Modified Behavioral Activation to Reduce Depression in College Students with ADHD: A Randomized Control Trial

ADHD affects an estimated 2-8% of college students. Despite their success gaining admission to college, students with ADHD still experience difficulties with college adjustment. An alarming 60% of college students with ADHD report a history of major depression which has drastic implications for their functioning in college.

Despite the negative outcomes associated with ADHD in college students, little work has been focused on interventions to improve mood-related outcomes in this population. As part of our ongoing NIAAA-funded study (AA022133; PI Chronis-Tuscano), we developed the SUCCEEDS (Students Understanding College Choices: Encouraging and Executing Decisions for Success) program. SUCCEEDS integrates ADHD psychoeducation, behavioral activation (BA) with motivational interviewing (MI) to assist college students with ADHD in leading healthy, productive lifestyles.

Seventy-one college students with ADHD were randomized to receive either SUCCEEDS or a comparison condition (psychoeducation+MI+supportive counseling).

Approximately, 51% of our sample reported lifetime major depressive disorder (MDD). At baseline, individuals with lifetime MDD experienced greater overall impairment, had lower grade point averages, and were more likely to have current cannabis use disorder, regardless of stimulant use. Following the intervention, college students receiving SUCCEEDS showed significant reductions in depressive symptoms, controlling for stimulant medication use.

Results indicate that college students with ADHD experience MDD at alarmingly high rates which puts them at risk for poor outcomes in college. SUCCEEDS significantly reduces depressive symptoms which could prove extremely beneficial for mental health providers in University Counseling Centers.