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Managing ADHD at the Post-Secondary Transition: A Qualitative Study of Parent and Young Adult Perspectives

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Abstract

Students with ADHD struggle substantially at the post-secondary transition. Yet, no empirical work identifies school-based intervention targets that specifically prepare graduating students for adjustment to this new phase of life. This study is a preliminary investigation of factors that promote success for students with ADHD during the post-secondary transition. Using qualitative methods, 25 in-depth interviews were conducted with 13 young adults with ADHD (age 18–21) and 12 parents of young adults with ADHD. Informants offered their perspectives of what factors were critical to post-secondary success and how (i.e., by what mechanisms) these factors influence young adult functioning. Twenty macrothemes were identified under three a priori categories: motivational, skills, and environmental factors. Two macrothemes outside of these categories were identified post hoc. Motivation and self-control difficulties were identified as the most commonly impairing deficits. Factors that enhanced and undermined these deficits were identified by parents and young adults. Implications for intervention are discussed.

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References

  • Abba, N., Chadwick, P., & Stevenson, C. (2008). Responding mindfully to distressing psychosis: A grounded theory analysis. Psychotherapy Research, 18(1), 77–87.

    Article  Google Scholar 

  • Altszuler, A. R., Page, T. F., Gnagy, E. M., Coxe, S., Arrieta, A., Molina, B. S., et al. (2016). Financial dependence of young adults with childhood ADHD. Journal of Abnormal Child Psychology, 44(6), 1217–1229.

    Article  Google Scholar 

  • Anastopoulos, A. D., King, K. A., Besecker, L. H., O’Rourke, S. R., Bray, A. C., & Supple, A. J. (2018). Cognitive-behavioral therapy for college students with ADHD: Temporal stability of improvements in functioning following active treatment. Journal of Attention Disorders. https://doi.org/10.1177/1087054717749932.

    Article  PubMed  Google Scholar 

  • Antshel, K. M., Faraone, S. V., & Gordon, M. (2012). Cognitive behavioral treatment outcomes in adolescent ADHD. Focus, 10(3), 334–345.

    Article  Google Scholar 

  • Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480.

    Article  Google Scholar 

  • Barbaresi, W., Katusic, S., Colligan, R., Weaver, A., & Jacobsen, S. (2007). Long-term school outcomes for children with attention-deficit/hyperactivity disorder: A population-based perspective. Journal of Developmental and Behavioral Pediatrics, 28, 265–273.

    Article  Google Scholar 

  • Barkley, R., Fischer, M., Smallish, L., & Fletcher, K. (2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 192–202.

    Article  Google Scholar 

  • Barkley, R. A., & Murphy, K. R. (2010). Impairment in occupational functioning and adult ADHD: The predictive utility of executive function (EF) ratings versus EF tests. Archives of clinical neuropsychology, 25(3), 157–173.

    Article  Google Scholar 

  • Barkley, R. A., Murphy, K. R., & Fischer, M. (2008). ADHD in adults: What the science says. New York: Guilford Press.

    Google Scholar 

  • Barron, K. E., Evans, S. W., Baranik, L. E., Serpell, Z. N., & Buvinger, E. (2006). Achievement goals of students with ADHD. Learning Disability Quarterly, 29(3), 137–158.

    Article  Google Scholar 

  • Bovier, P. A., Chamot, E., & Perneger, T. V. (2004). Perceived stress, internal resources, and social support as determinants of mental health among young adults. Quality of Life Research, 13, 161–170.

    Article  Google Scholar 

  • Boyer, B. E., Geurts, H. M., Prins, P. J., & Van der Oord, S. (2015). Two novel CBTs for adolescents with ADHD: the value of planning skills. European Child and Adolescent Psychiatry, 24, 1075–1090.

    Article  Google Scholar 

  • Castellanos, F. X., Sonuga-Barke, E. J., Milham, M. P., & Tannock, R. (2006). Characterizing cognition in ADHD: Beyond executive dysfunction. Trends in Cognitive Sciences, 10, 117–123.

    Article  Google Scholar 

  • Charmaz, K. (2009). Shifting the grounds: Grounded theory in the 21st century. JM Morse et al. (2009). Developing grounded theory: The second generation, 125–140.

  • Charmaz, K. (2014). Constructing grounded theory. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Chemers, M. M., Hu, L. T., & Garcia, B. F. (2001). Academic self-efficacy and first year college student performance and adjustment. Journal of Educational Psychology, 93, 55.

    Article  Google Scholar 

  • Cheung, K. K., Wong, I. C., Ip, P., Chan, P. K., Lin, C. H., Wong, L. Y., et al. (2015). Experiences of adolescents and young adults with ADHD in Hong Kong: Treatment services and clinical management. BMC Psychiatry, 15, 95.

    Article  Google Scholar 

  • Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300–314.

    Article  Google Scholar 

  • Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage.

    Google Scholar 

  • DuPaul, G. J., McGoey, K. E., Eckert, T. L., & VanBrakle, J. (2001). Preschool children with attention-deficit/hyperactivity disorder: Impairments in behavioral, social, and school functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 508–515.

    Article  Google Scholar 

  • Dvorsky, M. R., & Langberg, J. M. (2014). Predicting impairment in college students with ADHD: The role of executive functions. Journal of Attention Disorders. https://doi.org/10.1177/1087054714548037.

    Article  PubMed  Google Scholar 

  • Elliott, T. R., Godshall, F., Shrout, J. R., & Witty, T. E. (1990). Problem-solving appraisal, self-reported study habits, and performance of academically at-risk college students. Journal of Counseling Psychology, 37, 203.

    Article  Google Scholar 

  • Evans, S. W., Schultz, B. K., DeMars, C. E., & Davis, H. (2011). Effectiveness of the challenging horizons after-school program for young adolescents with ADHD. Behavior Therapy, 42, 462–474.

    Article  Google Scholar 

  • Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O’Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29, 129–140.

    Article  Google Scholar 

  • Fabiano, G. A., Pelham, W., Waschbusch, D., Gnagy, E., Lahey, B. B., Chronis, A., et al. (2006). A practical measure of impairment: Psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 35, 369–385.

    Article  Google Scholar 

  • Gawrilow, C., Morgenroth, K., Schultz, R., Oettingen, G., & Gollwitzer, P. M. (2013). Mental contrasting with implementation intentions enhances self-regulation of goal pursuit in schoolchildren at risk for ADHD. Motivation and Emotion, 37, 134–145.

    Article  Google Scholar 

  • Gerdes, H., & Mallinckrodt, B. (1994). Emotional, social, and academic adjustment of college students: A longitudinal study of retention. Journal of Counseling & Development, 72, 281–288.

    Article  Google Scholar 

  • Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.

    Google Scholar 

  • Gollwitzer, P. M., & Brandstätter, V. (1997). Implementation intentions and effective goal pursuit. Journal of Personality and Social Psychology, 73, 186.

    Article  Google Scholar 

  • Gut, J., Heckmann, C., Meyer, C., Schmid, M., & Grob, A. (2012). Language skills, mathematical thinking, and achievement motivation in children with ADHD, disruptive behavior disorders, and normal controls. Learning and individual Differences, 22, 375–379.

    Article  Google Scholar 

  • Halperin, J. M., Trampush, J. W., Miller, C. J., Marks, D. J., & Newcorn, J. H. (2008). Neuropsychological outcome in adolescents/young adults with childhood ADHD: Profiles of persisters, remitters and controls. Journal of Child Psychology and Psychiatry, 49, 958–966.

    Article  Google Scholar 

  • Hechtman, L. (1999). Predictors of long-term outcome in children with attention-deficit/hyperactivity disorder. Pediatric Clinics of North America, 46, 1039–1052.

    Article  Google Scholar 

  • Hechtman, L., Swanson, J. M., Sibley, M. H., Stehli, A., Owens, E. B., & Abikoff, H. B. (2016). Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. Journal of the American Academy of Child and Adolescent Psychiatry, 55, 945–952.

    Article  Google Scholar 

  • Hoza, B. (2007). Peer functioning in children with ADHD. Journal of Pediatric Psychology, 32, 655–663.

    Article  Google Scholar 

  • Jarrett, M. (2016). Attention-deficit/hyperactivity disorder symptoms, anxiety symptoms, and executive functioning in emerging adults. Psychological Assessment, 28, 245.

    Article  Google Scholar 

  • Jensen, P. S., Mrazek, D., Knapp, P. K., Steinberg, L., Pfeffer, C., Schowalter, J., et al. (1997). Evolution and revolution in child psychiatry: ADHD as a disorder of adaptation. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1672–1681.

    Article  Google Scholar 

  • Johnston, C., & Mash, E. J. (2001). Families of children with attention-deficit/hyperactivity disorder: Review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183–207.

    Article  Google Scholar 

  • Judge, T. A., & Bono, J. E. (2001). Relationship of core self-evaluations traits—Self-esteem, generalized self-efficacy, locus of control, and emotional stability—With job satisfaction and job performance: A meta-analysis. Journal of Applied Psychology, 86, 80.

    Article  Google Scholar 

  • Kent, K. M., Pelham, W. E., Molina, B. S. G., Sibley, M. H., Waschbusch, D. A., Yu, J., et al. (2011). The academic experience of male high school students with ADHD. Journal of Abnormal Child Psychology, 39, 451–462.

    Article  Google Scholar 

  • Kern, R. M., Rasmussen, P. R., Byrd, S. L., & Wittschen, L. K. (1999). Lifestyle, personality, and attention deficit hyperactivity disorder in young adults. Individual Psychology, 55, 186.

    Google Scholar 

  • Kessler, R. C., Price, R. H., & Wortman, C. B. (1985). Social factors in psychopathology: Stress, social support, and coping processes. Annual Review of Psychology, 36(1), 531–572.

    Article  Google Scholar 

  • Kuriyan, A. B., Pelham, W. E., Molina, B. S. G., Daniel, W. A., Gnagy, E. M., Sibley, M. H., et al. (2013). Young adult educational and vocational outcomes of children diagnosed with ADHD. Journal of Abnormal Child Psychology, 41(1), 27–41.

    Article  Google Scholar 

  • Langberg, J. M., Smith, Z. R., Dvorsky, M. R., Molitor, S. J., Bourchtein, E., Eddy, L. D., & et al. (2017). Factor structure and predictive validity of a homework motivation measure for use with middle school students with attention-deficit hyperactivity disorder. School Psychology Quarterly. https://doi.org/10.1037/spq0000219.

    Article  PubMed  Google Scholar 

  • Lefler, E. K., Sacchetti, G. M., & Del Carlo, D. I. (2016). ADHD in college: A qualitative analysis. ADHD Attention Deficit and Hyperactivity Disorders, 8, 79–93.

    Article  Google Scholar 

  • Mannuzza, S., Klein, R. G., Bessler, A., Malloy, P., & Hynes, M. E. (1997). Educational and occupational outcome of hyperactive boys grown up. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1222–1227.

    Article  Google Scholar 

  • Mannuzza, S., Klein, R. G., Bessler, A., Malloy, P., & LaPadula, M. (1993). Adult outcome of hyperactive boys: Educational achievement, occupational rank, and psychiatric status. Archives of General Psychiatry, 50, 565–576.

    Article  Google Scholar 

  • Masten, A. S., Burt, K. B., Roisman, G. I., Obradović, J., Long, J. D., & Tellegen, A. (2004). Resources and resilience in the transition to adulthood: Continuity and change. Development and Psychopathology, 16, 1071–1094.

    Article  Google Scholar 

  • Merkt, J., & Gawrilow, C. (2016). Health, dietary habits, and achievement motivation in college students with self-reported ADHD diagnosis. Journal of Attention Disorders, 20, 727–740.

    Article  Google Scholar 

  • Morsink, S., Sonuga-Barke, E., Mies, G., Glorie, N., Lemiere, J., Van der Oord, S., & et al. (2017). What motivates individuals with ADHD? A qualitative analysis from the adolescent’s point of view. European Child & Adolescent Psychiatry, 26(8), 923–932.

    Article  Google Scholar 

  • Nelson, J. R., & Roberts, M. L. (2000). Ongoing reciprocal teacher-student interactions involving disruptive behaviors in general education classrooms. Journal of Emotional and Behavioral Disorders, 8, 27–37.

    Article  Google Scholar 

  • Newark, P. E., Elsässer, M., & Stieglitz, R. D. (2016). Self-esteem, self-efficacy, and resources in adults with ADHD. Journal of Attention Disorders, 20(3), 279–290.

    Article  Google Scholar 

  • Olsson, C. A., Bond, L., Burns, J. M., Vella-Brodrick, D. A., & Sawyer, S. M. (2003). Adolescent resilience: A concept analysis. Journal of Adolescence, 26, 1–11.

    Article  Google Scholar 

  • Pelham, W., Gnagy, E., Greenslade, K., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 210–218.

    Article  Google Scholar 

  • Pew Research Center. (2014). The rising cost of not going to college. Washington, DC.

  • Priester, M. J., & Clum, G. A. (1993). Perceived problem-solving ability as a predictor of depression, hopelessness, and suicide ideation in a college population. Journal of Counseling Psychology, 40, 79.

    Article  Google Scholar 

  • Ratelle, C. F., Larose, S., Guay, F., & Senécal, C. (2005). Perceptions of parental involvement and support as predictors of college students’ persistence in a science curriculum. Journal of Family Psychology, 19, 286.

    Article  Google Scholar 

  • Reaser, A., Prevatt, F., Petscher, Y., & Proctor, B. (2007). The learning and study strategies of college students with ADHD. Psychology in the Schools, 44, 627–638.

    Article  Google Scholar 

  • Robbins, R. N., & Bryan, A. (2004). Relationships between future orientation, impulsive sensation seeking, and risk behavior among adjudicated adolescents. Journal of Adolescent Research, 19, 428–445.

    Article  Google Scholar 

  • Rokeach, M. (1973). The nature of human values. New York: Free Press.

    Google Scholar 

  • Safren, S. A., Sprich, S., Mimiaga, M. J., Surman, C., Knouse, L., Groves, M., et al. (2010). Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. JAMA, 304, 875–880.

    Article  Google Scholar 

  • Safren, S. A., Sprich, S. E., Perlman, C. A., & Otto, M. W. (2017). Mastering your adult ADHD: A cognitive-behavioral treatment program, therapist guide. Oxford University Press.

  • Schiffrin, H. H., Liss, M., Miles-McLean, H., Geary, K. A., Erchull, M. J., & Tashner, T. (2014). Helping or hovering? The effects of helicopter parenting on college students’ well-being. Journal of Child and Family Studies, 23, 548–557.

    Article  Google Scholar 

  • Schraw, G., Wadkins, T., & Olafson, L. (2007). Doing the things we do: A grounded theory of academic procrastination. Journal of Educational Psychology, 99(1), 12.

    Article  Google Scholar 

  • Schulenberg, J. E., Sameroff, A. J., & Cicchetti, D. (2004). The transition to adulthood as a critical juncture in the course of psychopathology and mental health. Development and Psychopathology, 16, 799–806.

    PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M., & Schwab-Stone, M. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from pervious versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.

    Article  Google Scholar 

  • Sibley, M. H. (2016). Parent-teen therapy for executive function deficits and ADHD: Building skills and motivation. New York: Guilford.

    Google Scholar 

  • Sibley, M. H., Campez, M., Perez, A., Morrow, A. S., Merrill, B. M., Altszuler, A. A., et al. (2016a). Parent management of organization, time management, and planning deficits among adolescents with ADHD. Journal of Psychopathology and Behavioral Assessment, 38, 216–228.

    Article  Google Scholar 

  • Sibley, M. H., Graziano, P. A., Kuriyan, A. B., Coxe, S., Pelham, W. E., Rodriguez, L. M., et al. (2016b). Parent-teen behavior therapy + motivational interviewing for adolescents with ADHD. Journal of Consulting and Clinical Psychology, 84, 699–712.

    Article  Google Scholar 

  • Sibley, M. H., & Kuriyan, A. B. (2016). DSM-5 changes enhance parent identification of symptoms in adolescents with ADHD. Psychiatry Research, 242, 180–185.

    Article  Google Scholar 

  • Sibley, M. H., Swanson, J. M., Arnold, L. E., Hechtman, L. T., Owens, L. E., & The MTA Cooperative Group. (2017). Defining ADHD symptom persistence in adulthood: Optimizing sensitivity and specificity. Journal of Child Psychology and Psychiatry, 58, 655–662.

    Article  Google Scholar 

  • Solanto, M. V. (2011). Cognitive-behavioral therapy for adult ADHD: Targeting executive dysfunction. New York: Guilford Press.

    Google Scholar 

  • Solanto, M. V., Marks, D. J., Wasserstein, J., Mitchell, K., Abikoff, H., Alvir, J. M. J., et al. (2010). Efficacy of meta-cognitive therapy for adult ADHD. American Journal of Psychiatry, 167, 958–968.

    Article  Google Scholar 

  • Swanson, E. N., Owens, E. B., & Hinshaw, S. P. (2014). Pathways to self-harmful behaviors in young women with and without ADHD: A longitudinal examination of mediating factors. Journal of Child Psychology and Psychiatry, 55, 505–515.

    Article  Google Scholar 

  • Swift, K. D., Hall, C. L., Marimuttu, V., Redstone, L., Sayal, K., & Hollis, C. (2013). Transition to adult mental health services for young people with Attention Deficit/Hyperactivity Disorder (ADHD): A qualitative analysis of their experiences. BMC Psychiatry, 13, 74.

    Article  Google Scholar 

  • Thompson, A. L., Molina, B. S., Pelham, W., & Gnagy, E. M. (2007). Risky driving in adolescents and young adults with childhood ADHD. Journal of Pediatric Psychology, 32, 745–759.

    Article  Google Scholar 

  • Toplak, M., Jain, U., & Tannock, R. (2005). Executive and motivational processes in adolescents with Attention-Deficit-Hyperactivity Disorder. Behavioral and Brain Functions, 1, 8.

    Article  Google Scholar 

  • Turgay, A., Lasser, R. A., Goodman, D. W., & Asherson, P. (2012). Lifespan persistence of ADHD: The life transition model and its application. Journal of Clinical Psychiatry, 73, 192–201.

    Article  Google Scholar 

  • Van Yperen, N. W., & Hagedoorn, M. (2003). Do high job demands increase intrinsic motivation or fatigue or both? The role of job control and job social support. Academy of Management Journal, 46(3), 339–348.

    Google Scholar 

  • Wechsler, D. (1999). Wechsler abbreviated scale of intelligence (WASI). San Antonio: Harcourt.

    Google Scholar 

  • Young, S. (2005). Coping strategies used by adults with ADHD. Personality and Individual Differences, 38, 809–816.

    Article  Google Scholar 

  • Zwart, L. M., & Kallemeyn, L. M. (2001). Peer-based coaching for college students with ADHD and learning disabilities. Journal of Postsecondary Education and Disability, 15(1), 1–15.

    Google Scholar 

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Sibley, M.H., Yeguez, C.E. Managing ADHD at the Post-Secondary Transition: A Qualitative Study of Parent and Young Adult Perspectives. School Mental Health 10, 352–371 (2018). https://doi.org/10.1007/s12310-018-9273-4

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