Preliminary Normative Data on DSM-IV Attention Deficit Hyperactivity Disorder in College Students

Abstract

Identification of attention deficit hyperactivity disorder (ADHD) in adults presents a number of problems because there is no one specific diagnostic test for the condition. Given this challenge, clinicians often struggle between restrictive and exclusionary diagnostic methods or overinclusive acceptance that ADHD is a prevalent and disabling problem. A modified version of the Attention Deficit Hyperactivity Rating Scale was administered to 468 students at a large midwestern university. Analysis of the results suggested that the degree of ADHD symptoms in college students is modest and indicated that cutoff scores of 4 for current symptoms of inattention and hyperactivity-impulsivity would be sufficient to identify a college student as distinct from the norm. Although it would be premature to accept the calculated thresholds completely, clinicians should be aware of these differences when evaluating college students for ADHD.

How Persistent is ADHD into Adulthood? Informant Report and Diagnostic Thresholds in a Female Sample

“…As the release of DSM-5 approached, a variety of recommendations were made to increase the applicability of ADHD criteria across the lifespan (e.g., Barkley, 2010;Barkley et al, 2008;Bell, 2011;Coghill & Seth, 2011;Hechtman, French, Mongia, & Cherkasova, 2011;Kessler et al, 2010;McGough & Barkley, 2004;McGough & McCracken, 2006;Polanczyk et al, 2010;Ramtekkar, Reiersen, Todorov, & Todd, 2010;Rutter, 2011). Initial proposed changes to the DSM-5 included shifting the diagnostic symptom threshold to 4/9 symptoms of IA or H/I in individuals aged 17 or older (for rationale, see Heiligenstein, Conyers, Berns, & Miller, 1998;Kooij et al, 2005). Ultimately, though, in addition to relaxing the age of onset criterion from under 7 to under 12 years of age for the presence of at least some impairing symptoms and modifying symptom descriptions to include adult-relevant manifestations, the published DSM-5 set the diagnostic cutoff at 5/9 symptoms of IA or H/I (American Psychiatric Association, 2013).…”

“…Because it offers a direct ADHD symptom count, Wave 3 SNAP-IV scores were used to set this study's DRC threshold, to test hypotheses concerning dimensional persistence estimates, and to compare the DRC's predictive utility with that of the DSM-IV threshold. Although such dimensional measures cannot include impairment, symptom duration, and the like, this approach has been used in other investigations of ADHD symptom thresholds (e.g., Barkley et al, 2002;DuPaul et al, 2001;Heiligenstein et al, 1998, Sibley et al, 2012.…”

The Effect of ADHD and Psychotropic Medication use on College Performance

“…In addition, it would be important to understand how use of medications for ADHD and other disorders such as depression or anxiety impact college performance (Heiligenstein, et al, 1998), and how many of the difficulties that students face in college can be addressed through non-medical interventions such as social support networks, tutoring, etc.…”

“…Between 5 and 10% of children in the United States have been diagnosed with ADHD (Vance & Weyandt, 2008;Heiligenstein et al, 1999).Interestingly, African American and Hispanic children are diagnosed with ADHD at only half the rate of Caucasian children (Rothe, 2005) and Non-Hispanic white males have the highest rate of diagnosis (Vance &Weyandt, 2008). Though it used to be believed that children "outgrew" this disorder, it has now become more accepted among diagnosticians that this disorder continues into adulthood even though ADHD symptoms decrease with age by approximately 50% every five years (Heiligenstein, Conyers, Berns, & Smith, 1998). While some studies indicate that up to 70% of children diagnosed with ADHD continue to have symptoms into adolescence and adulthood (Heiligenstein, et al, 1998;Heiligenstien, Buenther, Levy, Savino, & Fulwiler, 1999), Barbaresi,et al, 2013, found that only 29.3% of childhood ADHD cases persisted into adulthood.…”

“…Though it used to be believed that children "outgrew" this disorder, it has now become more accepted among diagnosticians that this disorder continues into adulthood even though ADHD symptoms decrease with age by approximately 50% every five years (Heiligenstein, Conyers, Berns, & Smith, 1998). While some studies indicate that up to 70% of children diagnosed with ADHD continue to have symptoms into adolescence and adulthood (Heiligenstein, et al, 1998;Heiligenstien, Buenther, Levy, Savino, & Fulwiler, 1999), Barbaresi,et al, 2013, found that only 29.3% of childhood ADHD cases persisted into adulthood. Unfortunately, there is no specific test to diagnose ADHD in young adults includeing college students.…”