|Title:||Improving the Educational and Social Emotional Functioning of College Students with ADHD|
|Principal Investigator:||Anastopoulos, Arthur||Awardee:||University of North Carolina, Greensboro|
|Program:||Postsecondary and Adult Education [Program Details]|
|Award Period:||4 years (7/01/2015 – 6/30/2021)||Award Amount:||$3,179,850|
|Type:||Efficacy and Replication||Award Number:||R305A150207|
Co-Principal Investigator: Joshua Langberg (Virginia Commonwealth University)
Purpose: The purpose of this project is to evaluate a postsecondary intervention called Accessing Campus Connections and Empowering Student Success (ACCESS) for students with attention deficit hyperactivity disorder (ADHD). Many postsecondary institutions provide additional services to help students with ADHD because these students are more likely to struggle and to drop out than students without ADHD. ACCESS targets college students' ability to self-regulate and addresses other core ADHD features that affect academic success. The current study will build on preliminary research that suggests ACCESS has positive impacts on student persistence and students' emotional well-being by testing the program using an experimental research design.
Project Activities: Researchers will conduct a multi-site, randomized experiment to evaluate the efficacy of the ACCESS intervention. In this study, 240 college students with ADHD enrolled in 2 large universities will be randomly assigned either to the ACCESS group or to a delayed treatment group (i.e., the group that will receive ACCESS an academic year later). The researchers will evaluate the impact of participating in ACCESS on students' executive functioning (e.g., ability to self-regulate behavior) as well as their psychological and social functioning, use of services (e.g., counseling, tutoring), and academic performance. In addition, the team will assess factors that may influence the strength of any measured effects.
Products: Products will include evidence of the impact of ACCESS on student outcomes and a cost analysis of the program. Researchers will present results to the research community through presentations and peer-reviewed publications.
Setting: The research will be conducted in North Carolina and Virginia.
Sample: Approximately 240 full-time college students with ADHD, ages 18 to 30, will participate in the study. All participants will undergo a rigorous multi-stage screening procedure and diagnostic evaluation to determine eligibility.
Intervention: ACCESS aims to address core ADHD deficits and related social and emotional problems that predict educational outcomes. Specifically, ACCESS seeks to increase students' understanding of their ADHD and of campus resources to assist them, build their academic success skills (e.g., organization, time management), and teach them to adhere to their ADHD treatment (e.g., medication, behaviors). It includes an initial 8-week phase with group cognitive-behavior therapy and weekly individual mentoring sessions. During a subsequent maintenance phase, ACCESS participants receive booster group sessions and up to six additional individual mentoring meetings.
Research Design and Methods: Each site will enroll five cohorts of approximately 24 students over the course of the 4-year study. Participants will be assessed for core ADHD features and educational, social, and emotional functioning prior to treatment. Participants who meet the screening criteria will be randomly assigned to receive ACCESS as part of the treatment group or to receive it after a delay. Each student will also be tested at the end of the active phase of intervention, at the end of the maintenance phase, and at a 6-month follow-up. Delayed-treatment participants will complete all the same assessments at the same time as the ACCESS treatment participants, except the 6-month follow-up.
Control Condition: Students in a delayed-treatment group will serve as controls. They will receive the ACCESS intervention during a session after the experimental session.
Key Measures: Key measures of ADHD knowledge and symptoms include the Test of ADHD Knowledge; the Strategies for Success assessment (for time management and other behavioral strategies); the ADHD Cognitions Test (ACT); and the Conners Adult ADHD Rating Scale. Key measures of academic success include self-reported ratings on scales such as Learning and Study Strategies and students' course performance including grade-point average (GPA), course credits attempted and earned, course withdrawals, and academic probation or suspensions. Social functioning measures include the ADHD Impact Module—Adult (AIM-A). Emotional functioning measures include the Beck Depression Inventory-II and the Beck Anxiety Inventory. Researchers will collect data on service utilization directly from students, using the Services for College Students Interview.
Data Analytic Strategy: The researchers will examine dropout rates for each group using both survival analysis (to estimate differences in participation duration) and logistic regression. They will assess the other primary outcomes using mixed-effects models and will use structural equation modeling to explore possible mediators. The researchers will compare the groups across a variety of pre-existing characteristics (e.g., ADHD severity, ethnicity, IQ or achievement scores, parent level of education, SES) to see if impacts vary as a function of these characteristics.
Anastopoulos, A.D., Langberg, J.M., Besecker, L.H., & Eddy, L.D. (2020). CBT for College Students with ADHD — A Clinical Guide to ACCESS. Springer.
Journal article, monograph, or newsletter
Anastopoulos, A.D., Langberg, J.M., Eddy, L.D., Silvia, P.J., & Labban, J.D. (2021). A randomized controlled trial examining CBT for college students with ADHD. Journal of Consulting and Clinical Psychology, 89 (1), 21–33. https://doi.org/10.1037/ccp0000553
Eddy, L.D., Anastopoulos, A.D., Dvorsky, M.R., Silvia, P.J., Labban, J.D., & Langberg, J.M. (2021). An RCT of a CBT intervention for emerging adults with ADHD attending college: Functional outcomes. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2020.1867989