Attention-deficit/hyperactivity disorder–specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.

KEYWORDS:

• ADHD-specific stimulants
• college students
• eating disorder risk
• eating disorders
• substance use

Conflict of interest disclosure

Dr Wilfley is a consultant for Shire Pharmaceuticals on binge eating disorder. All other authors declare no financial relationships or conflicts of interest with any organizations that may have an interest in the submitted work. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States and received approval from the Institutional Review Boards of Stanford University and Washington University in St. Louis.

Funding

Support for this research was received by the National Institutes of Health (R01MH081125, K24 MH070446, T32 HL007456) and the Agency for Healthcare Research and Quality (T32 HS000078).

Notes

* Differences in measures of eating disorder and comorbid pathology between participants at low risk for an eating disorder, high risk for an eating disorder, and with a clinical or subclinical eating disorder have been published previously.²⁹