Is ADHD, independent of ODD, associated with whether and why college students misuse stimulant medication?

Abstract

Although previous research suggests that undergraduates with untreated or undertreated attention-deficit/hyperactivity disorder (ADHD) symptoms may have academic motives for stimulant medication misuse, no previous work has examined the relation of ADHD symptoms, controlling for comorbid oppositional defiant disorder (ODD), to misuse, or has explored how these symptoms are differentially related to motives for misuse. Among a sample of 900 students from one public university, the current study first tested whether increased ADHD symptomology (using the Current Symptoms Scale, CSS) was associated with an increased likelihood of misusing stimulant medication, controlling for comorbid ODD. We then examined whether those with increased ADHD symptomology were more likely to report academic motives for misuse. The prevalence rate of misuse in the past year was 22%. Participants who met symptom count criteria for ADHD (controlling for comorbid ODD) were 2.90 times more likely to misuse stimulant medication than those who did not. Among misusers, those who met ADHD criteria were also 2.80 times more likely to report academic motives for misuse. These results support that stimulant medication misuse is likely driven, in part, by inadequate or absent care for the executive functioning impairments associated with ADHD. Therefore, a greater focus on assessment and treatment of college students with ADHD symptoms is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies

“…Individual study details are available in Table S1, available online. 9,11,15,[18][19][20][21][22]27,31,32,[42][43][44]50,52,54,55,58,61,63,[72][73][74][75][76][77]80,82,84,93,[95][96][97][98][99][100]103,105,109,118 NMU ¼ nonmedical use.…”

“…74 Similar age-related trends have been observed in college-aged students. 22,73 With some exceptions, 20,74,80 most studies find male students to be at greater risk for NMU than female students, across all age groups. 13,17,22,30,40,42,45,46,48,53,54,73,81,84,91,102 Those who report NMU are more likely to be white.…”

“…22,73 With some exceptions, 20,74,80 most studies find male students to be at greater risk for NMU than female students, across all age groups. 13,17,22,30,40,42,45,46,48,53,54,73,81,84,91,102 Those who report NMU are more likely to be white. 17,18,20,22,30,40,42,[72][73][74]77,84,102 For example, a survey of 4,572 US high-school seniors found the lifetime prevalence of NMU to be 11.2% among white students, 5.6% among Hispanic students, and 2.9% among African American students.…”

“…18 Among college students, those associated with fraternities or sororities are more likely than others to report NMU. 22,73,84,85,104 Individuals who report NMU have higher levels of ADHD symptoms than those who do not, 9,17,18,22,57,81,84,99,101,106 although the self-report nature of the data cannot rule out confounding from malingering. A longitudinal study of college students found that 17% of those reporting NMU had high levels of self-reported ADHD symptoms.…”

“…Academic motivations were cited by 50% to 89% of college students who reported NMU and were the most common motivations in almost every survey. 13,15,20,22,36,37,40,42,50,53,54,78,81,83,84,94,[96][97][98]101,104,118 The desire to be more productive was cited by 40% of those reporting NMU in a survey of 4,297 US adults. 80 The desire to enhance academic or work performance was cited by 38% to 57% of those reporting NMU among a representative sample of 10,000 US adults.…”