Sex differences in ADHD symptoms, problematic gaming, and impairment in college students

Objective: ADHD is associated with impairment in several important areas of life for college students, including lower grades and lower degree completion rates. Further, college students with ADHD may be involved in higher levels of problematic gaming than their peers, conveying incremental impairment. Therefore, the aim of the current study was to examine whether problematic gaming is associated with impairment in the context of elevated ADHD symptoms in college students, with a focus on possible sex differences. Method: College students ( N = 1,489; M age =19.13, 69.4% female, 86.7% white) from three universities completed an online survey assessing ADHD symptoms, problematic gaming, and functional impairment. Results: There was a significant 3-way interaction among inattention symptoms, problematic gaming, and sex on impairment, such that impairment was greatest among female college students high in inattention (IA) and problematic gaming. There was not a significant 3-way interaction that included hyperactivity/impulsivity (HI) symptoms, but significant 2-way interactions indicated that women who game experience more impairment than men who game, and that when gaming is added to elevated HI, impairment increases significantly. Conclusions: Our data suggest that problematic gaming by college students with elevated ADHD symptoms might lead to additional impairment, especially in women. We discuss clinical implications such as a potential problematic gaming module for college ADHD treatments, and a harm-reduction approach to gaming in this population.