IES study

We used a broad array of measures to evaluate treatment-induced changes, not only across multiple domains of functioning but also with respect to our hypothesized mechanisms of clinical change.

Findings from our randomized controlled trial provide strong evidence in support of the efficacy and feasibility of ACCESS as an intervention for young adults with ADHD attending college.

Primary Symptoms and Associated Features

Anastopoulos, A.D., Langberg, J.M., Eddy, L.D., Silvia, P.J., & Labban, J.D. (2021).  A randomized controlled trial examining CBT for college students with ADHD.  Journal of Consulting and Clinical Psychology, 89 (1), 21–33.  https://doi.org/10.1037/ccp0000553

• Latent growth curve modeling (LGCM) revealed significantly greater improvements among immediate ACCESS participants in terms of ADHD symptoms, executive functioning, clinical change mechanisms, use of disability accommodations, representing medium to large effects (Cohen’s d, .39 – 1.21).
• Across these same outcomes, clinical significance analyses using reliable change indices (RCI; Jacobson & Truax, 1992) revealed significantly higher percentages of ACCESS participants showing improvement.
• Although treatment-induced improvements in depression and anxiety were not evident from LGCM, RCI analyses indicated that immediate ACCESS participants were less likely to report a worsening in depression/anxiety symptoms.

Functional Impairment

Eddy, L.D., Anastopoulos, A.D., Dvorsky, M.R., Silvia, P.J., Labban, J.D., & Langberg, J.M. (2021). An RCT of a CBT intervention for emerging adults with ADHD attending college: Functional outcomes. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2020.1867989

• Multi-group latent growth curve models revealed moderate effect size improvements on self-report measures of study skills and strategies, as well as on self-report measures of time management, daily functioning, and overall well-being for participants in ACCESS.
• Importantly, treatment effects were maintained or increased in some cases from the end of the first semester to the end of the second semester.
• Improvements in self-reported interpersonal functioning, however, were not significantly different across groups.
• Neither group demonstrated significant changes over time in educational record outcomes, as measured by grade point average and number of semester credits earned.

Clinical Change Mechanisms

Langberg, J. M., Dvorsky, M. R., Silvia, P., Labban, J., & Anastopoulos, A. D. (2023). Clinical Change Mechanisms in the Treatment of College Students With ADHD: Trajectories and Associations With Outcomes. Behavior Therapy, 54(3), 444-460.  https://doi.org/10.1016/j.beth.2022.11.003

• Large gains were evident in two of the three theorized clinical mechanisms of change – behavioral strategies and ADHD knowledge.
• Growth mixture models revealed significant gains in the use of behavioral strategies, the trajectories of which were associated with large effect size improvements in measures of symptoms and functioning.
• Participants also displayed improvements in ADHD knowledge, but only those participants whose ADHD knowledge trajectories were characterized by rapid improvement displayed significantly better functional outcomes.
• Although improvements in the third mechanism, adaptive thinking, were small, they were strongly associated with both symptom and functional outcomes.
• Together, obtained findings (1) lend support to the conceptual underpinnings of ACCESS, and (2) demonstrate the importance of incorporating cognitive-behavioral principles and strategies in programs addressing the needs of college students with ADHD.