(PS1-71) A Systematic Review and Meta-analysis of Psychosocial Treatments for College Students with ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in college students cause impairments across several domains such as academic performance, interpersonal functioning, and mental health. College students with ADHD face a unique set of developmental and environmental challenges, making it crucial to assess the efficacy of psychosocial treatments adapted for this population (Fleming & McMahon, 2012). Existing reviews provide descriptive conclusions about the efficacy of these treatments, but a quantitative synthesis is lacking. A systematic review of psychosocial treatments for college students with ADHD was conducted followed by a meta-analysis of cognitive behavioral therapy (CBT) and behavioral therapy (BT) treatments on ADHD symptoms, executive functioning, GPA, anxiety, and depression. Effects were compared pre and post treatment and vs. control groups.

The systematic review and meta-analysis were conducted according to the PRISMA 2020 statement and the Cochrane Handbook guidelines. APA PsycInfo, APA PsycArticles, CINAHL, Psychology & Behavioral Sciences Collection, Academic Search Ultimate, Embase, PubMed, Google Scholar, OpenDissertations and ProQuest databases were searched. Controlled and non-controlled trials of psychosocial interventions for college students with a diagnosis of ADHD were included. Unpublished studies were also included to reduce publication bias. Studies were excluded if they did not meet the definition of a ‘psychosocial’ intervention (e.g. psychopharmacological interventions). Qualitative studies and studies of interventions targeting students with other neurodevelopmental disorders/without an ADHD subgroup were also excluded.

A total of 25 studies met inclusion/exclusion criteria, of which 8 were used to calculate a summary effect for total ADHD symptoms, 8 for ADHD inattentive (IN) symptoms, 6 for ADHD hyperactive/impulsive (HI) symptoms, 4 for executive functioning, 6 for GPA, 5 for anxiety, and 7 for depression. Sensitivity analyses were conducted for each outcome to identify outliers and moderator analyses were performed for treatment type (CBT vs. BT). A random effects meta-analysis indicated CBT and BT interventions had medium effects from pre to post treatment for some outcomes (total ADHD, g = -.60; 95% CI [-0.74, -0.46], ADHD-IN, g = -.77; 95% CI [-0.94, -0.60], executive functioning, g = -.50; 95% CI [-0.70, -0.30]), and small effects for others (ADHD-HI, g = -.22; 95% CI [-0.31, -0.12], depression, g = -.24, CI [-0.33, -0.14]). There was no significant change from pre to post for anxiety (g = -.18, CI [-0.42, 0.09]). Intervention groups had significantly larger improvements compared to controls for total ADHD (p = .002), ADHD-IN (p < .001), and executive functioning (p < .001), but not for ADHD-HI (p = .270), GPA (p = .510), and depression (p = .425). There were no significant differences between CBT and BT for any outcomes except ADHD-IN, where CBT was associated with a significantly larger improvement than BT (p = .009). Heterogeneity and publication bias results will be presented and interpreted in light of these findings. Limitations, implications for clinical practice, and directions for future research will be discussed.