ADHD Symptomology and Prescription Stimulant Misuse in College Students

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological disorder characterized by developmentally inappropriate levels of hyperactivity/impulsivity and inattention. These symptoms result in impairments for individuals across multiple settings and are developmentally inappropriate. While common during childhood, symptoms have been shown to persist into adulthood for 50% or more of those diagnosed before reaching age 18. Although prescription stimulants have been shown to benefit those with ADHD, increased popularity of prescription stimulant misuse among those without ADHD has been reported, despite the potentially harmful side effects that may accompany this use. Specifically, nonmedical use of prescription stimulants during adolescence led to increased risk of crime commitment and increased risk for subsequent addictions to other substances. Despite the negative effects of prescription stimulants on those misusing them, as many as 7% of undergraduate college students reported prescription stimulant medication misuse. The present NIH R01 funded study, Trajectories Related to ADHD in College (TRAC) is a 5-year longitudinal study conducted by Dr. Arthur Anastopoulos at the University of North Carolina at Greensboro (Lead Principal Investigator), Dr. George DuPaul at Lehigh University (Co-Principal Investigator), and Dr. Lisa Weyandt at the University of Rhode Island (Co-Principal Investigator). Through my work on this study, it became clear that although research concerning the patterns of misuse among college students has been performed and documented, the association between those with ADHD and nonmedical use of prescription stimulants has not been well studied. More specifically, research exploring the relationship between the severity of ADHD symptoms and prescription stimulant misuse is sparse. Therefore, the aim of this honors thesis is to assess the misuse among students both with, and without, ADHD, and to explore whether males and females differ in reported rates of prescription stimulant misuse

College Students\u27 Perceptions of Professor/Instructor Bullying: Questionnaire Development and Psychometric Properties

Objective: This study developed and examined the psychometric properties of a newly formed measure designed to assess professor/instructor bullying, as well as teacher bullying occurring prior to college. Additionally, prevalence of instructor bullying and characteristics related to victims of instructor bullying were examined. Participants: Participants were 337 college students recruited in 2012 from a northeastern university. Methods: An online questionnaire was administered to college students. A split-half, cross-validation approach was employed for measurement development. Results: The measure demonstrated strong criterion validity and internal consistency. Approximately half of students reported witnessing professor/instructor bullying and 18% reported being bullied by a professor/instructor. Report of teacher bullying occurring prior to college was related to professor/instructor bullying in college, and sex was a moderating variable. Conclusion: College students perceive instructor bullying as occurring but may not know how to properly address it. Prevention efforts should be made by university administrators, faculty, and staff

Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration

Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance

First-Year GPA and Academic Service Use Among College Students With and Without ADHD

Objective: ADHD is a chronic neurodevelopmental disorder that typically results in persistent academic difficulties over time. Although most colleges offer support services, students often do not use the available services or those to which they are entitled. The present study examined predictors of academic performance among college students with and without ADHD. In addition, the rate, predictors, and outcomes of academic service use were explored. Methods: A series of multivariate analyses of variance (MANOVAs) and regression analyses were conducted using SPSS v. 21 ® software. Results: First year college students with ADHD earned significantly lower grade point averages (GPAs) relative to students without ADHD. Additionally, ADHD combined with other disorders, but not ADHD alone, predicted higher rates of service use relative to students without ADHD. Finally, the findings suggest that typically available academic services are not independently related to GPA among first-year college students with or without ADHD. Conclusion: This study replicates previous work demonstrating significantly lower GPAs among a rigorously defined sample of students with ADHD relative to students without ADHD. Second, this study indicates that traditional predictors of college success may be less meaningful for students with ADHD relative to those without ADHD. Finally, additional research needs to be conducted regarding the use and effectiveness of academic services on college campuses

Self-Injurious Thoughts and Behaviors Among College Students: A Latent Class Analysis

This study explored emerging typologies of self-injurious thoughts and behaviors and how they relate to known psychological and cognitive correlates. Latent class analysis was employed to identify subgroups of college students (n = 626, mean age = 20, 73% female, and 83% White) based on history of self-injurious thoughts and behaviors. Differences among classes were tested to examine their associations with suicidal ideation, fearlessness of death, depression/hopelessness, thwarted belongingness, problems with alcohol or drugs, behavioral inhibition, and emotional control. Results of the latent class analysis supported a 3-class solution, with students classified as being likely to have (1) no history of any self-injurious thoughts and behaviors (78%); (2) a history of all self-injurious thoughts and behaviors (8%); or (3) a history of suicidal ideation, plan, and non-suicidal self-injurious thoughts and behaviors, but not suicide attempt (13%). Findings examining correlates of self-injurious thoughts and behaviors highlight the importance of fearlessness of death for distinguishing suicide attempters from non-attempters. Attention to mental health and suicide prevention initiatives should remain a critical priority across college campuses

Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors

Nonmedical use of prescription opioid medication (NMPO) in the United States is a public health crisis, resulting in high rates of emergency room visits, morbidity, and mortality. The purpose of this study was to explore prevalence estimates and correlates of NMPO among a convenience sample of college students in the northeast and southeast regions of the US to help generate directions for future research. Motivations for misuse, age of onset, access, concomitant substance use, and individual factors were investigated among a sample of undergraduate students from two universities. Participants (N = 847) completed a battery of various self-report measures. Findings revealed that 7.7% (Southeastern University) and 12.8% of students (Northeastern University) reported lifetime NMPO, whereas past-month NMPO was reported by 0.8% and 0.9% of participants, respectively. Lifetime history of regularly using alcohol, nonmedical use of benzodiazepine medication, nonmedical use of prescription stimulants, symptoms of depression and anxiety, and executive functioning (i.e., metacognition and behavioral regulation) were significantly related to lifetime history of NMPO in this college sample. These findings offer several potential subsequent lines of investigation regarding the associations between various demographic and psychological factors and NMPO. Future research is needed to help identify college students who are at risk of NMPO

Flanker performance in female college students with ADHD: a diffusion model analysis

Attention-deficit hyperactivity disorder (ADHD) is characterized by poor adaptation to environmental demands, which leads to various everyday life problems. The present study had four aims: (1) to compare performance in a flanker task in female college students with and without ADHD (N = 39) in a classical analyses of reaction time and error rate and studying the underlying processes using a diffusion model, (2) to compare the amount of focused attention, (3) to explore the adaptation of focused attention, and (4) to relate adaptation to psychological functioning. The study followed a 2-between (group: ADHD vs. control) × 2-within (flanker conflict: incongruent vs. congruent) × 2-within (conflict frequency: 20 vs. 80 %) design. Compared to a control group, the ADHD group displayed prolonged response times accompanied by fewer errors in a flanker task. Results from the diffusion model analyses revealed that the members of the ADHD group showed deficits in non-decisional processes (i.e., higher non-decision time) and leaned more toward accuracy than participants without ADHD (i.e., setting higher boundaries). The ADHD group showed a more focused attention and less adaptation to the task conditions which is related to psychological functioning. Deficient non-decisional processes and poor adaptation are in line with theories of ADHD and presumably typical for the ADHD population, although this has not been shown using a diffusion model. However, we assume that the cautious strategy of trading speed of for accuracy is specific to the subgroup of female college students with ADHD and might be interpreted as a compensation mechanism

Neuroticism And Individual Differences In Neural Function In Unmedicated Major Depression: Findings From The Embarc Study

BACKGROUND: Personality dysfunction represents one of the only predictors of differential response between active treatments for depression to have replicated. We examine whether depressed patients with higher neuroticism scores, a marker of personality dysfunction, show differences compared with depressed patients with lower scores in the functioning of two brain regions associated with treatment response, the anterior cingulate and anterior insula cortices. METHODS: Functional magnetic resonance imaging data during an emotional Stroop task were collected from 135 adults with major depressive disorder at four academic medical centers participating in the EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care) study. Secondary analyses were conducted including a sample of 28 healthy subjects. RESULTS: In whole-brain analyses, higher neuroticism among adults with depression was associated with increased activity in and connectivity with the right anterior insula cortex to incongruent compared with congruent emotional stimuli (all k $ 281, all p , .05 familywise error corrected), covarying for concurrent psychiatric distress. We also observed an unanticipated relationship between neuroticism and reduced activity in the precuneus (k 5 269, p , .05 familywise error corrected). Exploratory analyses including healthy subjects suggested that associations between neuroticism and brain function may be nonlinear over the full range of neuroticism scores. CONCLUSIONS: This study provides convergent evidence for the importance of the right anterior insula cortex as a brain-based marker of clinically meaningful individual differences in neuroticism among adults with depression. This is a critical next step in linking personality dysfunction, a replicated clinical predictor of differential antidepressant treatment response, with differences in underlying brain function