What the Article Focused On
The scholarly article Adjustments to College in Students with ADHD focuses on a research study that analyzed college students diagnosed with ADHD, their adjustments to college, ADHD medications’ effect on adjustment, as well as their non-medical use/misuse. They wished to study how college students adjusted while dealing with an ADHD diagnosis. The focus was to determine the effect of medical treatment during these transitions.
This allows for a baseline to start to pave the way for future research and finding parallel patterns as students transitioning has not yet been researched fully. This further allows correlations to be drawn in future studies based on the different patterns presented by ADHD students as they’re more likely to adjust than individuals with ADHD who are not enrolled in college.
These questions help further our understanding of how clinical trials for medications may differ from the reality of community settings and the actual adjustments to coping with increased demand, organizational and time management skills, and a decreased support system.
Who Was Part of the Study?
The participants in this study were controlled to be varied equally in sex, race, and site. Site is defined as from the public school, or the private school. There were 1,648 students who participated and were all traditional first-semester freshmen located in Southeastern USA. 803 of these students were from a private university where 51% of students participated. 845 of the participants were from a public university and 42% of students participated. This reflected a 46% overall participation which is consistent with similar studies.
How Did The Researchers Get the Information?
The study was conducted via a web-based survey using empirical and quantitative methods though some correlations were drawn.
Independent variables included in this research consisted of ADHD symptoms (inattention, hyperactivity, and impulsiveness), ADHD status including current and past diagnosis, personality traits using The Big 5 (TIPI model), academic concerns, social dissatisfaction, and substance use. Using a variance of sex, race, and site (remember site just means which school they went to), the dependent variables focused on included inattentiveness, hyperactive-impulsiveness, academic results, depressive symptoms, and social aspects.
It is important to note this research was done anonymously, so there is no way to confirm a medical diagnosis. These numbers also do not account for individuals who may have ADHD but were under-diagnosed or not yet diagnosed by a professional.
What Was Found in the Study?
Interestingly, 49 of the ADHD students were from the public university and only 8 were from the private university. The researchers speculate that this may be in part due to the fact that ADHD is known to adversely affect academic performance. As the private university had competitive selections for admission, it is likely that only high-functioning ADHD students were able to gain admission due to a history of accomplishment that aids in resiliency against depressive symptoms.
This means when someone is high-functioning their resilience to bounce back out of depression is stronger. When a person who struggles more with ADHD symptoms comes across depression, they need more support to come through it. If you have ADHD or are a loved one of someone who is dealing with it daily, building the support system as well as the trust of all parties in it, increases the chances of success in college.
Disclaimer: This does not mean you can't function in college with ADHD. It just means you need to be real about the accommodations that will make your life easier. If you don't have a formal diagnosis, seek one out. You are entitled to accommodations legally in both college and your professional career afterward, but a professional diagnosis is required to access those legal rights.
How Does This Affect ADHD Students?
In this study, the ADHD students were compared against 200 randomly selected control students, without ADHD, with an equal variance of sex, race, and site. The students with ADHD reported more academic concerns and depressive symptoms than those without. This supports the above-speculated hypothesis that individuals who struggle with ADHD, and resulting depressive symptoms, are less likely to be admitted to a prestigious private college.
The study revealed female participants reported higher levels of depression than their male counterparts. Regarding depressive symptoms and personality traits, emotional stability and extraversion were negatively related. Meaning individuals who were more extroverted and emotionally stable were less likely to report depressive symptoms in students both with and without ADHD. For further examination, personality traits were controlled, but symptoms of inattentiveness persisted as a significant predictor.
Inattention is a Different Beast
Inattention was found to be negatively correlated with conscientiousness, emotional stability, and agreeableness. So, as expected, if an individual is conscientious and emotionally stable, the inattention symptoms they experience will be less than individuals who are less conscientious. Even after controlling personality factors, inattentive symptoms hung on as a significant predictor of ADHD and aversion to adjustment to college. Which makes sense. If you're struggling to pay attention, college is really fucking hard.
The researchers quoted Biederman, Mick, & Faraone (2000), to call attention to the ADHD symptom of inattention. They pointed out that while hyperactivity and impulsivity tend to dissipate over time, the same cannot be said about inattention. It was noticed that currently diagnosed individuals had a marginally higher (p <.07) rate of attention difficulties than people who had previously been diagnosed. Speculatively, this could be in part due to medication, and coping skills learned over time, possibly skewing the data collected. More concise research is needed to clarify the questions raised in light of this new information.
So, medications might not be all bad, and maybe give them a chance if inattention is a struggle in your life. Additionally, learning ADHD coping skills and incorporating them into your life could be a game changer for you.
Other Findings
Similarly, academic concerns were unrelated to gender, site, and race, but were negatively related to both conscientiousness and emotional stability. “Even when individuals with ADHD have achieved sufficient academic success to enroll in college … they still experience greater concerns about academic performance during their initial semester than their [neurotypical] peers” (Rabiner, et al., 2008, p. 696).
The research shows substance abuse had little effect. Unmedicated individuals were more likely to state they had smoked a cigarette in the last 30 days, and those who were medicated had a slightly higher chance of smoking marijuana (at only p < .10 difference) than their non-diagnosed peers. Other drugs had no apparent relationship with ADHD diagnosis (Biederman, Mick, Faraone, 2000).
The study didn’t find a relationship between medication and a decrease in ADHD symptoms, social concerns, or better adjustment. The researchers speculate this could, in part, be due to the small participation pool.
While consistent with similar studies, it is an isolated location in the southeastern USA, and with less than 50% participation, there is no way to know the integrity of the data. There is no way to know if there are more individuals per capita in the remaining percentage of students that didn’t participate in the study. It is also possible that the students who were medicated had more severe symptoms of ADHD, to begin with, they could be taking less medication than prescribed, or the meds might not be working as efficiently in a high-stress environment with the change of structure and expectations.
Social dissatisfaction did not relate to any of the demographic variables. Logically, similar to academic concerns, inattention, and hyperactive-impulsivity, social dissatisfaction is related negatively to conscientiousness and emotional stability, but also to extraversion.
In conclusion, the study didn’t find a direct correlation between medication and the ability to adjust or deal with ADHD symptoms, but it didn’t rule it out, either. This web-based survey is not detailed enough to determine the severity of diagnosis, nor subcategories, therefore a strong conclusion cannot be made about whether or not medication makes a difference in adjusting ADHD students to college, more research is needed. There was, however, a significant relationship identified between ADHD students and symptoms such as depression and inattentiveness which was exasperated by adjustment. Still, more research is needed.
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Action Items if You're Considering Going to College and Have ADHD
Get a formal diagnosis. Start by going to your primary physician and explaining your concerns about going to college with your current symptoms. This is the first step in getting the accommodations you will need to ensure your success. Sure, you could probably tough it out and try to make the Neurotypical world work for you, or you could just ask for simple ways to make your life easier.
Have a list of symptoms ready. If you have a list of ways ADHD is affecting your life currently, it will be easier for your physician to refer you. There is a diagnosis standard of the DSM-5. If you meet those criteria, they will refer you to a specialist for testing.
Figure out a routine that works for you. Avoid Drowning in feelings of overwhelm. Routines are key to making college work. By getting ready now, you will give yourself a greater chance at success.
Pick an app to help remind you of things you can't see. Out of sight, out of mind, right? Apps can remind you to do the things you struggle to remember. I personally have enjoyed Reclaim.Ai which is an online Google plugin (no app available yet) that works with my Google calendar to schedule habits and tasks I've assigned it.
Figure out what you want to be when you grow up. No, I'm not being condescending. A symptom of ADHD that some people struggle with is hyper-focus. It's great while it lasts, but it sucks when it goes. If you spend time to figure out a general plan of what you want your life to look like before starting college, you're less likely to switch majors halfway through and might save yourself some hard-earned cash.
References
Rabiner, D. L., Anastopoulos, A. D., Costello, J., Hoyle, R. H., Swartzwelder, H. S. (2008). Adjustment to college in students with ADHD. Journal of Attention Disorders, 11(6), 689-699. https://doi.org/10.1177/1087054707305106
Biederman, J., Mick, E., & Faraone, S. V. (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptom type. American Journal of Psychiatry, 157, 816-818.
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