Factors Predicting College Success in Students with ADHD

Predictors of College Adjustment in Students with
Attention-Deficit Hyperactivity Disorder
by
Annabel Myers
Submitted to the Board of Study of Psychology
School of Natural and Social Sciences
in partial fulfillment of the requirements
for the degree of Bachelor of Arts
Purchase College
State University of New York
December 2015
Sponsor: Dr. Suzanne Clerkin
Second Reader: Dr. Lynn Winters

PREDICTORS OF ADJUSTMENT IN ADHD 2
Acknowledgments
Firstly, I would like to express my gratitude to my advisor, Professor Clerkin, for her
continuous support, motivation, patience, and knowledge in research. I am so thankful for
her guidance that has helped me throughout the entire research process. I would also like
to thank Professor Winters for her insightful feedback, and the rest of the psychology
board of study for continuing to strengthen my interest in psychology. I thank my fellow
lab mate, Aida Mejia, for helping with the recruitment process and data collection.
Lastly, I would like to thank my family and friends for always driving me to do my best.

Abstract
The present study assessed the relationships between stress, personality characteristics of
neuroticism and conscientiousness, and ADHD symptomatology in college students, and
to what extent these factors could predict academic adjustment, social adjustment, and
GPA. A total of 28 students completed questionnaires examining ADHD symptoms,
stress, personality, and academic and social adjustment to college. Analyses indicated
that higher levels of ADHD symptoms were significantly related to high levels of stress
and neuroticism, and low levels of academic adjustment, social adjustment and
conscientiousness. Regression analyses revealed that academic adjustment was predicted
by all of the variables of interest, social adjustment was predicted by ADHD symptoms,
and GPA was not significantly predicted by any of the variables of interest. These results
suggest that adjusting to academic demands may be the most difficult aspect of college
adjustment for students with ADHD, and should be the focus of future interventions.

Predictors of College Adjustment in Students with
Attention-Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder
characterized by symptoms of inattention, hyperactivity, and/or impulsivity (American
Psychiatric Association, 2013). About 5% of school children are diagnosed with ADHD.
Out of these individuals, 30% to 70% have persistent symptoms in adulthood (Barkley,
Fischer, Edelbrock, & Smallish, 1990; Klein & Mannuzza, 1989). Currently, an
increasing number of young adults with ADHD in childhood are seeking a college
education (Farrell, 2003). Approximately 2%-8% of college students in the U.S. report
having symptoms of ADHD, but the prevalence of clinically diagnosed college students
is unknown (Weydant & DuPaul, 2006). When students begin their college career they
face new responsibilities, more independence, less academic structure, and higher
academic demands (Crede & Niehorster, 2012). Symptoms of ADHD, particularly
inattentive symptoms, have been associated with impairment among college students
with ADHD (Weyandt & DuPaul, 2008; Frazier, Youngstrom, Glutting, & Watskins,
2007; Rabiner, Anastopoulos, Costello, Hoyle, & Swartzwelder, 2008). Academic
adjustment and success in college is likely impacted by ADHD symptoms, personality
characteristics, and perceived stress. Identifying the barriers to academic success for
college students with ADHD could potentially lead to improved interventions.
ADHD Symptoms in College Students
Individuals who are diagnosed with ADHD may be categorized as predominantly
inattentive, predominantly hyperactive/impulsive, or combined type, which is
characterized by a significant number of both inattentive and hyperactive/impulsive

symptoms (American Psychiatric Association, 2013). The inattentive symptoms of
ADHD include difficulty staying organized, difficulty completing a task, becoming easily
distracted, and making careless mistakes; the hyperactive symptoms of ADHD include
difficulty staying still, excessive talking and restlessness, and the impulsive symptoms
include impatience, blurting out comments, and frequently interrupting others. About
62% of a general adult sample was found to have the combined subtype, 31% had the
inattentive-only subtype, and only 7% had the hyperactive/impulsive-only subtype
(Wilens et al., 2009).
During adolescence, hyperactive/impulsive symptoms tend to decline to a greater
degree than inattentive symptoms (Biederman, Mick, & Faraone, 2000. Thus, inattentive
symptoms have been found to predominate and cause more impairment in adults with
ADHD (Wilens et al., 2009), and in college students (Weyandt & DuPaul, 2008),
compared to hyperactive/impulsive symptoms. A growing literature has begun to
document the relationships between the ADHD symptoms of college students and
academic achievement, personality characteristics, and social and academic adjustment to
college.
Academic Adjustment
College students with ADHD symptoms have been found to report more
academic difficulties, significantly lower GPAs, and less confidence about their academic
ability compared to their non-ADHD peers (Frazier et al., 2007). These students with
ADHD were also more susceptible to failure in an academic setting, and were less likely
than their non-ADHD peers to complete a college education.

Heiligenstein, Guenther, Levy, Savino, and Fulwiler (1999) assessed differences
in academic measures such as cumulative GPA, number of enrolled credits, and probation
status, between college students with ADHD and non-ADHD college students. In
addition to more academic difficulties and lower GPAs, the researchers also reported that
students with ADHD were more likely than non-ADHD students to be on academic
probation. Similarly, Norwalk, Norvilitis & Maclean (2009) found that students with a
greater number of inattentive symptoms displayed poorer academic adjustment measured
by the Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1989).
These students also reported poorer study habits and study skills. However, they did not
find a difference in GPA between ADHD students and non-ADHD students. This may be
due to differences in comorbidities, learning disabilities, and/or medication use between
the samples.
Utilizing both student and parent reports of ADHD symptoms, Frazier et al.
(2007) studied how self-reported symptoms and symptoms reported by parents predicted
academic achievement. College students with ADHD and their parents completed the
College ADHD Response Evaluation (CARE) two months before the first semester, or at
the beginning of the first semester. At the end of the student’s first year, information on
academic status was obtained. Symptoms of inattention, as rated by both students and
parents, predicted academic probation, while hyperactive and impulsive symptoms did
not predict academic probation. This may be due to the decreased influence of
hyperactive/impulsive symptoms with age, or the difficulty of accurately reporting these
symptoms (Frazier et al., 2007). Overall, inattentive symptoms, as rated by students or

parents, seem to be related to academic achievement and study skills to a greater extent
than hyperactive/impulsive symptoms (Frazier et al., 2007; Norwalk et al., 2009).
Overall, the literature supports the idea that college students with symptoms of
ADHD face a higher risk of academic impairment and difficulty keeping up with the
academic demands of college. However, there are a number of weaknesses in the current
literature. Existing studies on students with ADHD excluded those with comorbidities
(Heiligenstein et al., 1999) or did not screen for comorbidities. Excluding those with
comorbidities may decrease the generalizability of the findings, since comorbidities with
ADHD are so prevalent. In the current clinical population of adults with ADHD, 25-50%
display symptoms of comorbidity, most commonly depression and/or anxiety (Fischer et
al., 2007). Some studies also excluded participants taking psychotropic medication
(Heiligenstein et al., 1999), or did not screen for use of psychotropic medication
(Overbey, Snell, & Callis, 2009). About 56% of people with an ADHD diagnosis are
prescribed stimulant ADHD medication (Wilens et al., 2008). Most college students with
ADHD use stimulant medications to treat symptoms, and may take other medication as
well. Also, some studies did not screen for learning disabilities (Norwalk et al., 2009;
Heiligenstein et al., 1999). Having participants with learning disabilities may have
influenced the academic performance of students with and without ADHD.
Social Adjustment
Social adjustment is defined as the degree to which individuals adapt to their new
college setting and integrate themselves into social groups, instead of experiencing
negative relationships, loneliness, or missing family and social networks from home
(Crede & Niehorster, 2012). Having stable relationships in academic, social, and home

environments is extremely important for college adjustment. Social support from faculty
and staff can increase academic adjustment, while support from friends and family will
help facilitate social adjustment to a greater extent (Crede & Niehorster, 2012).
The presence of ADHD symptoms in college students has been found to affect the
maintenance of close relationships as well. Higher levels of ADHD symptoms were
found to be associated with less relationship satisfaction, and greater use of maladaptive
coping strategies in their relationships, such as self-criticism and problem avoidance
(Overbey, Snell, & Callis, 2009). In contrast, Rabiner et al. (2008) found that students
with ADHD did not report more social impairment in their first semester of college
compared to their non-ADHD peers. This may be due to the short duration of time in
their new college setting. Over time, students may feel less social satisfaction and more
issues with social adjustment as negative social experiences occur.
Students with ADHD symptoms have also been found to report lower levels of
social skills and self-esteem compared to their non-ADHD peers with matched age,
gender, and GPA (Shaw-Zirt, Popali-Lehane, Chaplin, & Bergman, 2005). A strong
positive correlation between GPA and academic achievement is often reported
(Heiligenstein et al., 1999; Frazier et al., 2007), but Shaw-Zirt et al. (2005)’s study
suggests that GPA does not always correlate with social adjustment. Although a few
studies have found contrasting results, many studies have found that students with ADHD
struggle with social adjustment, and building relationships (Shaw-Zirt et al., 2005;
Overbey et al., 2009), which may also be affected by personality characteristics and
psychological difficulties.
Personality Characteristics and Academic Achievement

The interplay between ADHD symptoms and personality characteristics may
affect academic achievement in college students with ADHD. Specifically,
conscientiousness and neuroticism are two personality characteristics that are thought to
have a direct impact on the academic achievement of students with ADHD (Rabiner et
al., 2008).
Conscientiousness is shown by behaviors of goal making, motivation, impulse
control, and thoughtfulness, while neuroticism is shown by behaviors that express
emotional instability such as anxiety, worry, and self-consciousness. Conscientiousness is
a key trait for academic success because it is associated with organizational skills and
planning, while neuroticism weakens academic success since it is associated with
instability and impairment (Crede & Niehorster, 2012). Students with more conscientious
traits have been shown to adjust to college more easily than students with more traits of
neuroticism (Crede & Niehorster, 2012). High levels of neuroticism can negatively
impact college adjustment due to the difficulty of adjusting to a new environment and
coping with change.
Adults with ADHD have been found to score significantly higher on a neurotic
personality scale, and significantly lower on a conscientious personality scale (Ranseen,
Campbell & Baer, 1998; Rabiner et al., 2008) compared to their non-ADHD peers.
Levels of inattention are seen as negatively correlated with conscientiousness and
emotional stability, suggesting that individuals with these symptoms will have a harder
time adjusting in both academic and social domains (Rabiner et al., 2008). Therefore,
college students with ADHD may show greater difficulty compared to students without
ADHD, especially when placed in a new academic setting.

Personality characteristics also contribute to social impairment in individuals with
ADHD symptoms, and may affect how these symptoms are manifested (Kern,
Rasmussen, Byrd, & Wittschen, 1997). A more recent study found that ADHD
symptoms were significantly associated with maladaptive personality problems such as
self-control, responsibility, and social concordance measured by the Severity Indices of
Personality Problems (Gudjonsson et al., 2010). Lower self-control, less awareness of
responsibility, and social issues can also relate to neurotic behavior. Students with ADHD
were also found to score lower on social scales such as going along, liked by all, and
softness (Kern et al., 1997), and were described as more confrontational and aggressive.
Thus, students with ADHD may display more independence and rebellion towards
conventions and rules, may be less influenced by corrective feedback, and may be
harsher in social settings. Having low scores on these social scales may negatively affect
social adjustment in a college environment.
Psychological Functioning and Stress
Psychological disorders such as depression and anxiety are extremely common in
adolescents and young adults. Compared to students without an ADHD diagnosis, college
students with ADHD are more at risk for depressive symptoms (Fleming & McMahon,
2012; Norwalk et al., 2009; Rabiner et al., 2008). Students with ADHD are also more at
risk for substance abuse, overall psychological difficulties (Fleming & McMahon, 2012),
and a lower quality of life (Grenwald-Mayes, 2002), compared to students without an
ADHD diagnosis. Researchers have examined how depression, anxiety, and other
psychological disorders may affect college students with ADHD. However, there are very

few studies that have focused on how stress affects the ADHD student population in
particular.
Stress can be defined as feeling overwhelmed or being unable to cope effectively
with events in one's life (Dey, Rahman, Bairagi, & Roy, 2014). Stress has been found to
be strongly and negatively related to overall adjustment to college in the general college
population due to new responsibilities, independence, and new academic and social
demands (Crede & Niehorster, 2012). Therefore, persistent symptoms of ADHD, and the
social and academic impairments common in those with ADHD are likely to be related to
stress. In college students, stress was more strongly related to academic adjustment rather
than social adjustment (Crede & Niehorster, 2012).
Stress is an extremely important factor when assessing academic achievement in
college students because it can hinder a student’s true academic potential. Overbey et al.
(2009) found that scores on the Inventory of College Students Recent Life Experiences
(ICSRLE) that measure stressful life events were positively and significantly correlated
with ADHD symptoms; however, there are very few studies to date that have examined
how stress may affect the academic careers of college students with ADHD. It is
hypothesized that students with ADHD may score higher on a stress scale compared to
students without ADHD. High scores on a stress scale would suggest that students with
ADHD may have a more difficult time dealing with stress, and need to utilize more
coping strategies than their peers.
Current Study
The presence of ADHD symptoms has been found to affect academic
achievement and academic and social adjustment in college students. Personality

characteristics, such as neuroticism and conscientiousness, have also been found to
interfere with and predict college adjustment. The existing studies contribute greatly to
the understanding of college students with ADHD and academic, social, and
psychological impairments. However, the research on ADHD students and stress is
minimal. It is clear that college students dealing with symptoms of ADHD face difficulty
throughout their college careers. The current study examined the extent to which stress,
the personality characteristics of neuroticism and conscientiousness, and symptoms of
inattention and hyperactivity/impulsivity predicted academic success and adjustment in
college students with ADHD. It was hypothesized that there would be positive
correlations between ADHD symptoms, stress, and neuroticism as well as negative
correlations between ADHD symptoms, academic and social college adjustment, and
conscientiousness. In addition, we hypothesized that inattentive and
hyperactive/impulsive symptoms of ADHD would predict academic adjustment, social
adjustment, and GPA when stress, anxiety, and depression were controlled for. Although
both inattentive symptoms and hyperactive/impulsive symptoms will be predictors of
academic adjustment, social adjustment, and GPA, inattentive symptoms will be a
stronger predictor.
Method
Participants
Twenty-eight Purchase College students (16 female, 12 male) between the ages of
18 and 26 (M = 20.82 years, SD = 1.91) participated. All participants reported a previous
diagnosis of ADHD from a physician or psychologist. The average age of first diagnosis
was M = 11.85 years, SD = 4.37. Eighty six percent of the participants (n = 24) were

currently taking medication, or have previously taken medication for ADHD. There was a
high rate of comorbidity in our sample. Sixty four percent of the participants had at least
one other mental disorder diagnosis. The primary comorbidities were generalized anxiety
disorder (n = 12) and major depressive disorder (n = 7).
Nineteen participants identified as Caucasian (54.3%), four participants identified
as Latino/Hispanic (11.4%), two participants identified as African American (5.7%), two
participants identified as Other (5.7%), and one participant identified as more than one
race (Caucasian and African American, 2.9%). Five participants were freshman (14.3%),
eight participants were sophomores (22.9%), nine participants were juniors (25.7%), and
six participants were seniors (17.1%).
Procedure and Materials
Participants were recruited through class announcements, flyers posted around
campus, the psychology subject pool, and by posting a picture of the recruitment flier on
the Purchase College Open Forum Facebook page. Participants recruited through the
psychology subject pool received research credit, and all other participants received ten
dollars reimbursement for participation.
Students who expressed interest in participating were scheduled for a private
laboratory appointment. Following the informed consent procedure, participants were
asked to open their Degree Progress Report on a laboratory computer to accurately report
their grade point average. The degree progress report is a live document transcript that
tells you information about credits in progress, credits completed, and GPA. Then, the
participants completed a packet containing the questionnaires listed below. The full
questionnaire packet for the larger study took between 60 and 90 minutes to complete.

The human subjects committee approved the methods of this study, which was part of a
larger study on the influence of stigma, personality, and stress on academic and social
adjustment in college students with ADHD.
Demographics Form. A demographics questionnaire consisted of items regarding
age, gender, race and ethnicity, grade point average, and psychiatric history.
The Connors Adult ADHD Rating Scale- Self-Report: Long Version (CAARS-S:
L; Conners, Erhardt, & Sparrow, 1999) is a 66-item scale measures current symptoms of
ADHD. Scores on the DSM-IV Inattentive Symptoms Index and DSM-IV Hyperactive-
Impulsive Symptoms Index were utilized.
The Wender-Utah Rating Scale (WURS; Ward, Wender, & Reimherr, 1993), is a
61-item Likert scale, was used to provide a retrospective assessment of childhood ADHD
symptoms in adult patients. A subset of twenty-five items associated with an ADHD
diagnosis was rated on a scale from 0 (Not at All or Very Slightly) to 4 (Very Much). A
cutoff score of 46 out of 100 is considered confirmation of clinically significant ADHD
symptoms in childhood.
The Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1989)
is a 67-item self-report questionnaire that assesses four domains of adjustment to college:
academic, social, personal-emotional, and institutional attachment. Higher scores on each
of the four subscales indicate greater levels of adjustment. The current study utilized the
academic adjustment and social adjustment subscales. Each subscale on The Student
Adaptation to College Questionnaire has a maximum T-score of above 75.
The Student-Life Stress Inventory (Gadzella, 1991) is a 52-item self-report
inventory that assesses stressors in five domains: frustrations, conflicts, pressures,

changes, and self-imposed stress. The inventory also assesses physiological, emotional,
behavioral, and cognitive reactions to stressors. The current study utilized one total stress
score, which was the combination of the five stressor domains. The stressful experience
subscales of the Student Life Stress Inventory have a maximum score of 115. The
sample’s score of 75.6 indicates substantially high levels of stress.
The Beck Depression Inventory (BDI-II; Beck, Epstein, Brown, & Steer, 1988) is
a 21-item inventory that measures the presence and severity of depressive symptoms. For
each item, participants were asked to recount how they have been feeling during the past
week on a 4-point Likert scale.
The Beck Anxiety Inventory (BAI; Beck & Steer, 1993) is a symptom inventory
that measures levels of current anxiety. Participants were given a list of 21 common
symptoms of anxiety, and were asked to recount how much the symptom has bothered
them during the past week on a 4-point Likert scale 0 (Not at All) to 4 (Severely). The
inventory has a maximum score of 63, and scores between 26-63 indicate severe anxiety.
The NEO Five Factor Inventory (NEO-FFI; Costa & McCrae, 1989) is a 60-item
self-report scale that measures the five major dimensions of adult personality:
neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness
with 12 items per domain. The current study utilized scores on the neuroticism and
conscientiousness subscales. The sample’s score of 62.8 indicates a very high level of
neuroticism, and the score of 34.9 indicates a very low level of conscientiousness.
Research Design and Analysis
The current study used a correlational design. First, the relationships between
scores on the BDI (depression), the BAI (anxiety), the NEO (neuroticism and

conscientiousness), the Student Life Stress Inventory (stress), and scores on the CAARS
Inattentive Symptom Index and Hyperactive/Impulsive Symptom Index were examined
using Pearson correlations. Then, three hierarchical regressions were performed to
examine the extent to which personality, stress, and ADHD symptoms predicted the
dependent variables of academic adjustment, social adjustment, and GPA, after
controlling for depression and anxiety. Since depression and anxiety are common in
students with ADHD and can affect academic and social functioning, scores on the BDI
and BAI were entered in the first step of the regression to control for these factors. On the
second step of each regression, scores on neuroticism and conscientiousness were
entered. These personality factors are considered to be relatively stable over time. On the
third step of each regression, scores on the stress inventory were entered to examine if
stress associated with the college environment predicted the dependent variables after
controlling for depression, anxiety, and personality factors. Finally, scores on the
Inattentive and Hyperactive/Impulsive indices of the CAARS were entered in the fourth
step to determine if either cluster of ADHD symptoms predicted our dependent variables
above and beyond the influence of all other factors in our model.
Scores for neuroticism and conscientiousness were missing for one participant.
The regression analyses were run twice: once replacing the values for the missing data
with the means for each personality score, and once excluding the participant from the
analyses. The results of these analyses differed only slightly; therefore, the results
reported include data from all participants with replacement of the missing personality
variables with the mean scores of the sample. Since four first-semester freshmen were
included, there were four missing values for GPA. The analyses were rerun excluding

these participants, and there were only slight differences in the results. The results
reported include data from the entire sample with the missing GPA values replaced with
the mean GPA of the sample.
Results
The means and standard deviations of each scale are shown in Table 1. The mean
scores on these scales support our hypotheses about college students with ADHD.
Notably, the current sample had a mean CAARS inattentive index score in the clinically
significant range (M = 69.8, SD = 14.4), but the mean score for hyperactive/impulsive
index was not in the clinically significant range (M = 59.8, SD = 13.6). The sample
reported a mean score on the Wender Utah scale that was indicative of clinically
significant childhood symptoms (M = 51.8, SD = 17.5).
Table 2 shows the results of the Pearson correlation analyses. Almost all of the
variables of interest were significantly correlated with each other. Supporting our first
hypothesis, stress was positively correlated with inattentive (r = .63, p < .01) and
hyperactive/impulsive symptoms (r = .47, p < .05). Neuroticism was also positively
correlated with inattentive (r = .76, p < .01), and hyperactive/impulsive symptoms (r =
.60, p < .01). Further supporting our first hypothesis, conscientiousness was negatively
correlated with inattentive (r = -.74, p < .01), and hyperactive symptoms (r = -.41, p <
.01). Academic adjustment was also negatively correlated with inattentive (r = -.72, p <
.01), and hyperactive/impulsive symptoms (r -.72, p < .01). Contrary to our hypothesis
and past research, symptoms of inattention had a significant positive correlation with
GPA (r = .41, p < .05). Compared to hyperactive/impulsive symptoms, inattentive
symptoms seemed to have more significant relationships with stress, neuroticism, and

conscientiousness. However, academic adjustment had equally strong correlations with
both inattentive and hyperactive/impulsive symptoms.
Table 3 is a summary of the regression analysis results with beta and p-values.
The hierarchical multiple regression predicting academic adjustment revealed that at the
first step, depression and anxiety accounted for 55% of the variance in academic
adjustment, F (2,25) = 15.25, p < .01. Depression was a significant predictor of academic
adjustment, while anxiety was not. Higher scores on the BDI predicted lower scores on
the academic adjustment subscale. Introducing the personality characteristics of
neuroticism and conscientiousness explained an additional 14.4% of variance in
academic adjustment, and this ∆R² was significant, F (2,23) = 5.39, p < .01. Both
neuroticism and stress were significant predictors of academic adjustment. Low levels of
neuroticism and high levels of conscientiousness predicted greater academic adjustment.
Adding stress to the regression model explained an additional 7.6% of the variance in
academic adjustment, and this change in R² was significant, F (1,22) = 7.24, p < .01.
Stress was positively related to academic adjustment. Finally, the addition of inattentive
and hyperactive/impulsive symptoms to the regression model explained an additional
3.79% of the variance in academic adjustment, and this ∆R² square was also significant,
F (2,20) = 3.78, p < .05. When all independent variables were included in stage four of
the regression model, they accounted for 77.4% of the variance in academic adjustment.
The hierarchical multiple regression predicting social adjustment revealed that
entering depression and anxiety in the first step accounted for 49.3% of the variance in
social adjustment, F (2,25) = 12.15, p < .001. Anxiety was a significant predictor, while
depression was not. Entering the personality characteristics of neuroticism and

conscientiousness only explained an additional 1.1% of variance in social adjustment,
and this ∆R² was not significant, F (2,23) = .25, p = .78. Adding stress to the regression
model on the third step only explained an additional .70% of the variance in social
adjustment, and this ∆R² was also not significant, F (1,22) = .33, p = .57. Stress was not
positively related to social adjustment. Finally, the addition of inattentive and
hyperactive/impulsive symptoms to the regression model explained an additional 14.8%
of the variance in social adjustment, and this ∆R² square was significant, F (2,20) = 4.33,
p = .03. When all independent variables were included in stage four of the regression
model, they accounted for 65.9% of the variance in social adjustment. Only anxiety,
inattentive symptoms and hyperactive/impulsive symptoms significantly predicted social
adjustment.
For the hierarchical multiple regression predicting GPA, adding depression and
anxiety in the first step accounted for 10% of the variance in GPA, and did not contribute
significantly to the regression model, F (2,25) = 1.38, p = .27. No relationships were
found between levels of depression, anxiety, and GPA. Introducing the personality
characteristics of neuroticism and conscientiousness explained an additional 5.6% of
variance in GPA, and this ∆R² was not significant, F (2,23) = .76, p = .48. Neither
neuroticism nor conscientiousness were significant predictors of GPA. Adding stress to
the regression model explained an additional 1.9% of the variance in GPA, but this ∆R²
was also not significant, F (1,22) = .51, p = .48. Stress was not predictive of GPA.
Finally, the addition of inattentive and hyperactive/impulsive symptoms to the regression
model explained an additional 4% of the variance in GPA, and this final ∆R² square was
also not significant, F (2,20) = .51, p = .61. When all independent variables were

included in the model, they accounted for 21.5% of the variance in GPA. GPA was not
significantly predicted by depression, anxiety, personality, stress or inattentive and
hyperactive/impulsive symptoms.
Discussion
The present study examined the relationships between inattentive and
hyperactive/impulsive symptoms, stress, personality, academic achievement and
academic and social adjustment to college in students with ADHD. Specifically, these
factors included experience with stressors, neuroticism, conscientiousness, academic
adjustment, social adjustment, and GPA. This study expanded on prior research of
college students with ADHD by examining the specific effects of stress and personality
on their adjustment.
It was predicted that there would be positive relationships between ADHD
symptoms, stress, and neuroticism as well as negative relationships between ADHD
symptoms, academic and social college adjustment, and conscientiousness. Supporting
the first hypothesis, significant positive relationships were found between inattentive and
hyperactive/impulsive symptoms, stress, and neuroticism, and significant negative
relationships were found between inattentive and hyperactive/impulsive symptoms,
academic adjustment, social adjustment, and conscientiousness. These results are not
surprising, since students with ADHD have been found to report greater academic
difficulties, poorer study habits, lower GPAs (Frazier et al., 2007), lower levels of social
skills and self-esteem (Shaw-Zirt et al., 2005), high levels of neuroticism, and low levels
of conscientiousness (Ranseen et al., 1998; Rabiner et al., 2008). Contrary to the findings
of Frazier et al. (2007), neither inattentive nor hyperactive/impulsive symptoms were

negatively related to GPA. In fact, there was a positive correlation between inattentive
symptoms and GPA. This result suggests that there may be an outside factor that is
mediating the relationship between GPA and inattention in our sample, such as the use of
stimulant medication.
The results from our hierarchical models show that academic adjustment was
predicted by all of our variables of interest: stress, personality, and symptoms of ADHD.
Although conscientiousness and neuroticism are thought to have a direct impact on
academic achievement (Rabiner et al., 2008) and social relationships (Gudjonsson et al.,
2010; Kern et al., 1997), our results showed that they did not significantly predict GPA or
social adjustment. Stress also did not significantly predict GPA or social adjustment. This
also supports Crede & Niehorster (2012)’s report that stress is more strongly related to
academic adjustment rather than social adjustment. These findings partially support the
second hypothesis, and suggest that academic adjustment might be the area that requires
most attention in college students with ADHD.
Overall, ADHD symptoms predicted academic and social adjustment above and
beyond depression, anxiety, personality, and stress. Depression, anxiety, personality, and
stress significantly predicted academic adjustment, but did not predict social adjustment.
GPA was not predicted by any of the independent variables. Contrary to the third
hypothesis, hyperactive/impulsive symptoms were a stronger predictor of academic
adjustment. High levels of hyperactivity/impulsivity seemed to predict lower levels of
academic adjustment, while inattentive symptoms were not predictive of academic
adjustment.

The high rate of comorbidity between depression, anxiety, and ADHD in our
sample supports previous findings that students with ADHD are at higher risk for
depressive symptoms and psychological difficulties (Fleming & McMahon, 2012;
Norwalk et al., 2009; Rabiner et al., 2008). When examining college adjustment it is
important to consider the role of depression and anxiety, especially in students with
comorbid ADHD. The strong relationships among depression, anxiety, and ADHD
indicate that they are important factors to examine in future research.
The current study had several limitations. To measure ADHD symptomology, this
study relied solely on the CAARS self-report scale with no formal clinical assessment by
a diagnostician. Although all participants reported receiving a clinical diagnosis of
ADHD, future studies should include a clinical interview to further verify the current
presence of ADHD symptoms. Although GPA was one of the dependent variables of
interest, four first-semester freshmen were included that were unable to provide a GPA.
Not obtaining these GPA values may have altered the relationship between GPA and
other variables. If there was a larger sample of college students with ADHD, ADHD
symptomology and personality may have been significant predictors of GPA. Also, it is
possible that our variables may change over time. For example, the relationships between
variables may not be the same during the initial adjustment period, compared to students
who are further along. Future studies should be sure to compare levels of adjustment
between lower and upperclassmen to see if these variables do change over time. The
demographics form did not ask participants to specify whether they were transfer or
commuter students. This may have affected college adjustment results, since experience
living on campus versus at home can be very different. The surveys did not include

questions about how the participant’s were handing their ADHD, and what types of skills
or interventions they found the most helpful. The average GPA of the sample was 3.11,
which indicates good academic standing. Knowing what skills have actually helped these
students could be the first step for building a better intervention. Further, the current
sample size was very small. Future studies need larger samples of ADHD college
students to see if these predictors of adjustment remain significant, and can be
generalized to a larger student population.
Despite the limitations of this study, it is one of very few that examined the
interplay between ADHD symptomology, stress, and personality, and how they all play a
role in student adjustment to college. The students with ADHD who participated in this
study provided important insight into the difficulties of college adjustment when ADHD
symptoms are present. Understanding areas of difficulty associated with ADHD in
college students is crucial, and can lead to tailored interventions to help promote success
and college retention. The results of this study suggest that adjusting to academic
demands may be the most difficult aspect of college for students with ADHD, and should
be the focus of future interventions. This can serve as the basis for interventions that
educate young adults with ADHD about the importance of strengthening academic skills,
and minimizing stress to do well in college. In addition to learning how to utilize
academic skills and coping strategies, learning ways to manage stress can potentially ease
the college adjustment process for students with ADHD. Future longitudinal studies are
needed to explore the relationship between stress and adjustment in students with ADHD,
and which interventions should be combined to produce the best results. Over time, these

tailored interventions can minimize stress and promote the use of coping strategies
throughout their college career.

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Table 1.
Mean Scores of Individual Scales
Scale Mean Standard Deviation Interpretive Range
GPA 3.11 .44 -
CAARS: Inattentive 69.8 14.4 Clinically significant
CAARS: Hyp./Imp. 59.8 13.6 Not clinically significant
Wender Utah 51.8 17.5 Clinically significant
Student Life Stress 75.6 11.6 High
Academic Adjustment 45.4 9.4 Low
Social Adjustment 43.7 8.9 Low
Neuroticism (NEO) 62.8 10.6 High
Conscientiousness (NEO) 34.9 10.4 Low
Beck Anxiety Inventory 26.7 16.2 Severe Anxiety
Beck Depression Inventory 16.9 13.4 Mild Depression

Table 2.
Correlations Between All Variables of Interest
CAARS: CAARS: Stress GPA Academic Social Anxi. Dep. Neurot.
Inattentive Hyp./Imp. Adjustment Adjustment
CAARS:
Inattentive
CAARS:
Hyp./Imp. .71**
Total Stress .63** .47*
GPA .41* .19 .36
Academic -.72** -.72** -.50** -.16
Adjustment
Social Adjustment -.56** .29 -.60** -.21 .42*
Anxiety (BAI) .44* .46* .67** .34 -.46* -.68**
Depression (BDI) .59** .58** .76** .21 -.74** -.60** .68**
Neuroticism .76** .60** .80** .33 -.56** -.56** .65** .78**
Conscientiousness -.74** -.41* -.57** -.30 .67** .43* -.43* -.56** -.55**
Note. p <.05*; p <.01**

Table 3.
Summary of Regression Analysis Results
Dependent Variable and Predictor Variables β p
Academic Adjustment
Depression -.44 .02*
Anxiety .11 .43
Neuroticism -.41 .04*
Conscientiousness .36 .02*
Stress .45 .02*
Inattention -.01 .95
Hyperactivity/Impulsivity -.32 .04*
Social Adjustment
Depression -.29 .25
Anxiety -.56 .01*
Neuroticism .20 .48
Conscientiousness -.23 .28
Stress -.03 .90
Inattention -.76 .01*
Hyperactivity/Impulsivity .48 .03*
GPA
Depression -.26 .50
Anxiety .27 .37
Neuroticism -.02 .95
Conscientiousness .02 .95
Stress .21 .59
Inattention .42 .33
Hyperactivity/Impulsivity -.17 .60
Note. *p < .05

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