Objective: High-risk alcohol use among college students has received substantial attention in recent years, and intervention and prevention efforts have increased dramatically. The current study examined ADHD as a risk factor for problematic drinking among college students. Trait disinhibition and difficulty stopping a drinking session were examined as potential mechanisms through which ADHD is associated with alcohol-related problems. Method: Participants included 100 full-time undergraduate students with (n = 48) and without (n = 52) Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ADHD. Results: Students with ADHD had higher rates of alcohol-related problems and alcohol-use disorders across multiple measures. Both disinhibition and difficulty stopping a drinking session independently mediated the relationship between ADHD and negative consequences of alcohol use. Conclusion: These findings indicate that college students with ADHD are at increased risk for alcohol-related problems. Trait disinhibition and difficulty stopping a drinking session represent mechanisms of high-risk alcohol use among college students with ADHD.
AmbrosiniP. (2000). Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). Journal of the American Academy of Child & Adolescent Psychiatry, 39, 49-58.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
4.
BaborT.Higgins-BiddleJ.SaundersJ.MonteiroM. (2001). AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for use in primary care. Geneva, Switzerland: World Health Organization.
5.
BachmanJ. G.Freedman-DoanP.O’MalleyP. M.SchulenbergJ. E.JohnstonL. D. (2008). Revisiting the marriage effects on substance abuse among young adults (Monitoring the Future Occasional Paper No. 68). Ann Arbor, MI: Institute for Social Research.
6.
BagwellC.MolinaB. S. G.PelhamW. E.HozaB. (2001). Attention-deficit hyperactivity disorder and problems in peer relations: Predictions from childhood to adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 1285-1292.
7.
BakerL.PrevattF.ProctorB. (2012). Drug and alcohol use in college students with and without ADHD. Journal of Attention Disorders, 16, 255-263.
8.
BarbaresiW.KatusicS.ColliganR.WeaverA.JacobsenS. (2007). Long-term school outcomes for children with attention-deficit/hyperactivity disorder: A population-based perspective. Journal of Developmental & Behavioral Pediatrics, 28, 265-273.
9.
BarkleyR. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.
10.
BarkleyR. A. (2002). Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 63, 10-15.
11.
BarkleyR. A.FischerM.SmallishL.FletcherK. E. (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology, 111, 279-289.
12.
BarkleyR. A.FischerM.SmallishL.FletcherK. E. (2004). Young adult follow-up of hyperactive children: Antisocial activities and drug use. Journal of Child Psychology and Psychiatry, 45, 195-211.
13.
BaronR. M.KennyD. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
14.
BernardiS.FaraoneS. V.CorteseS.KerridgeB. T.PallantiS.WangS.BlancoC. (2012). The lifetime impact of attention deficit hyperactivity disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Psychological Medicine, 42, 875-887.
15.
BiedermanJ. (2004). Impact of comorbidity in adults with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 65, 3-7.
16.
BiedermanJ.FaraoneS. V.SpencerT. J.MickE.MonuteauxM. C.AleardiM. (2006). Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. Journal of Clinical Psychiatry, 67, 524-540.
17.
BiedermanJ.SpencerT. J. (2002). Methylphenidate in treatment of adults with attention-deficit/hyperactivity disorder. Journal of Attention Disorders, 6(Suppl. 1), S101-S107.
18.
BeidermanJ.WilensT.MickE.FaraoneS.V.WeberW.CurtisS.. . . SorianoJ. (1997). Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 21-29.
19.
BiscaroM.BroerK.TaylorN. (2004). Self efficacy, alcohol expectancy and problem-solving appraisal as predictors of alcohol use in college students. College Student Journal, 38, 541-551.
20.
BlaseS. L.GilbertA. N.AnastopoulosA. D.CostelloE. J.HoyleR. H.SwartzwelderS.RabinerD. L. (2009). Self-reported ADHD and adjustment in college students: Cross-sectional and longitudinal findings. Journal of Attention Disorders, 13, 297-309.
21.
Chronis-TuscanoA.SeymourK. E.SteinM. A.JonesH. A.JilesC. D.RooneyM. E.RobbA. S. (2008). Efficacy of osmotic-release oral system (OROS) methylphenidate for mothers with attention-deficit/hyperactivity disorder (ADHD): Preliminary report of effects on ADHD symptoms and parenting. Journal of Clinical Psychiatry, 69, 1938-1947.
22.
ConnersC. K.ErhardtD.EpsteinJ. N.ParkerJ. D. A.SitareniosG.SparrowE. (1999). Self-ratings of ADHD symptoms in adults: I. Factor structure and normative data. Journal of Attention Disorders, 3, 141-151.
23.
Core Institute. (1994). Core Alcohol and Drug Survey—Long form. Carbondale, IL: Author, Southern Illinois University.
24.
CosdenM. (2001). Risk and resilience for substance abuse among adolescents and adults with LD. Journal of Learning Disabilities, 34, 352-358.
25.
CostaP. T.McCraeR. R. (1994). Set like plaster? Evidence for the stability of adult personality. Washington, DC: American Psychological Association.
26.
DarkesJ.GreenbaumP. E.GoldmanM. S. (1998). Sensation seeking-disinhibition and alcohol use: Exploring issues of criterion contamination. Psychological Assessment, 10, 71-76.
27.
DickD. M.SmithG.OlaussonP.MitchellS. H.LeemanR. F.O’MalleyS. S.SherK. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction Biology, 15, 217-226.
28.
DouglasK. A.CollinsJ. L.WarrenC.KannL.GoldR.ClaytonS.KolbeL. (1997). Results from the 1995 National College Health Risk Behavior Survey. Journal of American College Health, 46, 55-66.
29.
DuPaulG. J.WeyandtL. L.O’DellS. M.VarejaoM. (2009). College students with ADHD: Current status and future directions. Journal of Attention Disorders, 13, 234-250.
30.
ErhardtD.EpsteinJ. N.ConnersC. K.ParkerJ. D. A.SitareniosG. (1999). Self-ratings of ADHD symptoms in adults: II. Reliability, validity, and diagnostic sensitivity. Journal of Attention Disorders, 3, 153-158.
31.
FaraoneS. V.BiedermanJ.MilbergerS. (1995). How reliable are maternal reports of their children’s psychopathology? One-year recall of psychiatric diagnoses of ADHD children. Journal of American Academy of Child & Adolescent Psychiatry, 34, 1001-1008.
32.
FaraoneS. V.BiedermanJ.MonuteauxM. C. (2002). Further evidence for the diagnostic continuity between child and adolescent ADHD. Journal of Attention Disorders, 6, 5-13.
33.
FedeleD. A.LeflerE. K.HartungC. M.CanuW. H. (2012). Sex differences in the manifestation of ADHD in emerging adults. Journal of Attention Disorders, 16, 109-117.
34.
FirstM. B.SpitzerR. I.GibbonM.WilliamsJ. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-P). New York: New York State Psychiatric Institute, Biometrics Research.
35.
HarrisS. K.SherrittL.Van HookS.WechslerH.KnightJ. R. (2010). Alcohol policy enforcement and changes in student drinking rates in a statewide public college system: A follow-up study. Substance Abuse Treatment, Prevention, and Policy, 5, 18. Retrieved from http://www.substanceabusepolicy.com/content/5/1/18
36.
HeiligensteinE.GuentherG.LevyA.SavinoF.FulwilerJ. (1999). Psychological and academic functioning in college students with attention deficit hyperactivity disorder. Journal of American College Health, 47, 181-185.
37.
HendersonM. J.GoldmanM. S.CoovertM. D.CarnevallaN. (1994). Covariance structure models of expectancy. Journal of Studies on Alcohol, 55, 315-326.
38.
HildebrantH.BrokateB.ElingP.LanzM. (2004). Response shifting and inhibition, but not working memory, are impaired after long-term heavy alcohol consumption. Neuropsychology, 18, 203-211.
39.
HittnerJ. B.SwickertR. (2006). Sensation seeking and alcohol use: A meta-analytic review. Addictive Behaviors, 31, 1383-1401.
40.
HoganR.RobertsB. W. (2000). A socioanalytic perspective on person/environment interaction. In WalshB. W.CraikK. H.PriceR. H. (Eds.), New directions in person-environment psychology (pp. 1-23). Mahwah, NJ: Lawrence Erlbaum.
41.
HomackS.RiccioC. A. (2004). A meta-analysis of the sensitivity and specificity of the Stroop Color and Word Test with children. Archives of Clinical Neuropsychology, 19, 725-743.
42.
IacanoW. G.CarlsonS. R.TaylorJ.ElkinsI. J.McGueM. (1999). Behavioral disinhibition and the development of substance-use disorders: Findings from the Minnesota Twin Family Study. Developmental Psychopathology, 11, 869-900.
43.
JohnstonL. D.O’MalleyP. M.BachmanJ. G.SchulenbergJ. E. (2009). Monitoring the Future national survey on drug use, 1975-2008. Volume II: College students and adults ages 19-50 (NIH Publication No. 09-7402). Bethesda, MD: National Institute on Drug Abuse.
44.
KaufmanJ.BirmharB.BrentD.RaoU.FlynnC.MoreciP.RyanN. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980-988.
45.
KesslerR. C.AdlerL. A.BarkleyR. A.BiedermanJ.ConnersK. C.FaraoneS. V.ZaslavskyA. M. (2006). Prevalence and correlates of Adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163, 716.
46.
KingS. M.KeyesM.MaloneS. M.ElkinsI. J.LegrandL. N.IaconoW. G.McGueM. (2009). Parental alcohol dependence and the transmission of adolescent behavioral disinhibition: A study of adoptive and non-adoptive families. Addiction, 104, 578-586.
47.
KokotailoP.EganJ.GangnonR.BrownD.MundtM.FlemingM. (2004). Validity of the Alcohol Use Disorders Identification Test in college students. Alcoholism: Clinical & Experimental Research, 28, 914-920.
48.
KollinsS. H. (2008). ADHD, substance use disorders, and psychostimulant treatment: Current literature and treatment guidelines. Journal of Attention Disorders, 12, 115-125.
49.
KuriyanA. B.PelhamW. E.MolinaB. S.WaschbuschD. A.GnagyE. M.SibleyM. H.KentK. M. (2012). Young adult educational and vocational outcomes of children diagnosed with ADHD. Journal of Abnormal Child Psychology.
50.
LangleyK.FowlerT.FordT.ThaparA. K.van den BreeM.HaroldG.ThaparA. (2010). Adolescent clinical outcomes for young adults with attention-deficit hyperactivity disorder. British Journal of Psychiatry, 196, 235-240.
51.
LijffijtM.KenemansJ. L.VerbatenM. N.van EngelandH. (2005). A meta-analytic review of stopping performance in attention-deficit hyperactivity disorder: Deficient inhibitory motor control?Journal of Abnormal Child Psychology, 114, 216-222.
52.
LittlefieldA. K.SherK. J.WoodP. K. (2009). “Maturing out” of problematic alcohol involvement related to personality change?Journal of Abnormal Psychology, 118, 360-374.
53.
MannuzzaS.KleinR. G. (1999). Handbook of disruptive behavior disorders. New York, NY: Kluwer Academic/Plenum.
54.
MannuzzaS.KleinR. G.TroungN. L.MoultonJ. L.RoizenE. R.HowellK. H.CastellanosF. X. (2008). Age of methylphenidate treatment initiation in children with ADHD and later substance abuse: Prospective follow-up into adulthood. American Journal of Psychiatry, 165, 604-609.
55.
MaxwellS. E.ColeD. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. Psychological Methods, 12, 23-44.
56.
McCrystalP.PercyA.HigginsK. (2007). Substance use behaviors of young people with a moderate learning disability: A longitudinal analysis. American Journal of Drug and Alcohol Abuse, 33, 155-161.
57.
McGoughJ. J.BarkleyR. A. (2004). Diagnostic controversies in adult attention deficit hyperactivity disorder. American Journal of Psychiatry, 161, 1948-1956.
58.
McGoughJ. J.SmalleyS. L.McCrackenJ. T.YangM.Del’HommeM.LynnD. E.LooS. (2005). Psychiatric comorbidity in adult attention deficit hyperactivity disorder: Findings from multiplex families. American Journal of Psychiatry, 162, 1621-1627.
59.
MetznerB. S.LauerJ. B.RajeckiD. W. (2003). Predicting persistence among psychology majors at an urban university. North American Journal of Psychology, 5, 55-60.
60.
MolinaB. S. G.PelhamW. E. (2003). Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. Journal of Abnormal Psychology, 112, 497-507.
61.
MolinaB. S. G.PelhamW. E.CheongJ.MarshalM. P.GnagyE. M.CurranP. J. (in press). ADHD and growth in adolescent alcohol use: The roles of functional impairments, ADHD symptom persistence, and parental knowledge. Journal of Abnormal Psychology.
62.
NelsonJ. M.GreggN. (2012). Depression and anxiety among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Journal of Attention Disorders, 16, 244-254.
63.
NorwalkK.NorvilitisJ. M.MacLeanM. G. (2009). ADHD symptomatology and its relationship to factors associated with college adjustment. Journal of Attention Disorders, 13, 251-258.
64.
O’LearyM.MackieC. J.Castellanos-RyanN.Al-KhudhairyN.ConrodP. J. (2010). Personality-targeted interventions delay uptake of drinking and decrease risk of alcohol-related problems when delivered by teachers. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 954-965.
65.
ParkA.SherK.KrullJ. (2009). Selection and socialization of risky drinking during the college transition: The importance of microenvironments associated with specific living units. Psychology of Addictive Behaviors, 23, 404-414.
66.
ParkerJ. D. A.HoganM. J.EastabrookJ. M.OkeA.WoodL. M. (2006). Emotional intelligence and student retention: Predicting the successful transition from high school to university. Personality and Individual Differences, 41, 1329-1336.
67.
PiacentiniJ. C.CohenP.CohenJ. (1992). Combining discrepant diagnostic information from multiple sources: Are complex algorithms better than simple ones?Journal of Abnormal Child Psychology, 20, 51-63.
68.
PreacherK. J.HayesA. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879-891.
69.
PresleyC. A. (1994). Development of the Core Alcohol and Drug Survey: Initial Findings and Future Directions. Journal of American College Health, 42, 248-255.
70.
PresleyC. A.ChengY.PimentelE. (2004). Alcohol and drugs on American college campuses: A report to college presidents A Report to College Presidents. Carbondale, IL: Core Institute, Southern Illinois University.
71.
RabinerD. L.AnastopoulosA. D.CostellosJ.HoyleR. H.SwartzwelderH. S. (2008). Adjustment to college in students with ADHD. Journal of Attention Disorders, 11, 689-699.
72.
RobertiJ. W.StorchE. A.BravataE. (2003). Further psychometric support for the Sensation Seeking Scale–Form V. Journal of Personality Assessment, 81, 291-292.
73.
RobertsB. W.WaltonK. E.ViechtbauerW. (2006). Patterns of mean-level change in personality traits across the life course: A meta-analysis of longitudinal studies. Psychological Bulletin, 132, 1-25.
74.
RooneyM.Chronis-TuscanoA.YoonY. (2012). Substance use in college students with ADHD. Journal of Attention Disorders, 16, 221-234.
75.
SaundersJ.AaslandO.BaborT.De La FuentaJ.GrantM. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction, 88, 791-804.
76.
SchulenbergJ. E.O’MalleyP. M.BachmanJ. G.JohnstonL. D.LaetzV. B. (2004). How social role transitions form adolescence to young adulthood relate to trajectories of well-being and substance use (Monitoring the Future Occasional Paper No. 56). Ann Arbor, MI: Institute for Social Research.
77.
SheehanD. V.LecrubierY.SheehanK. H.AmorimP.JanavsJ.WeillerE.DunbarG. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22-33.
78.
SherK.BartholowB. D.WoodM. D. (2000). Personality and substance use disorders: A prospective study. Journal of Consulting and Clinical Psychology, 68, 818-829.
79.
SherK.GrekinE. R.WilliamsN. A. (2004). The development of alcohol use disorders. Annual Review of Clinical Psychology, 1, 493-523.
80.
SlobodaZ.StephensR. C.StephensP. C.GreyS. F.TeasdaleB.HawthorneR. D.MarquetteJ. F. (2009). The adolescent substance abuse prevention study: A randomized field trial of a universal substance abuse prevention program. Drug and Alcohol Dependence, 102, 1-10.
81.
SmithB. H.MolinaB. S. G.PelhamW. E.Jr. (2002). The clinically meaningful link between alcohol use and attention deficit hyperactivity disorder. Alcohol Research & Health, 26, 122-129.
82.
Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09-4434). Rockville, MD: Author.
83.
Swenson-GoguenL. M.HiesterM. A.NordstromA. H. (2010). Associations among peer relationships, academic achievement, and persistence in college. Journal of College Student Retention, 12, 319-337.
84.
TrullT. J.WaudbyC. J.SherK. J. (2004). Alcohol, tobacco, and drug use disorders and personality disorder symptoms. Experimental and Clinical Psychopharmacology, 12, 65-75.
85.
UpadhyayaH. P.RoseK.WangW.O’RourkeK.SullivanB.DeasD.BradyK. T. (2005). Attention-deficit/hyperactivity disorder, medication treatment, and substance abuse patterns among adolescents and young adults. Journal of Child and Adolescent Psychopharmacology, 15, 799-809.
86.
WeaferJ.FillmoreM. T.MilichR. (2009). Increased sensitivity to the disinhibiting effects of alcohol in adults with ADHD. Experimental and Clinical Psychopharmacology, 17, 113-121.
87.
WechslerH.DowdallG. W.DavenportA.CastilloS. (1995). Correlates of college student binge drinking. American Journal of Public Health, 85, 921-926.
88.
WechslerH.LeeJ. E.KuoM.LeeH. (2000). College binge drinking in the 1990s: A continuing problem: Results of the Harvard School of Public Health 1999 College Alcohol Study. Journal of American College Health, 48, 199-210.
89.
WeissG.HechtmanL. (1993). Hyperactive children grown up: ADHD in children, adolescents, and adults (2nd ed.). New York, NY: Guilford.
90.
WeyandtL. L.DuPaulG. J. (2008). ADHD in college students: Developmental Findings. Developmental Disabilities Research Reviews, 14, 311-319.
91.
WilensT. E. (2004). Attention-deficit/hyperactivity disorder and the substance use disorders: The nature of the relationship, subtypes at risk, and treatment issues. Psychiatric Clinics of North America, 27, 283-301.
92.
WilensT. E.BiedermanJ.SpencerT. J. (2002). Attention deficit/hyperactivity disorder across the lifespan. Annual Review of Medicine, 53, 113-131.
93.
WillcuttE. G.DoyleA. E.NiggJ. T.FaraoneS. V.PenningtonB. F. (2005). Validity of the executive function of theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336-1346.
94.
WolfL. (2001). College students with ADHD and other hidden disabilities: Outcomes and interventions. Annals of the New York Academy of Sciences, 931, 385-395.
95.
YazedjianA.PurswellK. E.SevinT.ToewsM. L. (2007). Adjusting to the first year of college: Students’ perceptions of the importance of parental, peer, and institutional support. Journal of the First-Year Experience & Students in Transition, 19, 29-46.
96.
ZuckermanM. (Ed.). (1994). Behavioral expressions and biosocial bases of sensation seeking. New York, NY: Cambridge University Press.
97.
ZuckermanM.EysenckS.EysenckH. J. (1978). Sensation seeking in England and America: Cross-cultural, age, and sex comparisons. Journal of Consulting and Clinical Psychology, 46, 139-149.
