Evaluating the consistency of scales used in adult attention deficit hyperactivity disorder assessment of college-aged adults

Objective: Neurocognitive evaluations are commonly integrated with clinical assessment to evaluate adult Attention Deficit Hyperactivity Disorder (ADHD). Study goal is to identify measures most strongly related to ADHD diagnosis and to determine their utility in screening processes. Participants: 230 students who were evaluated at the Vanderbilt University Psychological and Counseling Center between July 2013 and October 2015. Methods: We retrospectively examined charts, including clinical diagnosis, family history, childhood parental reported and current self-reported ADHD symptoms, psychiatric comorbidities, and continuous performance test (CPT). Result: Positive report of childhood and current ADHD symptoms, and lack of comorbid psychiatric symptoms were strongly associated with clinical diagnosis. CPT results were not associated with an ADHD diagnosis. The absence of reported childhood and current ADHD symptoms may serve as a contradictory marker for ADHD diagnosis. Conclusion: Clinical assessment of ADHD symptoms and ADHD childhood history, but not CPT, contributes to an accurate diagnosis of ADHD in college-aged adults.     

Quantifying the magnitude and potential influence of missing data in campus sexual assault surveys: A systematic review of surveys, 2010–2016

Objective: To understand how missing data may influence conclusions drawn from campus sexual assault surveys. Methods: We systematically reviewed 40 surveys from 2010–2016. We constructed a pseudo-population of the total population targeted across schools, creating records proportional to the respective response rate and reported sexual assault prevalence. We simulated the effects of 9 scenarios where the sexual assault prevalence among nonresponders differed from that of responders. Results: The surveys represented a total female undergraduate population of 317,387 with only 77,966 (24.6%) survey responses. Among responders, 20.4% reported experiences of sexual assault. However, prevalence of sexual assault could theoretically range from 5.0 to 80.4% under extreme assumptions about prevalence in nonresponders. Smaller, but still significant differences were observed with less extreme assumptions. Conclusions: Missing data are widespread in campus sexual assault surveys. Conclusions drawn from these incomplete data are highly sensitive to assumptions about the sexual assault prevalence among nonresponders.     

Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant,sex, and subtype differences

Objective: This study examined symptoms of anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD). Participants: Data were collected between March 2011 and March 2016 from 150 college students with ADHD and 150 college students without ADHD. Method: Participants with ADHD were compared to a sex- and ethnicity-matched control group. For the ADHD group, parent and self-report of anxiety and depression were also compared. Results: College students with ADHD self-reported significantly higher anxiety and depressive symptoms than did students without ADHD. Scores on parent-report measures of anxiety and depressive symptoms were significantly higher than scores on self-report measures. Significant sex differences were found for participants with ADHD, with females showing higher depressive and anxiety symptoms than males. Parent-reported anxiety symptoms were higher for those with inattentive type ADHD compared to combined type ADHD. Conclusion: The current study highlights the importance of multi-informant assessment in ADHD evaluations for college-aged adults.     

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.     

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.     

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.     

Eating Disorder Symptoms Among College Students: Prevalence,Persistence, Correlates,and Treatment-Seeking

Abstract

Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.     

Prevalence of Metabolic Syndrome and Individual Criteria in College Students

Abstract

Metabolic syndrome (MetS) is present in young adults and because coronary heart disease (CHD) is likely, screening to determine MetS prevalence and its criteria is critical. Objective: To determine MetS prevalence and most prevalent criteria in a sample of first-year college students. Participants: First-year college students between 18 and 24 years of age (n = 189). Methods: Metabolic syndrome was defined using the updated 2001 National Cholesterol Education Programs Adult Treatment Panel III. Anthropometrics and blood pressure were obtained. Lipid and glucose concentrations were determined. Results: Overall prevalence of MetS was 3.7%. Prevalence of 1 or 2 MetS criteria was 28.0% and 7.4%, respectively. Low high-density lipoprotein cholesterol (20.1%) and elevated triacylglycerol (17.5%) concentrations were the most prevalent criteria. Conclusions: Young adults have and are at risk of developing MetS. Identification of MetS early in life is critical and screening young adults will aid in targeted intervention development to decrease CHD risk.     

A Survey of Wellness/Healthy Lifestyling on College and University Campuses

Abstract

Mental health providers at university counseling and health centers should be alert to the possibility that college students with previously unrecognized attention deficit hyperactivity disorder (ADHD) may present for initial evaluation at their centers. This study was a systematic chart review of 42 students at an Upper Midwest university who were diagnosed with ADHD during calendar year 1993. Diagnoses were made by the treating psychiatrist, who reviewed records for presenting problems; recent associated problems; previous evaluations as a child, adolescent, or adult; and associated problems in childhood. Presenting problems included ADHD symptoms, mood symptoms, nonspecific learning disability, and academic underachievement. Associated problems were depressive disorders, anxiety disorders, drug and alcohol abuse or both, dependency, legal problems, learning disabilities, and eating disorders. Thirty-three percent had been evaluated for academic or behavior problems as children, and 36% had sought previous psychological care for non-ADHD symptoms as adults. Thirty-one percent were presenting at the university health center for their first evaluation. Childhood histories showed educational underachievement, learning disabilities, and behavior problems.     

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.     

Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach

Objective: The authors used quantitative and qualitative methodologies to investigate college students' perceptions and use of illegal Attention Deficit Hyperactivity Disorder (ADHD) stimulants during spring and summer 2006. Participants: From fall 2005 through fall 2006, the authors studied 1,811 undergraduates at a large, public, southeastern research university in the United States. Methods: The authors administered surveys to these students and conducted 175 in-depth interviews. Results: Of the study participants, 34% reported the illegal use of ADHD stimulants. Most illegal users reported using ADHD stimulants primarily in periods of high academic stress and found them to reduce fatigue while increasing reading comprehension, interest, cognition, and memory. Furthermore, most had little information about the drug and found procurement to be both easy and stigmafree. Conclusions: This study supplies a rich understanding of the growing national trend of illegal ADHD stimulant use. The authors discuss strategies for stemming the tide of ADHD stimulant use.     

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.     

Professor Perceptions of College Students With Attention Deficit Hyperactivity Disorder

Objective: From April to June 2005, the authors investigated professor perceptions of college students with attention deficit hyperactivity disorder (ADHD). Participants: 253 participants completed the ADHD Beliefs Survey-Revised, a 40-question survey measuring professor perceptions of ADHD. Methods: Analysis of variance measured false and reasonable beliefs related to ADHD. Results: Results indicated that professors with differing levels of education, years of teaching experience, colleges in the university or community college, previous experiences with a student with ADHD, and ADHD training did not differ significantly in perceptions regarding general ADHD knowledge or college students with ADHD.     

Safe Havens to Abandon Babies,Part I

Abstract

The occurrence of symptoms of Attention Deficit, Hyperactivity Disorder (ADHD) in eighty children adopted from Romania was studied. Their average age on arrival was 2.10 and at the start of this study 8 years. The 72 parent-couples (response 83%) were extensively interviewed and filled out the Dutch ADHD-questionnaire and the Child Behavior Checklist (CBCL). Twelve of the 80 participant children (15%, eleven boys and one girl) clearly showed symptoms of ADHD. In addition they exhibited more Externalizing Behavior (CBCL) than the remaining 68 children (75% vs. 25%). These 12 children more often attended special education than the others (67% vs. 25%). The ADHD children also showed less recovery over time. Ten of the twelve ADHD children also showed comorbidity, i.e., symptoms of posttraumatic stress reaction, post institutionalized autism and other behavioral disorders. The ADHD children needed more professional care than the remaining 68 children. Their parents, however, judged the received care more negatively than the Other parents.     

Young Adult Gambling Behaviors and their Relationship with the Persistence of ADHD

Young adulthood is a period renowned for engagement in impulsive and risky behaviors, including gambling. There are some indications that young adults exhibit higher gambling rates in comparison to older adults. Problem gambling has also been linked to ADHD. This longitudinal study examines the relationship between gambling and ADHD among an epidemiological sample of young adults (n = 235; males = 179, females = 56) aged 18-24. Results indicate that individuals who report childhood ADHD symptoms which persist into young adulthood experience greater gambling problem severity than participants with no ADHD or those with non-persistent 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.     

Longitudinal predictors of cigarette use among students from 24 Texas colleges

ABSTRACT

Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use sixmonths later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.