- Research on the efficacy of ADHD medication treatment in college students is extremely limited.
- College students may require symptom management that extends from morning through late at night, a time period which lasts longer than long-acting stimulants can cover.
- Students also generally assume greater responsibility for taking their medication as scheduled, as parents are less able monitor this, which may lead to these students not taking their medications as prescribed.
- Although the studies previously reviewed do not indicate any clear benefit of medication treatment, they are limited by the fact that students were not randomly assigned to treatment.

What do we know about ADHD in college students: Medication Treatment

- Clinicians should be aware that the diversion (defined as the transfer of any legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use) and misuse of ADHD medications are common problems on many college campuses.
- The prevalence of stimulant medication diversion by students with ADHD was found to be 26% in the previous six months, 35% in the previous 12 months, and 62% during their lifetime.
- In addition to diverting their medication, college students with ADHD frequently deviate from taking their medication as prescribed by taking it more frequently or at higher doses, using it in conjunction with other drugs, or intentionally misusing it to get high.

What do we know about ADHD in college students: Misuse and Diversion of ADHD Medications

- To date, no empirical studies testing the efficacy of psychosocial treatments for college students with ADHD have been published.
- Until such research becomes available, it has been recommended that cognitive-behavioral treatments, in conjunction to medication, should be used to treat ADHD.
- Other researchers report the efficacy of Meta Cognitive Therapy, which is designed to impart skills and strategies in time-management, organization, and planning to target bad behaviors that undermine effective self-management.
- Coaching is another approach to helping adults with ADHD, and may be particularly suited to use with college students, where coaches work with clients to identify important goals, develop plans and strategies for achieving them, and monitor progress toward attaining them.

What do we know about ADHD in college students: Psychosocial Treatment

- Colleges and universities typically offer academic accommodations, such as additional time for assignments and tests, and distraction-reduced test settings, to students with ADHD.
- One study indicated that only 40% of students with ADHD at one college were offered adequate accommodations, and just 45% of students with access to accommodations reported using the aid.
- Although the previous study was performed at a single institution, like many other studies on the topic, findings suggest that students with ADHD are not offered adequate accommodations and/or fail to use them.

What do we know about ADHD in college students: Academic Accommodations for Students with ADHD

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

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

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

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

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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