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The illicit or non-medical use of prescription stimulant medications on college campuses in the US has risen considerably in the past decade (McCabe, West, Teter, & Boyd, 2014) and is a relatively new manifestation of problematic drug use among college students. Stimulant misuse, defined as taking stimulants in a manner other than prescribed, has surged on college campuses, with estimated lifetime prevalence rates ranging from 5 - 55% (Advokat, Guidry, & Martino, 2008; Clegg-Kraynok, McBean, & Montgomery-Downs, 2011; Desantis, Noar, & Webb, 2009; Dupont, Coleman, Bucher, & Wilford, 2008; Dussault & Weyandt, 2013; Janusis & Weyandt, 2010; Low & Gendaszek, 2002; Rabiner et al., 2009), although prevalence estimates vary depending on ascertainment methods and time reference. Defined as giving, selling, or trading stimulants to others without a prescription, stimulant diversion prevalence rates on college campuses are also increasing and estimates range from 2 - 29% (Poulin, 2007; Upadhyaya et al., 2005; Verdi, Weyandt, & Zavras, 2014; Wilens et al., 2006). The current paper presents a primary prevention strategy for prescription stimulant misuse and diversion in college students

The present study examined the effect of personality traits and characteristics on quality of life and functioning in adults with ADHD. Participants were adults with (n=206) and without ADHD (n=123) who completed the Temperament and Character Inventory (TCI), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Social Adjustment Scale Self-Report (SAS-SR). Participants also provided information on academic, motor vehicle operation, legal, social, familial and occupational functioning. Outcomes were examined using stepwise linear regression, logistic regression (for binary outcomes) and negative binomial regression (for count outcomes) controlling for ADHD symptoms. Adults with ADHD significantly differed from controls across all TCI personality domains. On average, adults with ADHD endorsed more novelty seeking, harm avoidance, and self-transcendence, and less reward dependence, persistence, self-directedness, and cooperativeness. Personality traits and characteristics significantly predicted functional impairments even after controlling for ADHD symptoms, executive function deficits and current psychiatric comorbidities. In adults with ADHD, personality traits exert unique effects on quality of life and functional impairment across major life domains, beyond the effects expected of and associated with ADHD symptoms and other associated psychiatric conditions and cognitive vulnerabilities. Addressing personality traits in adults with ADHD may lead to improvements in quality of life and reductions in functional impairment.

This review presents a theory-guided approach to critiquing existing psychosocial interventions of cognitive behavioral therapy (CBT) for Attention Deficit / Hyperactivity Disorder (ADHD) in college students. Eight studies met inclusion criteria. Across studies, there were reductions in inattentive symptoms but little to no change in hyperactive / impulsive symptoms. There was some support for a moderate effect on self-reported quality of life and school/work functioning, but little to no support for any effect on GPA, response inhibition, social functioning, or executive functioning. Furthermore, the interpretation of treatment effects was marred by several theoretical, methodological, and statistical problems and inconsistencies. This review underscores the need to reconsider the application of CBT developed for adults with ADHD as a sufficient treatment for college students with ADHD. Presently, the literature offers equivocal support at best for the efficacy of CBT in its current form for college students with ADHD. Several directions for future research are recommended to improve upon the existing CBT clinical research evidence base.

Objective: To examine the effect of personality traits and characteristics on quality of life and functioning, independent of attention deficit / hyperactivity disorder (ADHD) symptoms in adults with ADHD. Method: Participants were adults with (n=206) and without ADHD (n=123) who completed the Temperament and Character Inventory (TCI), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Social Adjustment Scale Self-Report (SAS-SR). Participants also provided information on academic, motor vehicle operation, legal, social, familial, and occupational functioning. Results: Adults with ADHD significantly differed from controls across all TCI personality domains. On average, adults with ADHD endorsed more novelty seeking, harm avoidance, and self-transcendence, and less reward dependence, persistence, self-directedness, and cooperativeness. In adults with ADHD, personality traits and characteristics significantly predicted functional impairment across several domains of life functioning, even when controlling for ADHD symptoms. Furthermore, self-directedness emerged as an especially strong predictor of quality of life and novelty seeking emerged as an important predictor of functional impairment. Conclusions: In adults with ADHD, personality factors exert unique effects on quality of life and functional impairment across major life domains, beyond the effects expected and associated with ADHD symptoms alone. Improving self-directedness in adults with ADHD may lead to improvements in quality of life and reductions in functional impairment.

Introduction: Salivary alpha amylase (sAA) is emerging as a promising proxy for assessing sympathetic-adrenal-medullary (SAM) axis activity. Past studies have shown that sAA is reactive to physical exercise as well as acute psychosocial stress, such as an evaluative interview (i.e., the Trier Social Stress Test). However, it is not known whether a brief semi-structured behavioral assessment, such as the social competence interview (SCI), also elicits sAA changes. We tested the hypothesis that sAA would increase during the course of the SCI and decrease thereafter. We also hypothesized that social environmental stress (e.g.,exposure to violence) would predict the sAA response to the interview. Method: Participants were college students (n=64, 50% female, age = 18.8 ± 1.2 years; BMI = 23.54 ±3.5 kg/m2) recruited through a university research participant pool. Exposure to violence during childhood was assessed via self-report using the City Stress Inventory and saliva samples were collected at four time points (T1: baseline; T2: during the middle of the interview; T3: at the end of the interview; T4: 10 minutes after the interview) to assess for salivary alpha amylase. Results: As expected, we found a significant increase of sAA in response to the interview, from T1 to T3 (time effect: F (58, 1) =12.48 p=0.001) that did not vary by sex (p>.05). However, there was a sex difference with regard to the recovery of sAA (change score calculated by subtracting T4 from T3), with males experiencing a rapid decline in amylase back to baseline levels, and females experiencing a sustained elevation of amylase after the interview. Furthermore,exposure to violence in childhood was positively associated with both peak sAA (T2), r(56) = .337, p=.01, as well as rise in sAA (T3-T1), r(59)=.286, p=.028. Conclusions: These findings provide further evidence for the utility of the social competence interview as a behavioral assessment and tool for eliciting sympathetic arousal. Moreover, the data bolster support for the hypothesis that greater exposure to social environmental stress during childhood may lead to potential negative health consequences, for example, a more highly reactive SAM system.

Introduction: The relationship between socioeconomic status (SES) and health is well documented, but less is known about the relationship between subjective perceptions of status and health. We tested the hypotheses that greater perceived neighborhood disorder (ND) and lower subjective SES would predict higher perceived stress, depressive symptoms, and metabolic syndrome risk, defined as increased central obesity, higher fasting plasma glucose (FPG) levels, and reduced high density liproprotein (HDL). Methods: Participants were 215 adults (72% female, 63% black, 36% white; age = 32 ± 3.4 years; BMI = 30.9 ±7.8 kg/m2) who took part in the Project Heart studies in Baltimore during high school (1987-1997). Subjective SES, perceived ND, perceived stress, and depressive symptoms were assessed by self-report; central obesity was defined as waist circumference; and FPG and HDL were assessed by colorimetric and assay procedures. Results: Subjective SES was inversely related to perceived stress (r=-.32, p<.001), depressive symptoms (r=-.30, p<.01), BMI (r=-.16, p=.03) and waist-hip ratio (r=-.20, p=.01). Neighborhood disorder was positively associated with perceived stress (r=.21, p=.01) and depressive symptoms (r=.17, p=.02), but not BMI or WHR (p>.05). Regression analyses controlling for age, sex, and race, revealed that both ND (b=.16, p=.02) and subjective SES (b=-.21, p<.01) predicted greater waist circumference. Lower subjective SES, but not greater ND, predicted higher FPG (b=-.16, p=.02); however, neither ND nor subjective SES predicted reduced HDL levels (all p >.05). A between-groups ANOVA revealed that participants who met criteria for metabolic syndrome reported significantly lower subjective SES than those who did not (F=10.01, p=.002). Conclusions: These findings bolster support for the hypothesis that greater perceived neighborhood disorder and lower subjective SES predict heightened risk for developing metabolic syndrome.

Objective: Previous research has shown that within a restricted sample of relatively high objective socioeconomic status (SES) college students, striking gender differences emerge with regard to subjective social status (SSS) and inflammatory processes. Female students rate themselves lower than males on community SSS, and show higher circulating interleukin-6 (IL-6). A direct relationship between SSS and baseline IL-6, however, has not been not found; this phenomenon may be explained by the fact that unstimulated IL-6 shows low variability in young adults. The present study investigated whether persons with lower SSS would experience a higher IL-6 response to acute psychosocial stress. Methods: Nineteen healthy young adults (58% female, mean age 22 ± 4.25 years; mean body mass index 23.8 ± 3.5 kg/m2) were exposed to a standard psychosocial stress test (Trier Social Stress Test; TSST) on two consecutive afternoons. Blood samples were taken 1 minute prior to the TSST (baseline), and 30 and 120 minutes after stress on both study days. Plasma IL-6 was analyzed via high sensitivity ELISA, and the acute stress-induced IL-6 response was defined as the difference between baseline IL-6 and peak IL-6 at 2 hours post-stress. Subjective social status was measured via MacArthur social status ladders. Results: Plasma IL-6 increased significantly in response to acute stress (time effect: F= 35.1, p<.001); this did not vary by study day (F = 2.3, p=.11). Lower SSS in the community significantly predicted an increased IL-6 response to stress on the second day of the study b = -.57, p = .035, but not the first (p>.05). Analysis of covariance revealed that the magnitude of the IL-6 response did not differ by gender on either day of the study, and that there was no interaction of gender and SSS on IL-6 responses (all p>.05). Conclusions: Exposure to acute psychosocial stress reveals a significant relationship between low SSS and a health-relevant physiological mechanism—the inflammatory response to stress. However, no gender differences emerged in this analysis, despite the tendency of female students to rate themselves lower on the status ladder. Furthermore, the fact that SSS predicted a significant increase on the second, but not the first day of the study lends support to the hypothesis that responses to repeated stress may differentiate better than responses to an initial exposure. These results provide further evidence that SSS may be a better predictor of health than SES, especially within populations where minute differences in objective SES may be less important than subjective perceptions of differences in community social status.