- Limitations of the DSM-IV-TR criteria in diagnosing ADHD in college students overlap with those pertaining to diagnosing young adults more generally.
- Researchers suggest that current diagnostic criteria for ADHD are better suited for school-age children, and may not capture developmental changes in the manifestation of core symptoms.
- As is true for young adults, college students may experience much greater ADHD symptomology than their same-age peers, yet not meet DSM-IV criteria.
- Research suggests that adults reporting ADHD symptoms at or greater than the 99th percentile meet the diagnostic criteria for ADHD, which may indicate the need to reduce the number of symptoms required for diagnosis to 4-5 symptoms.

What do we know about ADHD in college students: Problems in the Use of DSM-IV-TR Diagnostic Criteria

- Malingering to obtain an ADHD diagnosis may be especially pertinent to college students.
- Students may deliberately over-report ADHD symptoms to procure academic accommodations or feign ADHD to obtain a prescription for stimulant medication.
- One study found that approximately 25-48% of students self-referred for ADHD evaluations exaggerate symptoms.
- Concerns about college students feigning ADHD have prompted efforts to identify reliable methods for detection.
- Some studies have identified that ADHD self-report scales, which are most commonly used when diagnosing ADHD, do not accurately differentiate between those feigning ADHD and those who do have ADHD.
- Available research indicates that clinicians should recognize that many college students requesting ADHD evaluation may feign symptoms to obtain a diagnosis, and self-report measures can be readily faked, and clinical interviews may or may not be more effective at identifying malingering.

What do we know about ADHD in college students: Malingering

Sections:
- Problems in the Use of DSM-IV-TR Diagnostic Criteria
- Malingering

Boston College

Research on ADHD in college students began in the 1990s and has been steadily increasing in recent years. Accumulating research suggest that college students with ADHD experience less academic success and greater psychological and emotional difficulties, and use substances at higher rates. However, conclusions drawn from this body of research may not be representative of the wider population of students with ADHD. This literature review expands upon the growing body of research on ADHD in college students, and touches upon the results of existing studies.

What do we really know about ADHD in college students?

Green, A.L., Rabiner, D.L. What Do We Really Know about ADHD in College Students?. Neurotherapeutics 9, 559–568 (2012). https://doi-org.ezproxy.lib.uconn.edu/10.1007/s13311-012-0127-8

Results of several longitudinal studies conducted by the late-1990s indicate that for roughly ½ to ⅔ of children with ADHD, symptoms persist into adolescence and adulthood. Even though student with ADHD are less likely than their peers to graduate from high school and attend college, it is estimated that approximately 25% of college students receiving disabilities are diagnosed with ADHD and this percentage is steadily increasing.

The goal of this study is to review current research addressing a number of issues pertaining to ADHD in college students, including:
- The prevalence in college populations.
- Diagnostic considerations of students.
- The association between ADHD and multiple domains of college adjustment.
- Treatment services for students.

What do we know about ADHD in college students: Introduction

- It has been estimated that between 2-8% of college students in the US have ADHD, however, these estimates are largely based on studies that obtained self-reported symptoms of diagnostic status from a convenience sample of students.
- Other researchers, in order to estimate prevalence, simply ask students whether they have a current ADHD diagnosis, which have estimated that approximately 4.5% of college students have a current ADHD diagnosis.
- The methods used to estimate ADHD prevalence in college populations differ substantially from the guidelines suggested by McGough and Barkley, who suggest that clinicians confirm at least 4 inattentive and/or hyperactive impulsive symptoms are present and contribute to impairment.
- Proper diagnostic techniques/diagnosis confirmation techniques are rarely followed when conducting research on ADHD.

What do we know about ADHD in college students: Prevalence of ADHD in College Students

What do we know about ADHD in college students: Diagnostic Issues in College Students

Sections:
- Academics
- Social Functioning and Romantic Relationships
- Psychological and Emotional Functioning
- Substance and Alcohol Use

What do we know about ADHD in college students: ADHD and the Adjustment of College Students

Sections:
- Medication Treatment
- Misuse and Diversion of ADHD Medications
- Psychosocial Treatment
- Academic Accommodations for Students with ADHD

What do we know about ADHD in college students: Treatment

- Since research on college students with ADHD appeared in the late-1990s, there has been a surge of interest in this population.
- Despite the growing number of research on ADHD in college students, this research remains limited, relative to work conducted on children, adolescents, and adults.
- One particular issue is that most studies on this topic relied on relatively small convenience samples of students at a single institution.
- Much of this research also relied on the self-report diagnostic status of students, which can easily be feigned, or may not apply to this age group.
- Most students also have not considered whether adjustment difficulties thought to be the result of ADHD may be, at least partially, explained by other psychiatric disorders.
- Studies that evaluate the impact of treatment on college students with ADHD are extremely limited.
- To sum up this literature review, although ADHD has become a major area of interest in the study of psychology, there is a very long way for this research to go, since many areas of study are lacking appropriate research and empirical support.

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