The Association Between ADHD Symptoms and Non-Suicidal Self-Injury in the Transition to College: A Systematic Review

The college transition is difficult for most students. In addition to increased difficulty in academics, the developmental period of emerging adulthood (ages 18-25) is defined by social stressors, increased autonomy, and decreased social support, as well as new demands such as budgeting time and money (Arnett, 2000). Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder distinguished by a persistent pattern of inattention, hyperactivity, and impulsivity. The symptoms of ADHD are heterogeneous across the lifespan, and individuals with the disorder experience different presentations of hyperactivity, impulsivity, and inattention from childhood through emerging adulthood (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]; American Psychiatric Association [APA], 2013). ADHD is associated with poor emotional regulation; this impairment is associated with higher rates of internalizing symptoms, such as stress, anxiety, and depression. This is largely due to the fact that individuals with elevated ADHD symptom counts experience difficulty inhibiting their emotions, and experience higher levels of emotional impulsivity (Barkley, 2014). Thus, recent research suggest that ADHD may be a risk factor for non-suicidal self-injury (NSSI) in adolescence and emerging adulthood (Swanson, Owens, & Hinshaw, 2014). This systematic review evaluates current literature on the transition to college and how this impairment affects internalizing problems and coping for students with varying levels of ADHD symptomatology, specifically NSSI and self-harm. Further research is warranted to better understand ADHD and NSSI impairment in the transition to college