Longitudinal Relations Between ADHD Symptoms and Substance Use Across the Transition to College and Evaluation of Promotive and Protective Factor

The prevalence of substance use and related problems increases during adolescence and peaks in young adulthood with substantial increases during the transition from high school to college (Johnston et al., 2018). However, these increases are not universal for all students (White et al., 2006), and there is substantial variation in rates of substance use during the first year of college (Borasri et al., 2007; Frisher et al., 2007). It is important to identify the individual and environmental factors that serve as risk factors for substance use as well as factors that may promote or protect against use during the high school to college transition. This prospective longitudinal investigated the impact of risk, promotive, and protective factors on the substance use outcomes of 150 high school seniors transitioning to college. The prevalence of alcohol and marijuana use substantially increased from high school to the first semester of college. Results indicate that ADHD symptoms at the end of high school predicted residualized change in alcohol and marijuana use during the first semester of college (i.e., controlling for the autoregressive effect of use during college). For alcohol use (but not marijuana), ADHD symptoms continued to predict subsequent use across the first year of college (from fall to spring of the first year). Promotive models revealed that adaptive social perceptions predicted decreased alcohol and marijuana use, and academic motivation predicted decreased alcohol use, after controlling for the role of ADHD symptoms. Adaptive social perceptions about each substance was protective against future alcohol and marijuana use both before and after the transition to college demonstrated by significant interaction effect with ADHD symptoms, after controlling for the direct risk and promotive effects in the model. These interactions illustrated that adolescents with elevated ADHD symptoms who have high friend disapproval of substances may experience resilience with respect to substance use outcomes. Academic motivation demonstrated promotive (direct) effects for reducing the risk for alcohol use but protective effects were not found. Future research should seek to elucidate more specific mechanisms through which youth and adolescents with elevated ADHD are protected against the high risk for substance use problems.