire. The authors stratified participants into normal-weight and overweight/obese groups and evaluated physical activity, EAT-26 score, purging behaviors, and answers to selected overweight screening questions on the basis of body mass index. A modified EAT-26 score of ≥ 11 was associated with overweight (p = .016). Results: Compared with normal-weight peers, overweight participants displayed an increased fear of bingeing, preoccupation with food, desire to be thinner, and engagement in dieting behavior. Mean body mass index also increased with age and physical inactivity (p < .001). Conclusions: Because physical inactivity, disordered eating perceptions, and disordered behaviors are associated with increased rates of overweight and obesity, identification of these risk factors in obese youths may increase understanding of weight loss barriers and facilitate the treatment of adolescent obesity.