College Students and Parents Rate ADHD Traits Differently

April 11, 2007 -- A college student’s perception of having Attention Deficit Hyper-Activity Disorder tells only part of the story, and a diagnosis might be missed if health professionals don’t also ask parents to report on the range of behaviors they see in their offspring who has left home.

A study being presented at the 2007 American Educational Research Association conference at 9 a.m. on April 10 has found that college students are likely to recognize a certain set of behaviors associated with ADHD, but not other behaviors that their parents are more likely to identify.

According to the researchers, parents were better at recognizing internal behaviors associated with ADHD, such as not listening, fidgeting and being distracted, while students were better at identifying the external behaviors, such as interrupting conversations, talking excessively and having difficulty engaging in leisure activities.

“Having both informants gives a broader perspective,” said Timothy Konold, associate professor in the University of Virginia Curry School of Education, who added that the combined information is more likely to lead to an accurate diagnosis. Konold and Joseph J. Glutting of the University of Delaware co-authored the study on ADHD and the variation of informants’ responses.

“Although it is recognized that individuals with ADHD are likely to have lifelong problems, less is known about ADHD at the college level than with children or adults,” the researchers say in their paper.

Unlike younger children, who some say are over-diagnosed with ADHD, college students are under-diagnosed because they’ve managed to compensate and cope until they get into college, a radically new environment that presents a different set of challenges.

College students may find themselves at a disadvantage when trying to adapt to academic life. They might not realize ADHD is the problem, because they weren’t diagnosed with it as children.

Symptoms of ADHD fall into two main categories — inattention and hyperactivity-impulsivity — but evidence suggests that the latter traits may decrease more over time. There is no current consensus, however, regarding what constitutes appropriate criteria for diagnosing adult ADHD.
In the national sample from 38 states of more than 1,000 college freshmen and one parent of each student, the informants were asked to rate a list of behaviors based on criteria from the main reference book for mental health professionals, the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV. Informants rated behaviors as they applied to their daily lives. Behaviors associated with inattention were described as internal, and behaviors that fit hyperactivity-impulsivity patterns were described as external.

Internal behaviors indicating inattention included: not listening well in a focused manner, fidgeting while watching television and being easily distracted.

External behaviors associated with hyperactivity-impulsivity included: interrupting other people’s conversations, talking excessively and having difficulty engaging in leisure activities.

When students and parents rated certain behaviors in each of the two categories of traits — inattention and hyperactivity-impulsivity — the researchers found parents were better at recognizing the internal behaviors, and students were better at identifying the external behaviors.

“The majority of postsecondary students with ADHD are referred because of difficulties in attention, concentration and behavioral regulation. These very same problems also appear to affect their responses to questions about ADHD — especially with respect to inattention. Parents in the current study were much more accurate raters of the inattention construct,” Konold’s paper says.

Konold also will discuss the study’s methodology — a “correlated trait–correlated method” application of factor analysis that disentangled trait and informant variations from measures of ADHD.

The study shows that the informants had a distinct impact on which set of behaviors they were rating, a result that mental health professionals should be aware of when evaluating college students for ADHD.