IES study

Overview

Under the direction of Dr. Arthur D. Anastopoulos (Principal Investigator, UNC Greensboro) and Dr. Joshua M. Langberg (Co-Principal Investigator, Virginia Commonwealth University), our research team recently completed a comprehensive examination of the benefits of ACCESS in the context of a four-year, randomized controlled trial (Goal 3) study, funded by the Institute of Education Sciences (IES) in the U.S. Department of Education. Findings from this trial revealed statistically and clinically significant improvements across multiple domains of functioning, thereby lending strong support to the efficacy of ACCESS as a treatment for college students with ADHD.    

Design

Over a period of five consecutive semesters, we recruited a total of 351 college students who volunteered for the project. All potential participants underwent rigorous eligibility screening. Data collected from these screening evaluations was carefully reviewed by a panel of ADHD experts who determined whether DSM-5 criteria were met not only for ADHD, but also for other mental health conditions. 250 college students with well-defined ADHD were then randomly assigned to receive ACCESS either immediately or on a one-year delayed basis.  Outcome data assessing multiple domains of functioning were collected at five time points: prior to the active phase, during the active phase (immediate ACCESS group only), following the active phase, at the end of the maintenance phase, and six months after the maintenance phase was completed (immediate ACCESS group only).

Assessment of Outcome

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.

ADHD Symptoms &
Executive Functioning
  • Conners Adult ADHD Rating Scale (CAARS-S:L)
  • Behavior Rating Inventory of Executive Functioning – Adult (BRIEF-A)
Depression &
Anxiety
  • Beck Depression Inventory-II (BDI-II)
  • Beck Anxiety Inventory (BAI)
Well-Being &
Quality of Life
  • ADHD Impact Module – Adult (AIM-A)
Academic
Functioning
  • Learning & Studies Strategies Inventory – Second Edition (LASSI-2nd)
  • Educational record data

Findings

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

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.

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.

Principal Investigators

Arthur D. Anastopoulos, Ph.D.

Principal Investigator
UNC Greensboro

Joshua M. Langberg, Ph.D.

Co-Principal Investigator
Virginia Commonwealth University

Collaborators

Laura D. Eddy, Ph.D.

Laura H. Besecker, Ph.D.

Paul J. Silvia, Ph.D.

Jeffrey D. Labban, Ph.D.

Melissa R. Dvorsky, Ph.D.

Former Staff – UNC Greensboro

Kristen A. King, Ph.D.

Erin Spence, L.P.C.

Kaicee Beal Postler, Ph.D.

Rachel Reid, M.S.

Sophie E. Burke, M.S.

Elizabeth Carter, M.S.

Jessica Goodman, M.S.

Loren M. Ranson, M.S.

Michele Stewart

Lydia Jodrey

Former Staff – VCU

Lauren Oddo, B.A.

Liza Bourchtein, M.S.

Stephen Molitor, Ph.D.

Zoe Smith, M.S.

Hana-May Eadeh, B.A.

ADHD Clinic at UNCG
1100 W. Market St., 3rd Floor
Greensboro, NC 27402
336-346-3192
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IES Disclaimer - ACCESS is a collaborative project among faculty at UNC Greensboro and Virginia Commonwealth University. This research was supported by a grant from the U.S. Department of Education, Institute of Education Sciences (R305A150207). The opinions expressed by the authors are not necessarily reflective of the position of or endorsed by the U.S. Department of Education.