Is ADHD, Independent of ODD, Associated With Whether and Why College Students Misuse Stimulant Medication?

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. Public Health Significance This study suggests that at least some of the risky, illegal stimulant medication misuse by college students is driven by inadequate or absent care for executive functioning impairments. Among an undergraduate sample, increased attention-deficit/hyperactivity disorder (ADHD) symptomology was associated with a higher likelihood of stimulant medication misuse and increased report of academic motivation for misusing stimulant medication.