14.2 FEASIBILITY, ACCEPTABILITY, AND EFFECTIVENESS OF A NEW COGNITIVE-BEHAVIORAL INTERVENTION FOR COLLEGE STUDENTS WITH ADHD

Abstract

This study assessed the feasibility, acceptability, and effectiveness of a group CBT intervention to enhance executive function (EF) in college students with ADHD. The treatment addressed time-awareness, distractibility, procrastination, poor planning, failure to complete academic tasks in a timely and effective manner, and the negative automatic thoughts that engender anxiety/depression and further impair academic functioning. Home exercise facilitated practice of the strategies between sessions. The intervention was delivered in 12 weekly 2-hour sessions at a major university in the Netherlands. Two parallel-group series each enrolled 9 undergraduate or graduate students meeting rigorous DSM-5 criteria for ADHD, who comprised the sample. Outcome measures included a clinician-administered structured interview of ADHD symptoms (Adult Investigator Symptom Rating Scale, AISRS), as well as self-report measures of inattentive symptoms (Conners Adult ADHD Rating Scales, CAARS), executive functions (Barkley Deficits in Executive Function Scale, BDEFS), and learning and study skills (Learning and Study Strategies Inventory, LASSI). Students rated program components on a scale from 0 (“not helpful”) to 3 (“very helpful”). Fifteen students (83%) attended 9 or more sessions. There were no study dropouts. Overall program helpfulness was rated as 2.27. The following strategies received the highest mean ratings: planner use (2.83), breaking down aversive tasks into smaller parts (2.56), and identifying (2.22) and challenging (2.00) negative automatic thoughts. Repeated measures analyses of change from pre- to posttreatment yielded improvement in clinician-rated inattentive symptoms (AISRS) (frequency: 6.78 vs 4.22, p = 0.000; effect size (ES) = 0.646), and self-ratings (CAARS) of inattentive symptoms (t scores = 80.22 vs 70.28, p = 0.000; ES = 0.640). Also significantly improved were scores on the BDEFS subscales of Self-Management to Time, Organization, and Total Executive Function, as well as the LASSI subscale of Concentration. Results support the feasibility, acceptability, and effectiveness of a CBT program in reducing inattentive symptoms and enhancing EFs in college students with ADHD and warrant examination in a randomized controlled trial.