Examination of ADHD Symptom Severity,Depression Symptoms,and Alcohol-Related Negative Consequences in College Students with ADHD

Abstract

College students with ADHD are at elevated risk for problem drinking behaviors and depression symptoms relative to their peers without ADHD. However, mechanisms underlying these constructs are unclear. This cross-sectional study examines two models: (1) alcohol-related negative consequences account for the covariation between ADHD symptom severity and depression symptoms and (2) depression symptoms account for the covariation between ADHD symptom severity and alcohol-related negative consequences. The sample included 106 college student drinkers with ADHD (M_age = 19.86, SD = 1.4). Results indicated that depression symptoms partially accounted for the covariation between ADHD symptom severity and alcohol-related negative consequences. Additionally, alcohol-related negative consequences partially accounted for the covariation between ADHD symptom severity and depression symptoms. Future directions and clinical implications are discussed such as understanding the bidirectional nature of these relationships longitudinally, improving alcohol and depression-related outcomes, and developing transdiagnostic treatments to address these comorbidities among young adults with ADHD.

Keywords

attention-deficit/hyperactivity disorder college depression mental health alcohol use

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References

Barkley

R. A.

(1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94. https://doi.org/10.1037/0033-2909.121.1.65

Barkley

R. A.

(2011). Barkley adult ADHD rating scale-IV (BAARS-IV). Guilford Press.

Beck

A. T.

Steer

R. A.

Ball

Ranieri

W. F.

(1996). Comparison of Beck depression inventories-IA and-II in psychiatric outpatients. Journal of Personality Assessment, 67(3), 588–597. https://doi.org/10.1207/s15327752jpa6703_13

Canu

W. H.

Stevens

A. E.

Ranson

Lefler

E. K.

LaCount

Serrano

J. W.

Willcutt

Hartung

C. M.

(2021). College Readiness: Differences Between First-Year Undergraduates With and Without ADHD. Journal of Learning Disabilities, 54(6), 403–411. https://doi.org/10.1177/0022219420972693

Collins

R. L.

Parks

G. A.

Marlatt

G. A.

(1985). Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology, 53(2), 189–200. https://doi.org/10.1037/0022-006X.53.2.189

Demartini

K. S.

Carey

K. B.

(2012). Optimizing the use of the AUDIT for alcohol screening in college students. Psychological Assessment, 24(4), 954–963. https://doi.org/10.1037/a0028519

Dennhardt

A. A.

Murphy

J. G.

(2011). Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students. Psychology of Addictive Behaviors, 25(4), 595–604. https://doi.org/10.1037/a0025807

Edwards

A. C.

Heron

Dick

D. M.

Hickman

Lewis

Macleod

Kendler

K. S.

(2014). Adolescent alcohol use is positively associated with later depression in a population-based UK Cohort. Journal of Studies on Alcohol and Drugs, 75(5), 758–765. https://doi.org/10.15288/jsad.2014.75.758

Fergusson

D. M.

Boden

J. M.

Horwood

L. J.

(2009). Tests of causal links between alcohol abuse or dependence and major depression. Archives of General Psychiatry, 66(3), 260. https://doi.org/10.1001/archgenpsychiatry.2008.543

10.

Glass

Flory

(2012). Are symptoms of ADHD related to substance use among college students? Psychology of Addictive Behaviors, 26(1), 124–132. https://doi.org/10.1037/a0024215

11.

Ham

L. S.

Hope

D. A.

(2003). College students and problematic drinking: A review of the literature. Clinical Psychology Review, 23(5), 719–759. https://doi.org/10.1016/S0272-7358(03)00071-0

12.

Harford

T. C.

Wechsler

Muthén

B. O.

(2003). Alcohol-related aggression and drinking at off-campus parties and bars: A national study of current drinkers in college. Journal of Studies on Alcohol, 64(5), 704–711. https://doi.org/10.15288/jsa.2003.64.704

13.

Holahan

C. J.

Moos

R. H.

Holahan

C. K.

Brennan

P. L.

Schutte

K. K.

(2005). Stress generation, avoidance coping, and depressive symptoms: A 10-year model. Journal of Consulting and Clinical Psychology, 73(4), 658–666. https://doi.org/10.1037/0022-006X.73.4.658

14.

Kahler

C. W.

Strong

D. R.

Read

J. P.

(2005). Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The brief young adult alcohol consequences questionnaire. Alcoholism: Clinical & Experimental Research, 29(7), 1180–1189. https://doi.org/10.1097/01.ALC.0000171940.95813.A5

15.

Khantzian

E. J.

(1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550

16.

Little

R. J. A.

(1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202. https://doi.org/10.1080/01621459.1988.10478722

17.

Meinzer

M. C.

Pettit

J. W.

Leventhal

A. M.

Hill

R. M.

(2012). Explaining the covariance between attention-deficit hyperactivity disorder symptoms and depressive symptoms: The role of hedonic responsivity: ADHD, depression, and reward responsivity. Journal of Clinical Psychology, 68(10), 1111–1121. https://doi.org/10.1002/jclp.21884

18.

Mesman

G. R.

(2015). The relation between ADHD symptoms and alcohol use in college students. Journal of Attention Disorders, 19(8), 694–702. https://doi.org/10.1177/1087054713498931

19.

Mowinckel

A. M.

Pedersen

M. L.

Eilertsen

Biele

(2015). A meta-analysis of decision-making and attention in adults with ADHD. Journal of Attention Disorders, 19(5), 355–367. https://doi.org/10.1177/1087054714558872

20.

Oddo

L. E.

Knouse

L. E.

Surman

C. B. H.

Safren

S. A.

(2018). Investigating resilience to depression in adults with ADHD. Journal of Attention Disorders, 22(5), 497–505. https://doi.org/10.1177/1087054716636937

21.

Pedersen

S. L.

Walther

C. A. P.

Harty

S. C.

Gnagy

E. M.

Pelham

W. E.

Molina

B. S. G.

(2016). The indirect effects of childhood attention deficit hyperactivity disorder on alcohol problems in adulthood through unique facets of impulsivity: Alcohol problems, impulsivity and ADHD. Addiction, 111(9), 1582–1589. https://doi.org/10.1111/add.13398

22.

Pelham

W. E.

Fabiano

G. A.

(2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 184–214. https://doi.org/10.1080/15374410701818681

23.

Rooney

Chronis-Tuscano

Yoon

(2012). Substance use in college students with ADHD. Journal of Attention Disorders, 16(3), 221–234. https://doi.org/10.1177/1087054710392536

24.

Saunders

J. B.

Aasland

O. G.

Babor

T. F.

De La Fuente

J. R.

Grant

(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(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

25.

Seymour

K. E.

Miller

(2017). ADHD and Depression: The Role of Poor Frustration Tolerance. Current Developmental Disorders Reports, 4(1), 14–18. https://doi.org/10.1007/s40474-017-0105-2

26.

Storch

E. A.

Roberti

J. W.

Roth

D. A.

(2004). Factor structure, concurrent validity, and internal consistency of the beck depression inventory? Second edition in a sample of college students. Depression and Anxiety, 19(3), 187–189. https://doi.org/10.1002/da.20002

27.

Tingley

Yamamoto

Hirose

Imai

Trinh

Wong

(2019). Package ‘mediation’. http://cran.uni-muenster.de/web/packages/mediation/mediation.pdf

28.

Vaillancourt

Brittain

H. L.

McDougall

Duku

(2013). Longitudinal links between childhood peer victimization, internalizing and externalizing problems, and academic functioning: Developmental cascades. Journal of Abnormal Child Psychology, 41(8), 1203–1215. https://doi.org/10.1007/s10802-013-9781-5

29.

Weyandt

L. L.

DuPaul

(2006). ADHD in college students. Journal of Attention Disorders, 10(1), 9–19. https://doi.org/10.1177/1087054705286061

30.

Young

(2005). Coping strategies used by adults with ADHD. Personality and Individual Differences, 38(4), 809–816. https://doi.org/10.1016/j.paid.2004.06.005