Helping College Students With ADHD Lead Healthier Lifestyles
Condition: Attention Deficit Hyperactivity Disorder; Alcohol-Related Disorders; Substance-Related Disorders
MeSH terms: Hyperkinesis; Substance-Related Disorders; Alcohol-Related Disorders; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      There are currently no published randomized controlled studies examining psychosocial
      interventions for college students with ADHD, and none specifically targeting AUDs in this
      population at any age, despite the clear indication from emerging research of the need for
      such interventions. In the current study, the investigators will develop BA-based treatment
      intended to increase involvement in healthy, goal-directed activities (e.g., academic,
      recreational or social activities) and to reduce problematic drinking behaviors and other
      risk behaviors (e.g., unsafe sex) among college students with ADHD (Behavioral Activation for
      Attention & Alcohol Disorders; BAAAD). Finalized treatment manuals, altered based on focus
      group feedback, will be tested in a stage I randomized controlled trial (RCT) among 80
      college students randomized to BMI + BAAAD or BMI + supportive counseling (SC). The
      investigators expect that BMI + BAAAD will be successful with college students with ADHD, in
      terms of decreasing the escalation of problematic alcohol use behaviors, as compared to BMI +
      SC. This treatment development study will set the stage for larger-scale RCTs.
    

Detailed description: 
      College students with Attention-Deficit/Hyperactivity Disorder (ADHD) are particularly
      vulnerable to problematic alcohol use (e.g., excessive alcohol consumption, failure to meet
      responsibilities because of drinking, or injury to self or others as a result of drinking)
      given their developmentally-inappropriate levels of inattention, hyperactivity and
      impulsivity, combined with the lifestyle associated with life on a college campus (including
      increased access to alcohol, decreased structure and parental supervision). Prior research
      demonstrates elevated rates of alcohol related problems and disorders (AUDs) among college
      students with ADHD; 47% of college students with ADHD meet lifetime criteria for alcohol
      abuse and 23% meet criteria for dependence, as compared to 12% and 6% of college students
      from the general population, respectively. There are currently no published randomized
      controlled studies examining psychosocial interventions for college students with ADHD, and
      none specifically targeting AUDs in this population at any age, despite the clear indication
      from emerging research of the need for such interventions. Moreover, brief motivation-based
      alcohol interventions (BMIs) that generally have been successful for college students show
      limited benefits among individuals with elevated impulsivity and poor self-regulation, both
      hallmarks of ADHD, calling for the need to modify BMIs for this vulnerable group. Thus, it is
      crucial to determine core treatment components that are efficacious for treating AUDs and
      that are developmentally-appropriate for college students with ADHD and designed in a manner
      which promotes transportability to the university counseling center setting. Behavioral
      activation (BA) is a brief behavioral approach that aims to increase individuals' contact
      with valued environments through systematic efforts to increase rewarding experiences,
      enjoyment of daily activities, and goal-directed behaviors. BA has been successfully applied
      to substance users in a range of settings, including college students with problematic
      drinking patterns. Importantly, BA has clear relevance for addressing ADHD-related executive
      functioning deficits, which may be associated with an increased propensity for engagement in
      problematic alcohol use. Further, BA teaches individuals to engage in healthy, goal-directed
      rewarding behaviors (e.g., academic, recreational or social activities), rather than relying
      on drinking to provide immediate rewards. Finally, BA is a highly adaptable intervention
      approach. In the current study, the investigators will develop BA-based treatment intended to
      increase involvement in healthy, goal-directed activities (e.g., academic, recreational or
      social activities) and to reduce problematic drinking behaviors and other risk behaviors
      (e.g., unsafe sex) among college students with ADHD (Behavioral Activation for Attention &
      Alcohol Disorders; BAAAD). This treatment will be developed in collaboration with the
      University Counseling Center, to ensure its applicability within this setting, utilizing
      focus group methodology with Center staff. Finalized treatment manuals, altered based on
      focus group feedback, will be tested in a stage I randomized controlled trial (RCT) among 80
      college students randomized to BMI + BAAAD or BMI + supportive counseling (SC). The
      investigators expect that BMI + BAAAD will be successful with college students with ADHD, in
      terms of decreasing the escalation of problematic alcohol use behaviors, as compared to BMI +
      SC. This treatment development study will set the stage for larger-scale RCTs.
    

Intervention name(s): SUCCEEDS Program; Living a Healthy College Lifestyle
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will receive ADHD Psychoeducation, Brief Motivational Interviewing (BMI) and Behavioral Activation for Attention & Alcohol Disorders (BAAAD).; Participants will receive ADHD Psychoeducation, BMI and Supportive Counseling (SC).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Attention Deficit Hyperactivity Disorder; Alcohol-Related Disorders; Substance-Related Disorders; Motivational Interviewing; Behavior Therapy