ADHD Symptoms and Risk for Alcohol Use and Cigarette Smoking Among College Students: What Role do Social-Cognitive Factors Play?

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder which often persists into adulthood and has been associated with an increased risk for substance use. Although more college students with high levels of ADHD symptoms are attending college, little research has examined whether ADHD symptoms are associated with substance use or whether social and cognitive factors help to explain whether ADHD symptoms are linked to this increased substance use risk. The aims of the current study were: (1) To examine whether ADHD symptoms were associated with increasing trajectories of cigarette smoking, alcohol use, and alcohol-related problems among first-year college students, and (2) To examine whether constructs related to Social Cognitive Theory-- perceived social norms, positive outcome expectancies, or self-efficacy-- mediated the proposed relation between ADHD symptoms and cigarette smoking, alcohol use, and alcohol-related problems trajectories. It was hypothesized that greater ADHD symptomatology would be related to increasing levels of cigarette smoking, alcohol use, and alcohol problems during the study. Further, it was hypothesized that perceived social norms, positive outcome expectancies, and self-efficacy would partially mediate these relations. Participants were 449 college freshmen who completed three online surveys during their first year of college. Hypotheses were largely unsupported, but results suggested that ADHD symptoms were positively associated with baseline alcohol problems after controlling for conduct disorder (CD) symptoms. ADHD was not significantly associated with changes in any of the substance use trajectories, and there was no evidence for the proposed social cognitive factors mediating the relation between ADHD and changes in substance use. Possible reasons for the null findings are discussed. Future directions and clinical implications are also presented