Longitudinal Course of ADHD in College Students

Arthur D. Anastopoulos, Ph.D. University of North Carolina at Greensboro

Arthur D. Anastopoulos, Ph.D.
University of North Carolina at Greensboro

If someone with Attention-Deficit/Hyperactivity Disorder (ADHD) can get into college, they should be just as likely as the next person to successfully earn their college degree, correct? Unfortunately, research findings paint a very different picture. When compared to their non-ADHD counterparts, college students with ADHD tend to earn lower grades, take longer to earn a college degree, and are more likely to drop out of college. Why might this happen? No one knows for sure but it may stem from a “perfect storm” of circumstances that converge to work against college students with ADHD. Inherent in the transition from high school to college is a dramatic increase in demands for regulating one’s own behavior, not only in terms of staying on top of school work but also with respect to managing personal matters, health, friendships, and money. Successfully navigating this transition is a major developmental challenge for anyone, ADHD or not. For someone with ADHD, a disorder characterized by significant deficits in one’s capacity for self-regulation, this developmental challenge is substantially greater. Further complicating matters is that various treatments (e.g, medication, counseling) and sources of support (e.g., parental monitoring, classroom accommodations), which may have been in place earlier, are often discontinued in college. The stage is therefore set for failure to occur.

Over the past five years my colleagues, Drs. George DuPaul (Lehigh University) and Lisa Weyandt (University of Rhode Island), and I have been conducting a longitudinal investigation funded by the National Institute of Mental Health. The goal of this study has been to gain insight into how ADHD unfolds across the college years and impacts educational and other types of functioning. A total of 456 first-year college students with and without ADHD began the project, with ADHD status and the presence of depression and other mental health conditions carefully determined by a panel of mental health experts. Similar diagnostic information, as well as information about each participant’s educational, psychological, social, emotional, and vocational functioning, was collected annually across a 4-year period.

Preliminary analyses have revealed some very interesting, yet sobering findings. Relative to their non-ADHD peers, college students with ADHD not only perform less well academically, but also display higher rates of depression and other psychological problems, engage in risky sexual behavior, and use tobacco, alcohol, and marijuana more frequently. Such differences emerge in the first year of college and continue to be present across four years.

So what does all of this mean? From a “perfect storm” perspective, it may be the case that college students with ADHD need to continue receiving treatment services and campus supports aimed at improving their capacity for self-regulation, in order to function more successfully in college. In the absence of such assistance, our findings also raise the possibility that college students with ADHD are likely to enter their post-college adult years at a distinct disadvantage relative to their non-ADHD counterparts, including remaining at increased risk for various psychological, social, and vocational difficulties.

Fortunately, there has been a recent surge of research interest in the development and testing of psychosocial interventions for ADHD during the high-risk college years. For college students with ADHD, the sooner such research is completed, the better.

Dr. Anastopoulos will be presenting at the 2017 APSARD Annual Meeting on “Longitudinal Course of ADHD in College Students.”

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