Skip to main content

Advertisement

Log in

ADHD in college: A qualitative analysis

  • Original Article
  • Published:
ADHD Attention Deficit and Hyperactivity Disorders

Abstract

Attention-deficit/hyperactivity disorder (ADHD) affects many adults and is particularly impairing for emerging adults enrolled in college. Research has shown substantial academic impairment for these individuals. However, research on ADHD impairment has largely been quantitative and focused on children. Therefore, the current study employed Interpretative Phenomenological Analysis to explore the lived experience of college students with ADHD with the following two research questions: (1) What is it like to be a college student with ADHD? and (2) What resources are utilized by college students with ADHD? Thirty-six college students with ADHD were interviewed in focus group settings. Our participants reported a complex and mixed experience living with ADHD in college and varied use of treatments and other accommodations. Specifically, three Constructs emerged in the current study: Consequences of Diagnosis, Impairment, and Treatment Management. Implications for professionals working with these students and future directions for researchers are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Advokat C, Lane SM, Luo C (2011) College students with and without ADHD: comparison of self-report of medication usage, study habits, and academic achievement. J Atten Disord 15:656–666. doi:10.1177/i087054710371168

    Article  PubMed  Google Scholar 

  • Allsopp DH, Minskoff EH, Bolt L (2005) Individualized course-specific strategy instruction for college students with learning disabilities and ADHD: lessons learned from a model demonstration project. Learn Disabil Res Pract 20:103–118. doi:10.1111/j.1540-5826.2005.00126.x

    Article  Google Scholar 

  • American Psychiatric Association (APA) (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Anastopoulos AD, King KA (2015) A cognitive-behavior therapy and mentoring program for college students with ADHD. Cogn Behav Pract 22(2):141–151. doi:10.1016/j.cbpra.2014.01.002

    Article  Google Scholar 

  • Arnett JJ (2000) Emerging adulthood: a theory of development from the late teens though the twenties. Am Psychol 55:469–480. doi:10.1037//0003-066X.55.5.469

    Article  CAS  PubMed  Google Scholar 

  • Arnett JJ (2014) Emerging adulthood: the winding road from the late teens through the twenties. Oxford University Press, Oxford. doi:10.1093/acprof:oso/9780199929382.001.0001

    Book  Google Scholar 

  • Auerbach CF, Silverstein LB (2003) Qualitative data: An introduction to coding and analysis. New York University Press, New York

    Google Scholar 

  • Barkley RA (2006) The nature of ADHD, Part I. In: Barkley RA (ed) Attention-deficit hyperactivity disorder, 3rd edn: a handbook for diagnosis and treatment. Guilford Press, New York, NY, pp 1–75

    Google Scholar 

  • Barkley RA (2011) Barkley adult ADHD scale-IV (BAARS-IV). Guilford Press, New York, NY

    Google Scholar 

  • Barkley RA, Fletcher K, Fischer M, Smallish L (2002) The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 111:279–289. doi:10.1037//0021-843X.111.2.279

    Article  PubMed  Google Scholar 

  • Barkley RA, Murphy KR, Fischer M (2008) ADHD in adults: what the science says. Guilford Press, New York, NY

    Google Scholar 

  • Beck BL, Koons SR, Milgrim DL (2000) Correlates and consequences of behavioral procrastination: the effects of academic procrastination, self-consciousness, self-esteem and self-handicapping. J Soc Behav Personal 15:3–13

    Google Scholar 

  • Biederman J, Faraone SV, Spencer T, Wilens T (1993) Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 150(12):1792–1798. Retrieved from ajp.psychiatryonline.org

  • Biederman J, Faraone SV, Spencer TJ, Mick E, Monuteaux MC, Aleardi M (2006) Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry 67:524–540. doi:10.4088/JCP.v67n0403

    Article  PubMed  Google Scholar 

  • Brown TE (2005) Attention deficit disorder: the unfocused mind in children and adults. Yale University Press, New Haven, CT, USA

    Google Scholar 

  • Canu WH, Carlson GL (2003) Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample. J Atten Disord 6:123–133. doi:10.1177/108705470300600304

    Article  CAS  PubMed  Google Scholar 

  • Canu WH, Newman ML, Morrow TL, Pope DW (2008) Social appraisal of adult ADHD: stigma and influences of the beholder’s big five personality traits. J Atten Disord 11(6):700–710. doi:10.1177/1087054707305090

    Article  PubMed  Google Scholar 

  • Cheung KK, Wong IC, Ip P, Chan PK, Lin CH, Wong LY, Chan EW (2015) Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management. BMC Psychiatry 15(1):1–11

    Article  Google Scholar 

  • Chew BL, Jensen SA, Rosen LA (2009) College students’ attitudes toward their ADHD peers. J Atten Disord 13:271–276. doi:10.1177/1087054709333347

    Article  PubMed  Google Scholar 

  • Corrigan P (2004) How stigma interferes with mental health care. Am Psychol 59:614–625. doi:10.1037/0003-066X.59.7.614

    Article  PubMed  Google Scholar 

  • Creswell JW (2014) Research design: qualitative, quantitative, and mixed methods approaches, 4th edn. Sage publications, Thousand Oaks

    Google Scholar 

  • Dipeolu A, Sniatecki JL, Storlie CA, Hargrave S (2013) Dysfunctional career thoughts and attitudes as predictors of vocational identity among young adults with attention deficit hyperactivity disorder. J Vocat Behav 82(2):79–84. doi:10.1016/j.jvb.2013.01.003

    Article  Google Scholar 

  • DuPaul GJ, McGoey KE, Eckert TL, VanBrakle J (2001) Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning. J Am Acad Child Adolesc Psychiatry 40:508–515. doi:10.1097/00004583-200105000-00009

    Article  CAS  PubMed  Google Scholar 

  • DuPaul GJ, Weyandt LL, O’Dell SM, Varejao M (2009) College students with ADHD: current status and future directions. J Atten Disord 13:234–250. doi:10.1177/1087054709340650

    Article  PubMed  Google Scholar 

  • Eakin L, Minde K, Hechtman L, Ochs E, Krane E, Bouffard R, Looper K (2004) The marital and family functioning of adults with ADHD and their spouses. J Atten Disord 8:1–10. doi:10.1177/108705470400800101

    Article  CAS  PubMed  Google Scholar 

  • Egan TE, Canu WH, Hartung CM, Lefler EK (2012) An examination of differences associated with age of diagnosis in adults with ADHD. Poster presented at the meeting of the association for behavioral and cognitive therapies. National Harbor, Maryland

  • Eisenberg D, Downs MF, Golberstein E, Zivin K (2009) Stigma and help seeking for mental health among college students. Med Care Res Rev 66:522–541. doi:10.1177/1077558709335173

    Article  PubMed  Google Scholar 

  • Fiske ST, Taylor SE (1991) Social cognition, 2nd edn. McGraw Hill, New York

    Google Scholar 

  • Fleming AP, McMahon RJ (2012) Developmental context and treatment principles for ADHD among college students. Clin Child Fam Psychol Rev 15:303–329. doi:10.1007/s10567-012-0121-z

    Article  PubMed  Google Scholar 

  • Fleming AP, McMahon RJ, Moran LR, Peterson AP, Dreessen A (2015) Pilot randomized controlled trial of dialectical behavior therapy group skills training for ADHD among college students. J Atten Disord 19(3):260–271. doi:10.1177/1087054714535951

    Article  PubMed  Google Scholar 

  • Flory K, Molina B, Pelham W, Gnagy E, Smith B (2006) Childhood ADHD predicts risky sexual behavior in young adulthood. J Clin Child Adolesc Psychol 35:571–577. doi:10.1207/s15374424jccp3504_8

    Article  PubMed  Google Scholar 

  • Frazier TW, Youngstrom EA, Glutting JJ, Watkins MW (2007) ADHD and achievement: meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. J Learn Disabil 40(1):49–65. doi:10.1177/00222194070400010401

    Article  PubMed  Google Scholar 

  • Gray SA, Fettes P, Woltering S, Mawjee K, Tannock R (2015) Symptom manifestation and impairments in college students with ADHD. J Learn Disabil. doi:10.1177/0022219415576523

    PubMed  Google Scholar 

  • Green AL, Rabiner DL (2012) What do we really know about ADHD in college students? Neurotherapeutics 9(3):559–568. doi:10.1007/s13311-012-0127-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Hartung CM, Canu WH, Cleveland CS, Lefler EK, Mignogna MJ, Fedele DA, Clapp JD (2013) Stimulant medication use in college students: comparison of appropriate users, misusers, and nonusers. Psychol Addict Behav 27(3):832–840. doi:10.1037/a0033822

    Article  PubMed  Google Scholar 

  • Hosain GM, Berenson AB, Tennen H, Bauer LO, Wu ZH (2012) Attention deficit hyperactivity symptoms and risky sexual behavior in young adult women. J Women’s Health 21(4):463–468

    Article  Google Scholar 

  • Hoza B, Mrug S, Gerdes AC, Hinshaw SP, Bukowski WM, Gold JA, Arnold LE (2005) What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder? J Consult Clin Psychol 73:411–423. doi:10.1037/0022-006X.73.3.411

    Article  PubMed  Google Scholar 

  • Hyde A, Howlett E, Brady D, Drennan J (2005) The focus group method: insights from focus group interviews on sexual health with adolescents. Soc Sci Med 61(12):2588–2599

    Article  PubMed  Google Scholar 

  • Jensen CM, Steinhausen HC (2014) Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Atten Deficit Hyperact Disord 7(1):27–38

    Article  Google Scholar 

  • Kroll T, Barbour R, Harris J (2007) Using focus groups in disability research. Qual Health Res 17(5):690–698

    Article  PubMed  Google Scholar 

  • Kuriyan A, Pelham W, Molina B, Waschbusch D, Gnagy EM, Kent KM (2013) Young adult educational and vocational outcomes of children diagnosed with ADHD. J Abnorm Child Psychol 41:27–41. doi:10.1007/s10802-012-9658-z

    Article  PubMed  PubMed Central  Google Scholar 

  • LaCount PA, Hartung CM, Shelton CR, Clapp JD, Clapp TW (2015) Preliminary evaluation of a combined group and individual treatment for college students with attention-deficit/hyperactivity disorder. Cogn Behav Pract 22(2):152–160. doi:10.1016/j.cbpra.2014.07.004

    Article  Google Scholar 

  • Lindgren E, Söderberg S, Skär L (2014) Managing transition with support: experiences of transition from child and adolescent psychiatry to general adult psychiatry narrated by young adults and relatives. Psychiatry J 2014:1–8

    Article  Google Scholar 

  • Massetti GM, Lahey BB, Pelham WE, Loney J, Ehrhardt A, Lee SS, Kipp H (2008) Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4–6 years of age. J Abnorm Child Psychol 36:399–410. doi:10.1007/s10802-007-9186-4

    Article  PubMed  PubMed Central  Google Scholar 

  • McCarthy JP, Anderson L (2000) Active learning techniques versus traditional teaching styles: two experiments from history and political science. Innov High Educ 24:279–294. doi:10.1023/B:IHIE.0000047415.48495.05

    Article  Google Scholar 

  • McKeague L, Hennessy E, O’Driscoll C, Heary C (2015) Retrospective Accounts of Self-Stigma Experienced by Young People with Attention-Deficit/Hyperactivity Disorder (ADHD) or Depression. Psychiatr Rehabil J. doi:10.1037/prj0000121

    PubMed  Google Scholar 

  • Meaux JB, Green A, Broussard L (2009) ADHD in the college student: a block in the road. J Psychiatr Ment Health Nurs 16:248–256. doi:10.1111/j.1365-2850.2008.01349.x

    Article  CAS  PubMed  Google Scholar 

  • Miles MB, Huberman AM (1994) Qualitative data analysis: an expanded sourcebook, 2nd edn. Sage, Thousand Oaks

    Google Scholar 

  • Millward LJ (2006) Focus Groups. In: Breakwell GM, Hammond S, Fife-Schaw C, Smith JA (eds) Research methods in psychology, 3rd edn. Sage Publications, Thousand Oaks, CA, pp 274–298

    Google Scholar 

  • Morgan DL (1997) Focus groups as qualitative research, 2nd ed, vol 16. Sage Publications, Newbury Park

    Google Scholar 

  • Murphy K, Barkley RA (1996) Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. Compr Psychiatry 37:393–401. doi:10.1016/S0010-440X(96)90022-X

    Article  CAS  PubMed  Google Scholar 

  • Overbey GA, Snell WE, Callis KE (2009) Subclinical ADHD, stress, and coping in romantic relationships of university students. J Atten Disord. doi:10.1177/1087054709347257

    PubMed  Google Scholar 

  • Pitcher TM, Piek JP, Hay DA (2003) Fine and gross motor ability in males with ADHD. Dev Med Child Neurol 45:525–535. doi:10.1111/j.1469-8749.2003.tb00952.x

    Article  PubMed  Google Scholar 

  • Pliszka SR (2000) Patterns of psychiatric comorbidity with attention deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin North Am 9:525–554

    CAS  Google Scholar 

  • Pollio HR, Beck HP (2000) When the tail wags the dog: perceptions of learning and grade orientation in, and by, contemporary college students and faculty. J Higher Educ 71(1):84–102. doi:10.2307/2649283

    Article  Google Scholar 

  • Pressman LJ, Loo SK, Carpenter EM, Asarnow JR, Lynn D, McCracker JT, Smalley SL (2006) Relationship of family environment and parental psychiatric diagnosis to impairment in ADHD. J Am Acad Child Adolesc Psychiatry 45:346–354. doi:10.1097/01.chi.0000192248.61271.c8

    Article  PubMed  Google Scholar 

  • Prevatt F, Yelland S (2013) An empirical evaluation of ADHD coaching in college students. J Atten Disord. Advance online publication. doi:10.1177/1087054713480036

  • Rabin LA, Fogel J, Nutter-Upham KE (2011) Academic procrastination in college students: the role of self-reported executive function. J Clin Exp Neuropsychol 33:344–357. doi:10.1080/13803395.2010.518597

    Article  PubMed  Google Scholar 

  • Rabiner DL, Anastopoulos AD, Costello J, Hoyle RH, Swartzwelder HS (2008) Adjustment to college in students with ADHD. J Atten Disord 11:689–699. doi:10.1177/1087054707305106

    Article  PubMed  Google Scholar 

  • Rabiner DL, Anastopoulos AD, Costello EJ, Hoyle RH, Esteban McCabe S, Swartzwelder HS (2009) The misuse and diversion of prescribed ADHD medications by college students. J Atten Disord 13(2):144–153. doi:10.1177/1087054708320414

    Article  PubMed  Google Scholar 

  • Rabiner DL, Anastopoulos AD, Costello EJ, Hoyle RH, Swartzwelder HS (2010) Predictors of nonmedical ADHD medication use by college students. J Atten Disord 13(6):640–648. doi:10.1177/1087054709334505

    Article  PubMed  Google Scholar 

  • Sacchetti GM, Lefler EK (2015) ADHD symptomology and social functioning in emerging adults. J Atten Disord. doi:10.1177/1087054714557355

  • Samuelsson S, Lundberg I, Herkner B (2004) ADHD and reading disability in male adults: is there a connection? J Learn Disabil 37(2):155–168. doi:10.1177/00222194040370020601

    Article  PubMed  Google Scholar 

  • Sepúlveda DR, Thomas LM, McCabe SE, Cranford JA, Boyd CJ, Teter CJ (2011) Misuse of prescribed stimulant medication for ADHD and associated patterns of substance use: preliminary analysis among college students. J Pharm Pract 24(6):551–560. doi:10.1177/0897190011426558

    Article  PubMed  PubMed Central  Google Scholar 

  • Shaw-Zirt B, Popali-Lehane L, Chaplin W, Bergman A (2005) Adjustment, social skills, and self-esteem in college students with symptoms of ADHD. J Atten Disord 8:109–120. doi:10.1177/1087054705277775

    Article  PubMed  Google Scholar 

  • Sherriff N, Gugglberger L, Hall C, Scholes J (2014) “From start to finish”: practical and ethical considerations in the use of focus groups to evaluate sexual health service interventions for young people. Qual Psychol 1(2):92

    Article  Google Scholar 

  • Smith JA (1996) Beyond the divide between cognition and discourse: using interpretative phenomenological analysis in health psychology. Psychol Health 11:261–271. doi:10.1080/08870449608400256

    Article  Google Scholar 

  • Smith JA, Eatough V (2006) Interpretive phenomenological analysis. In: Breakwell GM, Hammond S, Fife-Schaw C, Smith JA (eds) Research methods in psychology, 3rd edn. Sage Publications, Thousand Oaks, CA, pp 322–341

    Google Scholar 

  • Smith JA, Eatough V (2007) Interpretive phenomenological analysis. In: Lyons E, Coyle A (eds) Analysing qualitative data in psychology. Sage Publications, Thousand Oaks, CA, pp 35–50

    Chapter  Google Scholar 

  • Swift KD, Hall CL, Marimuttu V, Redstone L, Sayal K, Hollis C (2013) Transition to adult mental health services for young people with ADHD: a qualitative analysis of their experiences. BioMed Central Psychiatry 13:1–11. doi:10.1186/1471-244X-13-74

    Article  Google Scholar 

  • Thompson AC, Lefler EK (2015) ADHD stigma among college students. ADHD Attention Deficit Hyperactivity Disorders. Published online first. doi:10.1007/s12402-015-0179-9

  • Thompson AL, Molina BSG, Pelham W Jr, Gnagy EM (2007) Risky driving in adolescents and young adults with childhood ADHD. J Pediatr Psychol 32:745–759. doi:10.1093/jpepsy/jsm002

    Article  PubMed  Google Scholar 

  • Waschbusch DA, Craig R, Pelham WJ, King S (2007) Self-handicapping prior to academic-oriented tasks in children with attention deficit/hyperactivity disorder (ADHD): medication effects and comparisons with controls. J Abnorm Child Psychol 35(2):275–286. doi:10.1007/s10802-006-9085-0

    Article  PubMed  Google Scholar 

  • Wehmeier PM, Schacht A, Barkley RA (2010) Review article: social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health. doi:10.1016/j.jadohealth.2009.09.009

    PubMed  Google Scholar 

  • Weyandt LL, Oster DR, Marraccini ME, Gudmundsdottir BG, Munro BA, Zavras BM, Kuhar B (2014) Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants. Psychol Res Behav Manag 7:223–249. doi:10.2147/PRBM.S47013

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilens TE, Martelon M, Joshi G, Bateman C, Fried R, Petty C, Biederman J (2011) Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. J Am Acad Child Adolesc Psychiatry 50(6):543–553

    Article  PubMed  PubMed Central  Google Scholar 

  • Willcutt EG (2012) The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 9:490–499. doi:10.1007/s13311-012-0135-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilmshurst L, Peele M, Wilmshurst L (2011) Resilience and well-being in college students with and without a diagnosis of ADHD. J Atten Disord 15:11–17. doi:10.1177/1087054709347261

    Article  PubMed  Google Scholar 

  • Wymbs B, Molina B, Pelham W, Cheong J, Gnagy E, Belendiuk K, Waschbusch D (2012) Risk of intimate partner violence among young adult males with childhood ADHD. J Atten Disord 16:373–383. doi:10.1177/1087054710389987

    Article  PubMed  PubMed Central  Google Scholar 

  • Young S, Bramham J, Gray K, Rose E (2008) The experience of receiving a diagnosis and treatment of ADHD in adulthood: a qualitative study of clinically referred patients using interpretative phenomenological analysis. J Atten Disord 11:493–503. doi:10.1177/1087054707305172

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Crystal Sivia for her assistance with data collection, Megan Schau for her contributions during data analysis, and the research assistants who transcribed hours and hours of focus group discussions. Finally, we are grateful to the students with ADHD who so graciously shared their experiences. This project was funded by a University of Northern Iowa Internal Seed Grant.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth K. Lefler.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lefler, E.K., Sacchetti, G.M. & Del Carlo, D.I. ADHD in college: A qualitative analysis. ADHD Atten Def Hyp Disord 8, 79–93 (2016). https://doi.org/10.1007/s12402-016-0190-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12402-016-0190-9

Keywords

Navigation