Date of Degree

9-2021

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Sarah O'Neill

Committee Members

Frances R. Levin

Teresa Lopez-Castro

Lissa Weinstein

Deidre Anglin

Subject Categories

Clinical Psychology

Keywords

Attentio-Deficit/Hyperactivity Disorder, Alcohol, Alcohol-Related Impairment, Impulsivity, College Students

Abstract

Aims: We examined (1) if students with high childhood ADHD symptoms, and at high risk for alcohol use disorder (AUD) reported greater alcohol-related impairment (ARI) than their low childhood ADHD peers who had comparable rates of alcohol use; and (2) whether alcohol-related problems were more severe for those with high childhood ADHD and high AUD risk when their trait impulsivity was high.

Method: 18-to 25-year-old (N=81), racially/ethnically diverse, college students completed a two-part study. An online survey assessed childhood ADHD symptoms (Wender Utah Rating Scale) and past-year alcohol use (Alcohol Use Disorders Identification Test). Laboratory assessment comprised neuropsychological and self-report measures of impulsivity, diagnostic interview (MINI), and time-line follow-back interview detailing alcohol use. Participants were categorized into four risk groups: Low ADHD/Low AUD; High ADHD/Low AUD; Low ADHD/High AUD; and High ADHD/High AUD. Group differences in alcohol use and impulsivity were tested using the Kruskal-Wallis H test and one-way ANOVA, respectively. Moderation analyses were conducted using Hayes (2018) PROCESS.

Results: High AUD risk groups engaged in greater alcohol use than the Low AUD risk groups. Compared to the Low ADHD/High AUD group, the High ADHD/High AUD group did not consume alcohol in greater quantities or more frequently, but their use was more hazardous and there was trend for them to experience more severe past-year ARI. The High ADHD risk groups were more impulsive than the Low ADHD risk groups by most self-report measures, but not objective measures. Higher Positive Urgency, but not Negative Urgency, was associated with greater ARI severity across risk groups. No Group x impulsivity interactions were obtained.

Conclusions: For at-risk college drinkers, higher trait impulsivity may exacerbate alcohol-related impairment. Broad-based interventions on college campuses, including psychoeducation and harm reduction strategies, may be useful to reduce the likelihood and severity of negative outcomes subsequent to alcohol consumption.

Keywords: Attention-Deficit/Hyperactivity Disorder; Alcohol; Alcohol-Related Impairment; Impulsivity; College Students.

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