Summary of studies that have examined ADHD among college students and problems ADHD college students face.

Although ADHD is the most extensively research disorder of childhood, there is relatively little research on ADHD in adults. Even more limited is research on how ADHD impacts the academic and social functioning of college students. Because a significant percentage of college students report having been diagnosed with ADHD, or as struggling because of ADHD symptoms, there is a pressing need for additional research on this population.

ADHD College Students Have Academic and Social Difficulties

The few studies that have examined ADHD among college students have reported that they experience greater academic problems and attain lower GPAs. In addition, some researchers have reported that college students with ADHD experience increased levels of other psychological symptoms, have lower levels of self-esteem and less well-developed social skills, and are more likely to display their anger in socially unacceptable ways. Despite these scattered findings, however, there continues to be a dearth of information on how individuals with ADHD adapt to the varied demands of college life.

A recent study published in the Journal of Attention Disorders, the only peer reviewed journal devoted exclusively to research on attention difficulties in children, adolescents, and adults, presents interesting new data in this area (Shaw-Zirt et al. (2005). Adjustment, social skills, and self-esteem in college students with symptoms of ADHD. Journal of Attention Disorders, 8, 109-120.) Participants in this study were 21 undergraduates diagnosed with ADHD in college and 20 undergraduates without ADHD who were matched on age, gender, and self-reported GPA. All students attended 1 of 2 commuter campuses of a large Catholic university in he Northeast. Unlike most studies of ADHD, the majority of participants were female.

The diagnosis of ADHD was based on a self-report measure of ADHD symptoms, a structured clinical interview, as well as an interview with an adult who knew the participant well, e.g., a parent, relative, or lifelong friend selected by the participant. The interview with informants inquired about the presence of symptoms when the subject was a child, as well as symptoms that were currently observed. The former is important because one of the diagnostic criteria for ADHD is the presence of symptoms prior to age 7. Interestingly, although all students meeting criteria for ADHD were reported to have displayed significant symptoms during childhood, only one had been previously diagnosed. Thus, nearly all of these students had gone through childhood and early adolescence without any appropriate treatment, something that remains unfortunately common.

The authors were particularly interested in examining 3 aspects of students' functioning: their adjustment to college, their self-esteem, and their social skills. Adjustment to college was assessed by having students complete the Student Adaptation to College Questionnaire, a 67-item measure that examines perceived academic adjustment, social adjustment, personal-emotional adjustment, and feelings of affiliation and attachment to one's school.

Self-esteem was measured using two scales - the Social Self-Esteem Inventory and the Rosenberg Self-Esteem Scale. The former includes 30 items that focus specifically on feelings of self-worth in a wide variety of social situations. The latter was used to obtain a more general assessment of students' self-esteem.

Students also reported on their social behavior using the 100-item Social Performance Survey Schedule. On this measure, participants are asked to rate how frequently they engage in a variety of specific social behaviors, particularly interactions involving same-se, friends. Unlike many other measures for assessing social skills, this measure asks about both positive and negative behaviors, and composite scores for each dimension were computed for all participants.

Results

Adjustment to College - Students with ADHD reported a more difficult adjustment to college in all 4 areas measured by the college adjustment scale. Thus, relative to matched control students, they indicated that they were doing less well academically (despite having equally high IQ scores), less well socially, less well emotionally, and that they felt less strongly connected to their school. The magnitude of these differences was large - between 1 and 2 standard deviations on each of the 4 scales. A similar pattern of results was obtained for males and females.

Self-esteem - Students with ADHD reported lower levels of both social self-esteem and general self-esteem. As with self-reported adjustment to college, the group differences were fairly robust and were similar for males and females.

Social skills - The results obtained for social skills were less clear-cut. For the positive social skills scale, significant differences between students with and without ADHD were not found, although females overall reported higher levels of positive social skills than males. For negative social skills, females with ADHD reported higher rates (on this scale, higher is worse) than females without ADHD. Among males, no such difference was evident.

In two final analyses, the authors explored the role of self-esteem and social skills in determining students' adjustment to college. They found that poorer college adjustment among students with ADHD was partially explained by the adverse impact that ADHD has on self-esteem. In other words, it appeared that ADHD might lead to poorer college adjustment by lowering self-esteem, which, in turn, results in poorer adjustment. In contrast, there was less evidence that poorer social skills were responsible for the greater adjustment difficulties experienced by students with ADHD.